Unscrupulous authors have polluted medical literature abusing peer review system-Irene Hames

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From the Peer Review Congress in Chicago

Unscrupulous authors have polluted medical
literature abusing peer review system-Irene Hames

Half or more of replication studies are done by authors
of original research- John Ioannidis

Citation Impact Factors are “rotten” and “stupid”- Tobias Opthof

From our correspondent

CHICAGO (USA): The 7th International Congress on Peer Review and Biomedical Publications attracted over five hundred medical journal editors, publishers and researchers from all over the world. Scientific programme of the conference was divided into different sessions devoted to Authorship, Citations, Peer Review, Ethical issues and misconduct, Publication bias, Trial Registration, Data content sharing, availability and access, Quality of Trials, Reporting Guidelines for Trials, Post Publication Access, Dissemination and Exchange. Salient features of the conference included plenary lectures by eminent editors from JAMA and BMJ and some other European medical journals. A Business meeting of World Association of Medical Editors (WAME) was also held on September 9th. Apart from oral presentations, a number of poster presentations were also on display during the congress.

Prof. Maj. Gen. M. Aslam Vice Chancellor UHS Lahore and Dr. Akhtar Sherin
President PAME at the Peer Review Congress recently held at Chicago, USA.

Prof. Major Gen. Mohammad Aslam, Vice Chancellor University of Health Sciences from Lahore who is former President of Pakistan Association of Medical Editors (PAME) and Dr. Akhtar Sherin from Kohat University of Science and Technology the current President of PAME participated from Pakistan. Major Gen. M. Aslam also had a poster presentation on “Attitude towards Publication in Electronic Journals: A Glimpse into the Mind of the decision makers in Universities”. They also availed this opportunity to meet delegates from India and decided to form the South Asian Association of Medical Editors (SAAME) to promote the discipline of medical journalism in South Asia. The concept was approved and contacts will be established with representatives from all the South Asian countries to give it a practical shape.
The Peer Review congress started with a plenary lecture by John Ioannidis who spoke on “Replication and Reproducible Research: Utopia or a Reality”. The well known epidemiologist is known for being a provocateur author of “Why most published research findings are false”. In his presentation he pointed towards a very low rate of successful replication of genome-wide association studies as an example of deep-seated problems in discovery science. He was of the view that almost half of replication studies are done by the authors of the original research. He went on to say that it is the same authors trying to promote their own work. Now industry is becoming more concerned with replicability of research than most scientists are. Some firms now hire CROs to validate scientific research before committing serious funds to a project, he remarked. Speaking about why there is so much un-reproducible research, Ioannidis said that there are many sources of bias in research. Trawling through more than 17 million articles in PubMed revealed that discussion of 235 different kinds of bias. There is so much bias that it can be termed an encyclopedia of bias.
His conclusions were that we need to go back and consider what science is all about? If it is not just about having an interesting life or publishing papers, it is about getting closer to the truth, and then validation practices have to be at the core of what we do. We have to get used to small genuine effects and not expect excessive claims. We also need to have and use research reporting standards besides chalking out a strategy of registering research: protocols through to datasets.
Medical Journal Editors are faced with many ethical issues and sometimes to overcome the shortage of good reviewers, they request the authors to suggest some reviewers. But be careful. A presentation by Irene Hames from Committee on Publication Ethics (COPE) revealed that unscrupulous authors have abused the peer review system, leaving it contaminated with manuscripts that fall well short of normally high standards for scientific publications. These authors have polluted the medical literature. Speaking at the end of the first day of peer review congress, Hames offered a succession of well-research studies documenting the violation of publishing taboos. One of the studies examined fraudulent authorship; another study looked at duplication in publication while another looked at retractions besides two studies concerning plagiarism. Hames referred to a 2012 episode involving fake reviewers. In this case the authors suggested names of well-known colleagues as reviewers and supplied fictitious e mail addresses. These e mail addresses could be monitored by the authors of papers themselves. Fallout from this episode has spread across countries, across journals; across disciplines with the result that one author had twenty eight papers retracted.
COPE, Hames said has no enforcement powers with which to punish such polluters. However, in an effort to detoxify the literature, she unveiled a new and improved database of five hundred publication ethics cases which can be used to provide much-needed training to newly hired medical editors.
Elizabeth Wager made a startling presentation on “ Too much of a Good Thing? A study of prolific authors”. A veteran peer reviewer from UK gave details of an investigative project with her colleagues. She pointed out that in the publish-or-perish world of academics and industrial research; it is easy to get caught up in the mindset that more publications credit is better than fewer. But it is not always true. She looked at seemingly superhuman feats of certain authors she presented a study which identified twenty four authors whose names were listed on atleast one publication every two weeks for an entire year. These types of numbers, Wager feels, should send clear signals to university administrators as well as editors of medical journals that something was wrong. In their study, Elizabeth, Sanjay Singhvi and Sabine Kleinert included publications in Medline from 2008-2012 covering four therapeutic areas. They used special software to analyze characteristics beyond first and the last name, such as affiliation, past publication history and co-authorship. The maximum number of publications per year per author was forty three which might be possible if majority of the writings were letters to the editors or abstracts. However, according to them one person claimed to have authored fifteen clinical trials in one year- which they termed as unfeasibly prolific.
Conclusions from their study were that when measuring productivity, medical institutions and funders should be alert not only to unproductive researchers but also to unfeasible prolific ones. Authorship of such a large number of publications may indicate guest authorship, plagiarism or fabrication. Misconduct in South Asian Journals: Results of an Online Survey of Editors was presented by Sandhya Srinivasan, Sanjay Pai, Rakesh Aggarwal and Peushi Sahni from India.
Ana Marusic and her colleagues presented findings of their survey on deciding authorship conducted among Clinical Investigators, Journal Editors, Publication Planners and Medical Writers. Their conclusions were that groups which participate in publishing process had different opinions on adjudication of challenging real world authorship scenarios. They suggested a framework to improve transparency when recognizing contributors to all clinical trial publications.
Fiona Godlee Editor-in-Chief of BMJ wondered whether we can trust the results of clinical trials published in even high impact factor journals. Clinicians, she opined, are asking “Why are these studies appearing in these high impact journals”. In an interview published by Peer Review Conference Report she referred to the so called “Marketing Trials” or “Seeding Trials”, trials which appear to be undertaken more with the intent of boosting drug sales than producing useful clinical of scientific knowledge.
Sara Sschroter also from BMJ gave details of efforts of a small group of elite editors to develop a consensus on the hallmarks of a marketing trial. This should include strong manufacturer support, many medical centers in a large number of countries, a small number of patients enrolled at each center, a sophisticated statistical analysis paid for by the manufacturer and drugs for common or prevalent diseases. Our findings, she said, suggest that a fifth of all drug trials published in the highest impact general medical journals in 2011 were designed primarily for marketing purposes. She highlighted the characteristics for editors, reviewers and readers to be aware of when assessing such published trials.
Some of the participants taking part in the discussion were very critical of the investigators research approach. They opined that the arguments by the investigators were circular, lacked logic and indefensible absent some evidence of intent. The investigators have themselves admitted their efforts to describe marketing trials using statistical methods had failed completely and they were all in positions of conflict of interest as employees of the journals whose publications they were investigating. At the same time some participants commended the investigators and urged them to continue their work. Some others suggested that the responsibility for detecting and preventing unethical or improper trials rests with institutional review boards not journal editors. Howad Bauchner Editor-in-Chief of JAMA participating in the discussion said that he “struggles” with whether to publish these trials.
Incidentally a day before Kay Dickersin from the Johns Hopkins Bloomberg School of Public Health addressing the congress had emphasized on enhancing the quality and transparency of health research. He had exhorted the congress participants to trust and respect each other more, as members of the same biomedical publishing ecosystem.
Isuru Ranasinghe and their team from Yale looked at un-cited and poorly cited research in cardiovascular research. They stated that while the proportion is not changing over time the overall quantity was rising rather dramatically as the biomedical literature grows. One in four journals have more than 90% of their content going un-cited or poorly cited five years down the track. Almost half of all articles do not have an influence if one judges it by citation, they added. Earlier there was heated debate on citation as a measure and influence on research. The presentation also referred to Citation Impact Factors as “rotten” and “Stupid”. Research, it was stated has to be about doing research, not just publishing a lot of manuscripts. Someone who publishes too many papers, it was stated, could be of even more concern than someone who does research but publishes little. Incentives and expectations of authorship really no longer serve us well – if they ever did Elizabeth Wager remarked.
Sally Hopewell from Oxford University told the congress that about a third of the analyzed reports changed their conclusions in response to reviewer’s comments mostly to tone down spin because they had “gotten a bit overexcited”. They reviewed 93 primary reports of randomized trials in the BMC Medical Series. One in five of the final papers included additional analyses requested by peer reviewers and about a quarter added information about trial registration. Others clarified how subjects were randomized and allocated and which outcome was primary and secondary. About one in five reviews mentioned the CONSORT statement evidence based minimum set of recommendations for reporting randomized controlled trials. They found that peer review did lead to noticeable improvements in reporting.
Joseph Wislar and colleagues in their presentation stated that manuscripts with more authors had higher citations as compared to articles with few authors and this does not appear to be affected by the type of the article. Sushrut Jangi and colleagues in their presentation stated that highly viewed papers within the first year of publication of original research do not predict citations over the following two years. On the contrary papers which are highly cited become increasingly viewed over time.
Yet another interesting presentation during the congress was by Deborah Levine and colleagues on Editorial Triage and its Potential Impact. Their findings were that editorial peer review triage identified 38% new information representing the most common reason for such scoring. In their journal, they said, editorial triage represents an efficient method of diminishing reviewer burden without a substantial loss of quality of papers. In yet another startling presentation Marrio Malicki and colleagues pointed out that more than half the duplicate publications identified in PubMed have not been corrected by the Journals. They were of the view that all stake holders in research publishing should take seriously the integrity of published record and take a proactive role in alerting the publishing community to redundant publications.Presentation by Paula and colleagues on Stability of Internet References in General Medical Journals showed that the use of Internet references in medical journals has increased while stability of internet references has decreased substantially overtime. This decline was most pronounced in Methods section where retention of exact information on study methodology as cited originally could be most crucial to allow subsequent confirmation.
Earlier Drummond Rennie from JAMA welcomed the congress participants on the first day. This congress, it may be recalled, was started by JAMA in 1989 and since then it goes on and its theme remains “Peer Review and Biomedical Publication”. Seventh Peer Review congress had many provocative speakers and the programme was fascinating for everyone concerned with what is happening in medical science and science behind editing. The decision where the 8th congress on Peer Review will be held will be taken later.

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