When The Lancet and The New England Journal of Medicine pulled an influential pair of Covid-19 papers last Thursday, it was a rare event in scientific publishing. For medical researchers, this was like seeing The Washington Post and The New York Times take down related news stories at the same time—a confluence of editorial failures that raises dire questions about what went wrong and why. But how surprising is this scandal, really? Could these be among “the biggest retractions in modern history,” as one observer described the news about the paper in The Lancet? That depends entirely on how you read history. Science meltdowns of this type—and the “biggest” retractions that ensue—occur with shocking regularity. Again and again, over decades, scientists and the public have had their confidence in the enterprise shaken by these sorts of disturbing revelations; and then, again and again, over decades, everyone has been surprised. Cue Casablanca.
The latest scandal is, indeed, a bad one. At the moment, we don’t know the full story of what went wrong, beyond that the papers’ authors and the journals’ editors decided that they could no longer trust the underlying data. Both studies purportedly drew from the medical records of 96,000 patients with Covid-19, seen at hundreds of different hospitals around the world. The NEJM article reported that those with cardiovascular disease were at increased risk for death from Covid-19, and that the use of certain heart medications did not appear to compound that risk. The Lancet paper reported that the drugs hydroxychloroquine and chloroquine did not help the 15,000 patients who took them; in fact, these medications seemed to cause significant harm.
The giant data set was never made available for inspection by other scientists, which would be critical for demonstrating that results are reproducible. More astounding, the private and secretive company that owned the data, called Surgisphere, denied full access to the papers’ authors too. That’s bad faith, and it violates best practices for respectable science.
Again and again, over decades, scientists and the public have had their confidence in the enterprise shaken by these sorts of disturbing revelations; and then, again and again, over decades, everyone has been surprised. Cue Casablanca.
The NEJM article didn’t make much of an impact, but the Lancet paper was a different matter. Upon publication, the World Health Organization paused an ongoing trial testing the malaria drugs for Covid-19. The trial only started up again when the journal expressed doubts about the validity of the results last week. (Whiplash notwithstanding, the bulk of the available evidence suggests that hydroxychloroquine is useless against the disease.)
Still, many other retractions have held at least as much significance for the public health and for the scientific fields in which they occurred. Remember Andrew Wakefield, the disgraced doctor whose bogus study linking vaccines to autism bred mistrust of lifesaving immunizations against measles, and cyclical outbreaks of the disease? Or Yoshitaka Fujii, a Japanese anesthesiologist whose misconduct led to the retraction of more than 180 papers in the last decade—a record so far for a single author?
How about Anil Potti, a former superstar at Duke University who fabricated data in his research on cancer therapies, which 60 Minutes called “one of the biggest medical research frauds ever” in 2012? Or John Darsee, a Harvard cardiologist caught falsifying data in a case from the early 1980s that, per the Times, raised “fundamental questions about the self-policing system of science”? You get the picture.
Some leaders in the areas of research affected by these episodes have taken stock and implemented reforms: new policies on data sharing, preregistration of studies, even hiring statisticians and image sleuths to look for suspicious findings in manuscripts. But in treating every new scandal as an aberration, scientists and policymakers allow themselves to sidestep a central issue they have failed to address for many years. Namely: Problematic research is not nearly as rare as the powers that be in science would like us to think, and efforts to self-police haven’t been particularly effective.
Assigning blame in the newest unraveling isn’t hard. The papers’ authors, led by Harvard researcher Mandeep Mehra, shouldn’t have put their names on a paper lacking transparent data. The journals’ editors are on the hook, too, for accepting articles with the same limitations on sharing. And coauthor Sapan Desai, the CEO of Surgisphere—who has written papers in the past on fraud and “moral turpitude” in medical publishing—well, we don’t quite know what he did or didn’t do.