Fraud in scientific research - birth of the Concordat to uphold research integrity in the United Kingdom

COVID-19 research: pandemic versus "paperdemic", integrity, values and risks of the "speed science"

Scientific integrity is a learned skill. When researchers and students learn integrity in laboratories or in the classroom, they are empowered to use similar principles in other aspects of their lives. This commentary reviews the concepts related to scientific integrity at a time when science faces important challenges related to the increase number of articles produced regarding research on coronavirus disease 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has ignited another parallel viral pandemic, with science ranging from robust studies to dishonest studies being conducted, posted, and shared at an unprecedented rate. A balance is needed between the benefits of the rapid access to new scientific data and the threat of causing panic or erroneous clinical decisions based on mistakes or misconduct. The truth is that the "scientific research has changed the world" but now, and more than ever, "it needs to change itself". A pandemic with a "paperdemic" will be even more complicated to manage if it progresses in an uncontrolled manner and is not properly scrutinized.

Modern Plastic Surgical Practice: Technical Competence Alone Is Not Enough

Annually, an estimated 234 million major surgical operations occur worldwide, with concomitant seven million complications and one million deaths. It is now well established that technical competence is necessary, but not sufficient for modern surgical practice and outcomes. Breakdown in non-technical skills has been attributed as a key root cause for near misses and patient harm in the operating room. This article discusses the multi-faceted skills-set that is necessary for the modern surgeon to succeed and for optimal patient outcomes. This includes technical skills, non-technical skills, with a focus on key CanMEDS framework domains, including leadership, communication, evidence-based surgery and mentorship.

Effect of a national focused course on academic medicine for UK candidates applying for a Clinical Academic Programme

Background Academic medicine is crucial for healthcare advancement. However, recruitment of junior doctors into academia remains an area of concern globally. In the UK, a national integrated clinical academic pathway was developed to address these issues, with the Academic Foundation Programme as the 'first opportunity for research'. We aimed to evaluate whether a focused course on academic medicine could enhance knowledge, confidence and preparedness of candidates wishing to apply for an academic programme. Methods UK medical students attended a national course conducted by current UK Academic Foundation Programme doctors that comprised lectures on academic medicine and various aspects of the Academic Foundation Programme. An online questionnaire-based cross-sectional study was conducted with participants rating measures including knowledge, preparedness and confidence related to Academic Foundation Programme applications. Outcomes were measured using Likert scales (1=low; 5=high). Results In total, 103 out of 155 attendees from 11 different UK medical schools responded to the survey (66% response rate). Pre and post-course data showed increase in participants' knowledge (median score 2 vs 4, p < 0.0001), understanding of the application process (median score 2 vs 4, p < 0.0001), confidence (median score 2 vs 4, p < 0.0001) and preparedness (median score 2 vs 4, p < 0.0001) in applying for the Academic Foundation Programme. Conclusion To our knowledge this is the first study in the available literature that demonstrates a focused course on academic medicine may enhance UK medical students' knowledge, confidence and preparedness in applying for a clinical academic programme. Further research will ascertain whether such courses can augment trainee numbers undertaking and remaining within academic medicine.

The visibility of scientific misconduct: A review of the literature on retracted journal articles

Retractions of scientific articles are becoming the most relevant institution for making sense of scientific misconduct. An increasing number of retracted articles, mainly attributed to misconduct, is currently providing a new empirical basis for research about scientific misconduct. This article reviews the relevant research literature from an interdisciplinary context. Furthermore, the results from these studies are contextualized sociologically by asking how scientific misconduct is made visible through retractions. This study treats retractions as an emerging institution that renders scientific misconduct visible, thus, following up on the sociology of deviance and its focus on visibility. The article shows that retractions, by highlighting individual cases of misconduct and general policies for preventing misconduct while obscuring the actors and processes through which retractions are effected, produce highly fragmented patterns of visibility. These patterns resemble the bifurcation in current justice systems.

Research misconduct: time for a re-think?

The incidence of research misconduct appears to be increasing, drawing attention in the general media and academic literature. Concerns have been expressed about probable under-reporting, harms arising, lack of an agreed international definition, welfare of whistleblowers and the adequacy of the investigation processes and any subsequent sanctions. A fully satisfactory approach to prevention, detection, investigation and adjudication has yet to emerge. While the definition of research misconduct contained in the Australian Code for the Responsible Conduct of Research is comprehensive, universities and other research institutions at times struggle in their task of investigating and adjudicating allegations of research misconduct. A more centralised, independent process of oversight and monitoring of this role played by the universities and institutions would help support those institutions and help maintain community confidence in the research endeavour.

Fraud in a population-based study of headache: prevention, detection and correction

Background

In medicine, research misconduct is historically associated with laboratory or pharmaceutical research, but the vulnerability of epidemiological surveys should be recognized. As these surveys underpin health policy and allocation of limited resources, misreporting can have far-reaching implications. We report how fraud in a nationwide headache survey occurred and how it was discovered and rectified before it could cause harm.

Methods

The context was a door-to-door survey to estimate the prevalence and burden of headache disorders in Pakistan. Data were collected from all four provinces of Pakistan by non-medical interviewers and collated centrally. Measures to ensure data integrity were preventative, detective and corrective. We carefully selected and trained the interviewers, set rules of conduct and gave specific warnings regarding the consequences of falsification. We employed two-fold fraud detection methods: comparative data analysis, and face-to-face re-contact with randomly selected participants. When fabrication was detected, data shown to be unreliable were replaced by repeating the survey in new samples according to the original protocol.

Results

Comparative analysis of datasets from the regions revealed unfeasible prevalences and gender ratios in one (Multan). Data fabrication was suspected. During a surprise-visit to Multan, of a random sample of addresses selected for verification, all but one had been falsely reported. The data (from 840 cases) were discarded, and the survey repeated with new interviewers. The new sample of 800 cases was demographically and diagnostically consistent with other regions.

Conclusion

Fraud in community-based surveys is seldom reported, but no less likely to occur than in other fields of medical research. Measures should be put in place to prevent, detect and, where necessary, correct it. In this instance, had the data from Multan been pooled with those from other regions before analysis, a damaging fraud might have escaped notice.