Editorials

The need for a national body for research misconduct

Nothing less will reassure the public

News p 1695 Education and debate p 1726 Personal view p 1755

The British medical research community is busy assembling its response to research misconduct. The question is no longer, "Do we have a problem?" but rather, "How can we best respond?" The BMJ has thus commissioned five answers to the question (p 1726),¹ two from people outside Britain with extensive experience of research misconduct. One recurrent theme is that Britain needs a central body to lead on this difficult issue.

The answers are published in a week when we have to retract yet another article because of probable fraud (p 1700).² One of the authors of the retracted paper was recently struck off by the General Medical Council for research misconduct. ^{3 4} He had also lied about his qualifications. Cameron Bowie, his coauthor, then started from the inevitable assumption that all of the rest of his work was fraudulent until proved otherwise and found that he could not satisfy himself that his coauthor had completed the work he said he had. Bowie describes his miserable experience in a personal view and has retracted a paper that has gained wide attention and been influential in developing policy (p 1755).⁵

This week also sees the publication of the first annual report from the Committee on Publication Ethics (COPE),⁶ a body set up by medical editors to support each other in tackling suspected research misconduct and considering the ethical problems that arise all the time in scientific publishing.^7-9 The group has considered 25 cases, many of them minor, but in the past yearas a result of COPEI personally have referred an author to the General Medical Council (to discover that he had already been struck off) and made a complaint to a chief executive of a trust. It's a terrible thing to refer an author to such authorities, but editors have decided that we can no longer ignore misconduct. Nor can we investigate and punish, which is why we must refer authors to their employers or other authorities. Our experience with COPE makes it clear that once editors begin to pay serious attention to misconduct it is there before their eyes.

In the introduction to the annual report Mike Farthing, the chairman of COPE, argues that Britain needs a national agency to manage research misconduct.¹⁰ The same message comes from Povl Riis, one of the founders of the Danish committee,¹ and from Drummond Rennie, deputy editor (west) of JAMA and a member of the United States Commission on Research Integrity.¹ Rennie pleads with Britons to learn from the United States' experience, which goes back 20 years. In the early days in the US each institution created its own rules for dealing with research misconduct. "The results," writes Rennie, "were frequently slow, bungled, idiosyncratic, and unfair to almost everybody." So was born the Office of Research Integrity to oversee and enforce institutions' compliance with federal regulations governing research.

Another important message from the US is that a legal rather than a scientific method is needed for managing cases of misconduct. "Scientists," writes Rennie, "are not trained in conflict resolution; their intuitive response is usually wrong and they tend to set up shaky ad hoc procedures that do not guarantee the accused notice of all the charges, the opportunity to respond to all the charges, and a decision based on rigorous standards."¹ COPE has been lucky to receive the help of Ian Kennedy, a professor of law.

The president of the GMC, Sir Donald Irvine, has set up a committee chaired by George Alberti, president of the Royal College of Physicians, to consider a better response to research misconduct. The committee includes the secretary of the Medical Research Council, which has now produced excellent advice on how allegations of misconduct should be investigated in its own units. ^{1 11} Crucially, it offers a procedure to follow in that very first and awkward stage when misconduct is suspected but far from proved. This is the stage that editors find so difficult: they have strong suspicions but no moreand no means to investigate. One problem with the emerging British response is that it doesn't cover all scientific research, but the National Academies Policy Advisory Group (a group that covers the bodies representing scientists, engineers, doctors, and the humanities) has also been studying research misconduct. It unfortunately is still at the stage of deciding whether there is a problem.

There is an understandable reluctance to create a national body to lead on research misconduct. Nobody wants more quangos than are absolutely necessary, and everybody would like to think that local bodiesuniversities or research institutionscan keep their own houses in order. Unfortunately the experience from the United States and from other countries that have acted on research misconduct and from Britain so far is that local responses are often inadequate. The institutions don't have enough experience and face a terrible conflict of interest in exposing one of their staff as a fraudster. A national body should take the lead in defining research misconduct, developing procedures for dealing with accusations, and ensuring that institutions comply with them. In additionand ultimately more importantlythe national body could also lead in studying and preventing the problem.

The British publicstunned by the revelations from the Bristol case of surgeons continuing to operate when they knew their results were poor (p 1685)¹²needs reassurance that everything possible is being done to ensure the purity of the research record. A national body is needed to provide that reassurance.