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Press releases Saturday 30 July 2005
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(1) BMJ HIGHLIGHTS
LACK OF INTERNATIONAL COOPERATION TO INVESTIGATE SCIENTIFIC FRAUD
(2) ACUPUNCTURE
CUTS TENSION HEADACHE RATES BY ALMOST HALF
(3) BLACK PEOPLE
MORE LIKELY TO SURVIVE A STROKE THAN WHITE PEOPLE
(1) BMJ HIGHLIGHTS LACK OF INTERNATIONAL COOPERATION
TO INVESTIGATE SCIENTIFIC FRAUD
(Suspected research fraud:
difficulties of getting at the truth)
http://bmj.com/cgi/content/full/331/7511/281
(Are these data real? Statistical
methods for the detection of data fabrication in clinical trials)
http://bmj.com/cgi/content/full/331/7511/267
(Investigating the previous
studies of a fraudulent author)
http://bmj.com/cgi/content/full/331/7511/288
(Editorial: Investigating
allegations of scientific misconduct)
http://bmj.com/cgi/content/full/331/7511/245
This week, the BMJ expresses concern about the validity of a paper it published in 1992 written by Dr Ram B Singh of Moradabad, India.
We also highlight the case of another author, R K Chandra, who had a study retracted by the journal Nutrition earlier this year. As with Singh, serious doubts now hang over the rest of his work.
The stories of Singh and Chandra have been told to highlight the problems associated with investigating allegations of research fraud and to challenge the international scientific community to take action where necessary.
In 1992, the BMJ published a paper by Dr Singh on the protective effects of diet on the heart. But doubts were soon raised about this study and subsequent manuscripts submitted by the same author.
In the absence of answers from the author, Richard Smith, then editor of the BMJ, tried to find an authority in India that would investigate and resolve the doubts over Singh’s work, but no institution would take on the task. A statistical analysis of one of Singh’s papers, also published in this week’s issue, concludes that data “were either fabricated or falsified.”
After several years of fruitless correspondence, the BMJ decided it had no option but to publish an account of the suspicions and the failed attempts to have them resolved.
Richard Smith, who left the BMJ in 2004, accepts that it has taken far too long to bring the case of Dr Singh to light, and admits that “the failure is in part mine.” However, he adds that “the bigger shame lies with the scientific community that lacks means to investigate these international scandals and has to leave it to an individual journal.”
He resolutely stands by the decision to publish the saga, and believes that the scientific community has an obligation to the public to do better.
But once the validity of one study is called into question, who should investigate the rest of the author’s work and, if necessary, mete out punishment, and correct the scientific record? Richard Smith believes that employers are best able to conduct this process but there needs to be an international body to take the lead. He also suggests that we should mark suspicious studies as “dubious” on international databases such as Pubmed.
Although the BMJ may have done more, it has still taken us over 10 years to try to resolve this issue, write BMJ editors, Fiona Godlee and Jane Smith. What more can journals do when their attempts to get someone to investigate fail?
Some argue that journals should keep “black lists” of suspected papers and authors. Others suggest that journals should ask authors to deposit a copy of their raw data in a secure archive so that these could be audited if questions arise.
Perhaps journals should be more ready to share their concerns about published papers, as the BMJ has done this week. This does not resolve the suspicions, but it alerts the scientific community, and it may in turn prompt a legitimate organisation to do the necessary investigations, they conclude.
Contacts:
Fiona Godlee, Editor, British Medical
Journal, London, UK
Email: fgodlee@bmj.com
Jane Smith, Deputy Editor, British
Medical Journal, London, UK
Email: jsmith@bmj.com
Richard Smith, Chief Executive,
UnitedHealth Europe, London, UK
Email: richardswsmith@yahoo.co.uk
Caroline White, Freelance Medical
Journalist, London, UK
Email: cwhite@bmjgroup.com
(2) ACUPUNCTURE CUTS TENSION HEADACHE RATES BY ALMOST HALF
Online First
(Acupuncture in patients with tension-type headache: randomised controlled
trial)
http://bmj.bmjjournals.com/cgi/rapidpdf/bmj.38512.405440.8F
Acupuncture is an effective treatment for tension headache, cutting rates for sufferers by almost half, shows a study on bmj.com this week.
And a minimal acupuncture course works almost as well as traditional Chinese therapy, say the researchers.
In a randomised controlled trial - the gold standard of clinical trials - researchers in Germany divided 270 patients with a similar severity of tension headache into three groups.
Over an eight week period one set were treated with traditional acupuncture, one with minimal acupuncture (needles inserted only superficially into the skin, at non-acupuncture points), and one group had neither treatment (‘control’ group).
Those receiving traditional acupuncture care saw their headache rates drop by almost half - suffering 7 days less headaches over the four weeks following the treatment. Those receiving minimal acupuncture had 6.6 less days of headaches. While the control group experienced 1.5 less days of headaches - a drop of just a tenth.
Improvements to headache rates continued for months after the acupuncture treatment, though they began to rise slightly as time went on.
Those in the ‘no treatment’ group were subsequently given acupuncture for eight weeks after the main study period. These patients also improved significantly after the treatment, though not to the same level as those given acupuncture initially.
Of the 195 patients in the acupuncture groups, 37 reported some side effects - the most common being dizziness, other headaches and bruising.
Such a small difference in results between traditional and minimal acupuncture treatments seems to indicate that the location of acupuncture points and other aspects of traditional Chinese acupuncture do not make a major difference for tension headache, say the authors.
Acupuncture treatments are sometimes associated with strong placebo effects, caution the authors. But these findings show that acupuncture produces just as good improvements for tension headache sufferers as treatments already accepted, they conclude.
Contact:
Dr Wolfgang Weidenhammer, Centre
for Complementary Medicine Research, Technische Universitat Munchen, Munich,
Germany
Email: Wolfgang.Weidenhammer@lrz.tu-muenchen.de
(3) BLACK PEOPLE MORE LIKELY TO SURVIVE A STROKE THAN WHITE
PEOPLE
Online First
(Survival differences after stroke in a multiethnic population: follow-up
study with the south London stroke register)
http://bmj.bmjjournals.com/cgi/rapidpdf//bmj.38510.458218.8F
Black people are more likely to survive a stroke than white people, according to new research published on bmj.com today.
The risk of stroke and death from stroke are generally higher in black people than whites in the United Kingdom and the United States. In south London, where this study took place, the average age of people with stroke is 10 years lower than in the whole population.
The study involved over 2,000 patients registered on the south London stroke register after having a first stroke between 1995 and 2002. Data on ethnicity, socioeconomic class, and treatment of existing health problems were collected and survival was calculated.
Despite an increased risk of stroke, black patients were more likely to survive than white patients. The results showed a clear survival advantage, with five year survival being 57% for black people and 36% for white people. This trend remained after adjusting for several factors that may have affected the results, such as age and socioeconomic status.
Older black people in particular (75 and over) had a substantial survival advantage over similar white people. Current smoking, untreated atrial fibrillation (irregular heart rhythm) and diabetes, treated or untreated, were all associated with worse survival.
It seems that black people have better access to stroke unit care and more active management of some modifiable risk factors before stroke, say the authors.
They suggest that more detailed measures of socioeconomic status, education, and care after stroke need to be incorporated into future studies to identify the contribution of such factors on survival.
Contact:
Charles Wolfe, Professor of Public
Health Medicine, King’s College London, UK
Email: charles.wolfe@kcl.ac.uk
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