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Major medical fraud

JJM

Graduate Poster
J
Joined
Nov 17, 2006
Messages
1,853
I think this is a news item that should circulate, I don't know if there are any principles to discuss. A doctor who has published a lot of papers on the topic of pain management has committed massive fraud, and 21 of his articles (to date) have been withdrawn. At least two of the studies he reported never took place (were lies)!

http://www.theness.com/neurologicablog/?p=495

http://scienceblogs.com/insolence/2009/03/the_most_massive_scientific_fraud_ever.php

http://www.sciencebasedmedicine.org/?p=406

If there is anything non-scientists may not realize, it is that we are heavily reliant on the honesty of researchers when they present data. When we review articles, we look to see if the data support the conclusions; it is nearly impossible to locate fraud (or, even, simple mistakes) in the data reported in a paper. There is a saying "Never attribute to malice that which can be explained by incompetence." I have seen bad data; but I have never suspected fraud.

That written, I bet there are a lot of people, today, wondering how they missed the fraud in so many papers. There are probably a lot of doctors who suspected something was wrong; but lacked the resources to do the proper experiments. Clinical research is terribly expensive and slow.
 
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[rhetorical]Why? Why would someone do this? Why would someone betray science, the patients, and other doctors?[/rhetorical]

Yes, I know, for the money and the power trip.

But whenever I read a story like this, I just cannot understand why.
 
Hang on, its a well-known fact that skeptics never criticise this sort of thing... ;)
 
LibraryLady said:
[rhetorical]Why? Why would someone do this? Why would someone betray science, the patients, and other doctors?[/rhetorical]

Yes, I know, for the money and the power trip. ...
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I think you nailed it; but I think one could subdivide your suggestions between conniving and mental illness.
 
El Greco said:
This is the most terrifying. "Peer reviewed" my anus.
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This is the problem with peer review - it's terrible at catching fraud. That said, this fraud was revealed following increasing doubt from some members of the pain management field, who had tried similar clinical experiments and had been unable to achieve the kind of successes that Reuben had reported.

As always, it's hard to be a whistle blower, especially when you're making the call against someone who is prestigious in the field. I can speak to this point firsthand -- back when I was in grad school, my lab attempted to replicate an important result from the biggest lab in the field (its PI is a likely future Nobelist) and could not. We compared notes with other labs in the field, and we all realized we were having the issue. In this case, we went to the source lab, and they realized they'd made a mistake, and were reporting an artifact (that's a result generated by some part of your experimental mechanism, rather than by the thing you thought you were testing). They tested it again and issued a correction.

What's horrifying in the Reuben case is that patient pain management was actually being carried out based on his fraudulent results.

Especially in the wake of this case, there's been a call for criminal charges and not just funding-based and academic sanctions against people who commit this kind of fraud. I support this idea. If you have committed fraud while taking NIH (or other government agency) money, you have at the least committed fraud against the government and by extension the taxpayers. In cases like Reuben, it may be possible to show that his fraud has also caused harm directly to patients via incorrect pain management, and to levy criminal charges against him based on that as well.

The immediate consequence is that hospitals are now stopping their (expensive!) multimodal pain management methods and reverting to 'older' methods that have reliable clinical evidence.

I think JJM set up the dilemma here properly - it's expensive and difficult to replicate clinical research, and in combination with the human dislike of calling foul on someone else, it took a while for enough suspicion to build to yield the eventual outing of this fraud. I don't know if criminalizing it would help in prevention, but as another NIH-funded researcher, I view such fraud as a betrayal of the public trust we are intrinsically given with our funding, and I would like to see that betrayal prosecuted.

It occurs to me that this would be a good time to write my representative and senators about this.
 
LibraryLady said:
[rhetorical]Why? Why would someone do this? Why would someone betray science, the patients, and other doctors?[/rhetorical]

Yes, I know, for the money and the power trip.

But whenever I read a story like this, I just cannot understand why.
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And sex. Don't forget about sex.

It is bizarre. If was a matter of being paid by Pfizer to come up with positive results, it's simply unnecessary, when it's possible to achieve the same thing without lying.

HARLOT

Linda
 
El Greco said:
This is the most terrifying. "Peer reviewed" my anus.
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How can you tell if someone has invented their results? You can't. Even Benveniste, who was strongly suspected of doing something questionable because his results were so unbelievable, got his paper published before the veracity check was carried out. And even then, you can read Benveniste's outraged protests that this was just not cricket, to doubt a man's word in his journal submissions.

The only way to tell if someone has invented their data is to do the experiment again. And again, until it's obvious who's right. That's the test of repeatability (which is the one that homoeopathy has consistently failed miserably). But you can't do that until the data are out there for people to see, and try to replicate.

That's why pointing to a single paper and saying look, peer-reviewed evidence, is at best mildly interesting.

Rolfe.
 
I'm a pain researcher. I've followed the evolution and controversy regarding multi-modal analgesia. I have never reviewed any of these papers as the topic is just outside what I do in cancer-related post-op pain.

But, I am having trouble processing this. Accepting it. I feel as if I am in denial or a sort of shock. I feel lied to and betrayed. I feel embarrassed for my whole field.

Was it so important for him to be "star" that he had to risk patient safety and the reputation of our field?

It is difficult enough to get people to use pain medication well - there are so many fears of addiction and side effects. This will set us all back.

I just can't believe it. I feel nauseous.
 
Rolfe said:
How can you tell if someone has invented their results? You can't. Even Benveniste, who was strongly suspected of doing something questionable because his results were so unbelievable, got his paper published before the veracity check was carried out. And even then, you can read Benveniste's outraged protests that this was just not cricket, to doubt a man's word in his journal submissions.

The only way to tell if someone has invented their data is to do the experiment again. And again, until it's obvious who's right. That's the test of repeatability (which is the one that homoeopathy has consistently failed miserably). But you can't do that until the data are out there for people to see, and try to replicate.

That's why pointing to a single paper and saying look, peer-reviewed evidence, is at best mildly interesting.

Rolfe.
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Yes, this is an important thing that was raised in another thread: peer-review is not the same thing as independent verification.

When all the research is conducted by one experimenter (or one team of experimenters) it's a little bit suspicious, but for obscure things that might be all we have. Many findings are not unexpected, so there is less call for independent verification in these circumstances.

When there is mixed results and all the positive results are produced by one experimenter (or team), it's very suspicious, and grounds for investigation.

This is the purpose of literature reviews.
 
Looks like a whole speciallity of medicine will have to rethink.

Interresting, there was a mentioning of a Wakefield and how the woo´s still embrace him.
Found one on wiki, faking sideeffects of vacine.
Guess this will at least show the difference in science´s and woo´s abillity to selfcorrect.

The whole HARLOT file is only for subscribers.
 
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JJM Thank you for posting this.

Stuff like this makes you feel you've been kicked in the kidneys.:mad:
 
blutoski said:
Yes, this is an important thing that was raised in another thread: peer-review is not the same thing as independent verification.

When all the research is conducted by one experimenter (or one team of experimenters) it's a little bit suspicious, but for obscure things that might be all we have. Many findings are not unexpected, so there is less call for independent verification in these circumstances.

When there is mixed results and all the positive results are produced by one experimenter (or team), it's very suspicious, and grounds for investigation.

This is the purpose of literature reviews.
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Agreed. Going through a semester of Clinical Research Ethics, we reviewed all the major medical fraud cases from Mendel all the way down the Dr. Hwang's cloning fraud.

Unfortunately what we see with these cases are that they tend to occur in the most productive researchers and that's part of the problem, the need to produce. Part of it is greed, part of it is a need for validation and often it is mental laziness. Even the smartest people can do really stupid things and get in over their heads.

While this fellas research never impacted my field of research or my practice, it is very disappointing that a colleague would do this.
 
TruthSeeker said:
I'm a pain researcher. I've followed the evolution and controversy regarding multi-modal analgesia. I have never reviewed any of these papers as the topic is just outside what I do in cancer-related post-op pain.

But, I am having trouble processing this. Accepting it. I feel as if I am in denial or a sort of shock. I feel lied to and betrayed. I feel embarrassed for my whole field.

Was it so important for him to be "star" that he had to risk patient safety and the reputation of our field?

It is difficult enough to get people to use pain medication well - there are so many fears of addiction and side effects. This will set us all back.

I just can't believe it. I feel nauseous.
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I have trouble with this as well. Usually there's all sorts of other individuals involved with a study - study co-ordinators, other physicians identifying suitable patients for recruitment, etc. Was he really acting alone? How did he hide the lack of usual activity associated with recruiting a patient (the questions regarding suitability, follow-up arrangements, paperwork like consent forms)?

Linda
 
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