How Common is Dishonesty in Medical Research?

Richard Smith, former editor of the BMJ, writes about Peter Wilmshurst, a British cardiologist, an unusually brave and honest man:

He was the coprincipal investigator on a trial funded by NMT, an American company, to see whether closing a hole in the heart of patients with migraine would cure their migraine. It didn’t. He refused to agree to be an author on a paper published in the journal Circulation because the paper was misleading, and he gave an interview to a journalist in the US pointing out the problems in the study. NMT sued him for libel, not in the US, where proving libel is difficult, but in England, where the onus is on the defendant to prove his innocence.  NMT probably assumed (rightly in the case of most people) that the financial risk would cause Wilmshurst to cave in. They were wrong, and the case collapsed when NMT went bust.

The interesting thing about the stories Smith tells about Wilmshurst is the high rate of misconduct they imply:

[In 1996] we invited him to come to the BMJ and give a talk—behind closed doors—to our staff and advisers and colleagues from the Lancet. He reeled off case after case of misconduct, many of them involving prominent people. The audience listed intently, but I was unsure of the reaction. Might somebody leap up and say “How dare you accuse x of misconduct. He is one of the great men of British medicine”? In fact in my memory the reaction was the opposite. People said things like “Actually, it’s worse than you know…” . . .

Many of [Wilmshurst's stories] involve doctors who are guilty of misdemeanours but who sit in judgement on others. He told the story of Peter Richards who decided to bury the fact that Clive Handler, a doctor, at Northwick Park Hospital, was found guilty of using NHS research funds to subsidise his private practice at a time when Richards was medical director of the hospital and chair of the professional conduct committee of the GMC. Previously he had been dean of St Mary’s Medical School, prorector for medical education at Imperial College, and chair of the Council of Deans of UK Medical School and Faculties. When Handler eventually appeared before the GMC, the GMC’s lawyers ask that Richards stand down from chairing the committee. As Wilmshurst said, it’s as if a judge at the Old Bailey were to say “I’ll have to excuse myself from hearing this case as I helped the accused bury the body.” After having to stand down from this committee Richards continued to chair other conduct committees. Wilmshurst told several stories of doctors who had been found guilty of research misconduct but [had] gone on to be deans and others in charge of researchers.

Smith does not point out what this means. Doctor X is found guilty of research misconduct. Everyone knows this. Doctor X is still appointed dean or whatever. Maybe the people who make these appointments don’t care. Or maybe research misconduct is so common it cannot be a disqualification.

At the end of the article Smith points out his long friendship with Wilmshurst:

RS has known Wilmshurst for 16 years . . . the BMJ was sued for libel over an article by Wilmshurst that was published when RS was editor of the journal. The article has not been retracted but is not available on the BMJ website.

Presumably Smith was forced by BMJ lawyers to be this vague. I have not been able to locate the article. From  a talk by Wilmshurst. “Eventually Rubin got his report published in [The New England Journal of Medicine, under the editorship of Dr. Arnold Relman], because he threatened that unless his report was published he would go to the press and point out the collusion between the journal and Sterling-Winthrop.”

Wilmshurst’s conclusion: “Dishonesty is common in medical research.”

Thanks to dearime.

10 Responses to “How Common is Dishonesty in Medical Research?”

  1. Jim Purdy Says:

    Is anybody surprised?

    Seth: I was surprised that people were promoted to dean and similar posts after being found guilty of research misconduct. I was also surprised that Smith did not give a reference to the Wilmshurst paper in the BMJ mentioned at the end.

  2. L Says:

    I’m not surprised. Dr Linder emailed me back! He’s the guy Seth wrote about a few days ago. He emailed me right away

  3. Nancy Lebovitz Says:

    More about the poor quality of published science

    Publication bias, resistance to replication efforts, fraud. Also, descriptions of efforts to solve the problems.

  4. Tom Says:

    If Taubes’ and Attia’s NuSI can get some honest research done, it’ll be revolutionary for that fact alone.

  5. Nathan Says:

    I think a relevant question to consider is “how common is dishonesty in every field/endeavor?”

    I think that you provide good evidence about dishonesty in medicine, but do you think it is more common than in other places? Or perhaps you just think it’s more damaging to lie when it affects physical health directly.

    Seth: I think you can do a lot more damage inside the body (drugs, surgery, medical devices) than outside the body (most goods and services). So dishonesty — e.g., hiding bad side effects — is much more damaging.

  6. Txomin Says:

    I also am far from surprised. Dishonesty is ubiquitous in the academic world. I expect nothing different from scientific circles. It is an issue of human nature.

  7. kxmoore Says:

    great ted presentation here on suppression of clinical trial publications. scary stuff. http://blog.ted.com/page/5/

  8. Tuck Says:

    “…to see whether closing a hole in the heart of patients with migraine would cure their migraine. It didn’t.”

    That ironic. As it happens, I have such a hole in my heart: a “patent foramen ovale”. When it was discovered, I spoke to a colleague of mine, who had the surgery to close it up. To his suprise, his life-long string of migraines ended, and he’s not had one since.

    Turns out there’s two types of patent foramen ovale: the one I have, which operates normally (no blood flow between chambers) and the one he had, which allows blood flow between the chambers, and hence creates micro-clots which can cause micro-strokes, which are thought to be one of the causes of migraines.

    I wonder if the failure of this experiment was simply checking the wrong variable?

    As to the topic of your quote, I wish it were surprising, but after a few years of research diet and the medical profession, I’ve a: realized that my high esteem for doctors was a matter of faith, not reason, and b: I’ve lost that faith.

  9. Ray Cathode Says:

    “Dishonesty is common in medical research.” Thankfully, we know that this could not happen with climate change…

  10. L Says:

    Hey dearime used to comment everyday. Where u at now babe??

    Doctors are not ur friends!! We are not ur friends. Seth, stop trying to fight the system and do something more lucrative w ur life. No Nobel prize for people who hurt the prize givers! Cmon, u should do something more positive.