Fraud in science seriously harms health (and science itself)

In 1998, British physician Andrew Wakefield and twelve other co-authors published a case series in the journal The Lancet suggesting that there was an association between the MMR vaccine, which protects against measles, rubella and mumps, and the development of autism in children. Despite the fact that the epidemiological design used was of low quality and did not allow a causal relationship between the vaccine and autism to be established, that article began to receive great media coverage.

The population considered the media as a reliable source of information and ignored the voices that emerged from the scientific community that questioned the veracity of the data used. The concern generated caused many parents to decide not to vaccinate their children with the MMR vaccine for fear that they would develop autism.

This translated into a decrease in measles, mumps and rubella vaccination coverage worldwide. The consequences are still being observed today, with outbreaks involving adults not vaccinated in childhood, the so-called “Wakefield cohort”.

12 years after its publication, the article was retracted in 2010. It was acknowledged that the data used had been fabricated, as well as that there were conflicts of interest. But it was too late: the damage had already been done. The findings of the Wakefield study had helped strengthen the discourse of so-called anti-vaccine groups around the world. What’s more, a third of Americans still believe that vaccines can cause autism.

Possibly, this has been one of the most important and well-known fraud cases in the history of medicine.

Fraud in science: why does it exist?

Research is necessary to advance scientific knowledge. However, science is not free from human malice, known in the scientific community as science misconduct or fraud.

Scientific misconduct encompasses fabrication, falsification, and plagiarism of data or images. But also the non-declaration of conflicts of interest or the interference of private companies for profit in the results of the investigation, among others.

What encourages these unethical behaviors in scientific research? On the one hand are economic and personal interests. And on the other, closely related to the above, the pressure to publish.

In the Anglo-Saxon world this is called publish or perish and arises as a result of the current system of evaluating researchers, based on the number of publications and citations received. The more publications an investigator accumulates, the more prestige they will have and the faster they will progress in her career. This results in researchers feeling pressured to produce more and more publications, often leading to low-quality studies and less frequently, to the proliferation of unethical behavior.

Today, scientific misconduct is the most frequent cause of retraction, surpassing unintentional errors. This is a problem, since fraudulent scientific publications undermine the public’s trust in science.

The Surgisphere case and covid-19

Wakefield’s has not been the first nor the last case of fraud in science. Another very recent one took place during the covid-19 pandemic and is known as the Surgisphere case.

The objective of the study was to verify if hydroxychloroquine was an effective and safe treatment for covid-19. To do this, data from thousands of patients provided by an American company, Surgisphere Corporation, were used. The results suggested that this active ingredient increased the risk of in-hospital death. As a result, the World Health Organization paralyzed the branch of the Solidarity clinical trial that was being carried out to study this drug and doctors stopped prescribing hydroxychloroquine to covid-19 patients.

Quickly, many researchers and healthcare professionals expressed skepticism about the completeness and validity of the data. And this led the magazine to start an investigation. Surgisphere Corporation refused to share the data, which caused the article to be retracted as it could not verify its veracity. Subsequently, it was found that the administration of hydroxychloroquine did not have any beneficial effect in covid-19 patients, but neither did it produce any serious adverse effects. But what if it had been effective and it had stopped prescribing due to a case of fraud? How much damage could that have done globally?

Due to the advance of globalization and the increase in competition between researchers, it is reasonable to think that, if effective measures are not taken, research fraud will continue to represent a significant and growing problem in the coming years.

Do we need an office of scientific integrity?

While it is true that notorious cases of fraud in science are few, it has been shown that just one of them can pose a threat to public health on a global level, as happened with Wakefield and could have happened with Surgisphere. Most likely, these cases are just the tip of the iceberg, and that there are more cases that we are still unaware of.

That is why some countries have scientific integrity offices, although this is not the case in Spain. It is likely that the mere existence of an office of these characteristics has a deterrent effect against potential unethical conduct, including new types of fraud such as the case of papermills. In the same way that public funds from competitive research projects can be audited, shouldn’t the same happen with scientific research production?

It is also important to reconsider the systems of professional promotion of researchers to minimize the perverse incentives that may tempt some to resort to scientific misconduct. The Hong Kong principles, proposed by some researchers, are a good option to face fraud in science.

Article written with the advice of the Spanish Society of Epidemiology.

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