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New England Journal of Medicine engages in typical academic corporate ass-covering behavior

James Watson (not the racist dude who, in 1998, said that a cancer cure was coming in 2 years) writes:

About a month ago, when the infamous Lancet hydroxychloroquine/chloroquine paper was still “real science” (i.e. in the official scientific record), we decided to put extra pressure on the authors by writing an open letter to the New England Journal of Medicine. Prof Mehra and his Surgisphere colleague Sapan Desai had published a paper derived from the same “database” in the New England Journal of Medicine a few weeks before their Lancet publication. This was an important but rather boring paper (ACE inhibitors not dangerous in COVID). I guess because it did not have immediate ramifications, none (to our knowledge) had critiqued it openly. But on close examination it didn’t take long to see glaring inconsistencies. Numbers from Turkey and the UK (they made the mistake of giving country-level numbers!) were basically impossible, and the relationship between age and mortality didn’t agree with later reports. The open letter can be found here. A few hours after we posted this letter online NEJM posted an expression of concern re Mehra et al, and hours later Lancet did the same (I’m not claiming full causality but it could be argued!). A few days later both papers were retracted.

On the 3rd of July we got the (expected) reply from NEJM:

Dear Dr. Watson,

I am sorry to inform you that your submission, “Expression of concern regarding data integrity and results,” has not been accepted for publication in the Journal. It was evaluated by members of our editorial staff. After considering its focus, content, and interest, we made the editorial decision not to consider your submission further. We are informing you of this promptly so that you can submit it elsewhere.

Thank you for the opportunity to consider your submission.

Sincerely yours,

Eric Rubin, MD, PhD
Editor-in-Chief

I’m not sure that one month counts as prompt given the importance of the concerns. And given that 174 researchers/clinicians signed the letter, from around the world. I can understand people not liking these massive group signatory letters, but this aspect is important in my opinion. Every statement was carefully reviewed by each signatory – many changes were proposed and made. Most of the signatories are individuals actively working in COVID-19 and the fact that none of them had heard or knew of Surgisphere activities gave considerable confidence that it was all fraudulent.

It’s a shame that NEJM didn’t publish our letter. I don’t understand why they can’t openly accept that a mistake was made. Publishing the letter formally records the worrying patterns that point to pure data fabrication and fraud. And it highlights that Prof Mehra and co-authors made a serious error appending their names to a publication with no knowledge of data provenance. In The Lancet it is stated that the corresponding author (Mehra) and coauthor ANP (Patel) had full access to all the data in the study and had final responsibility for the decision to submit for publication. Mehra and Patel must have signed this – yet when retracting the paper they claimed they did not have access to the data! (and asked a third party to audit the data).

As discussed many times on your blog, this shows a major problem in academic publishing: there are few (any?) incentives for post-publication review . And journals don’t take post-publication review seriously. Journals like NEJM and Lancet appear to believe that 2-5 anonymous reviewers will be better at spotting problems than hundreds/thousands of individuals who read it after publication. This is obviously silly. So why not encourage post-publication review instead of stamping it out?

I recently came across this somewhat remarkable example of how post-publication might happen with a responsible and modern journal, not surprisingly it’s from PLoS.

A very nice example of transparency.

Further background here.

It’s that never back down “culture of poverty,” attitude. But . . . the editors of the New England Journal of Medicine are not poor people. They have no excuse!

19 Comments

  1. NEJM editors have a good excuse: authors keep submitting their best papers to them, and readers keep trusting the NEJM brand. Why should they care?

  2. Klaas van Dijk says:

    The fraudulent paper in NEJM was retracted on 25 June 2020. Copy/pasted from https://www.nejm.org/doi/full/10.1056/NEJMc2021225?query=recirc_curatedRelated_article

    “Because all the authors were not granted access to the raw data and the raw data could not be made available to a third-party auditor, we are unable to validate the primary data sources underlying our article, “Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19.”1 We therefore request that the article be retracted. We apologize to the editors and to readers of the Journal for the difficulties that this has caused. Mandeep R. Mehra, Sapan S. Desai, Timothy D. Henry, Amit N. Patel”.

  3. Carlos Ungil says:

    In retrospect, the global adverse impact on ongoing randomized controlled trials evaluating chloroquine or hydroxychloroquine in the prevention or treatment of COVID-19 was not so major. At least regarding the two highest-profile trials Recovery (UK) and Solidarity (WHO). The former continued enrollment; it was stopped on June 5 when they concluded that it didn’t show a benefit. The latter saw enrollment suspended between May 25 and June 3; it was stopped two weeks later considering the results from Recovery and the lack of efficacy signal on their own data.

  4. Dale Lehman says:

    Given the NEJM policy here, my bigger concern is how this may influence future efforts towards open data. Their response in this case makes me believe they will be less likely to pursue open data policies in the future. After all, open data just makes it more likely that people might find errors in future published articles, further damaging their brand. I do believe they will try extra hard to avoid having a similar thing happen in the future – but I am not optimistic they will succeed, given all the problems with reproducing results, lack of referee’s time, difficulties with complex big data analyses, etc. So, while they will go to extra lengths to try to avoid similar occurrences, their likely reaction will be to avoid open data as much as possible. That is my biggest fear about this story.

  5. James says:

    That “racist dude” was part of threeish-person team who made one of the most important discoveries in the history of biology, thank you very much.

    • Andrew says:

      James:

      Indeed, had that other James Watson just been a random racist who said that cancer was gonna be cured by 2000, he wouldn’t have been noticed at all. DNA was his main thing; racism and cancer cure forecasting were just his side gigs.

      • Keith O'Rourke says:

        > part of threeish-person team who made one of the most important discoveries in the history of biology
        Would be better to avoid having heroes in science all together.

        This is a somewhat concise and balanced account of heroes in science by Hilda Bastian – even though it reports this account

        “David Freedman wrote that while Ioannidis’ legacy had recently “seemed unassailable”, speaking to a class of medical students this year he wondered, “To them Ioannidis may always be the fringe scientist who pumped up a bad study that supported a crazy right-wing conspiracy theory in the middle of a massive health crisis”.

        https://absolutelymaybe.plos.org/2020/06/30/science-heroes-and-disillusion/

  6. Jade Davis-Lewis, Ph.D. says:

    As a lesbian of Color who identifies as a member of the MSTA (Moorish Science Temple of America, if you didn’t know), I would like to respectfully ask, Andrew, as a White Male, what is your definition of racist, since you seem to like using this word and dissing people in terms of it? Do you mean “believes that there are average differences of any type between groups that individuals believe they belong to based on what is in ordinary usage viewed as race.” Or that policies should and/or shouldn’t be based on such differences, if they exist; or that no one should ever talk about race at all, or at least, scientists should not (since ordinary folks seem to want to talk about it)? Is “Black is Beautiful” racist? Is claiming that “black folks have more soul” racist? (Actually, they do, but that’s a different story.)

    • Andrew says:

      Jade:

      “Racism” is not a precise term, and different people have different definitions of it. I discuss definitions of racism here, where I write:

      Wade does not characterize himself as a racist, writing, “no one has the right or reason to assert superiority over a person of a different race.” But I characterize his book as racist based on the dictionary definition: per Merriam-Webster, “a belief that race is the primary determinant of human traits and capacities and that racial differences produce an inherent superiority of a particular race.” Wade’s repeated comments about creativity, intelligence, tribalism, and so forth seem to me to represent views of superiority and inferiority.

  7. Jade Davis-Lewis, Ph.D. says:

    I know different people have different definitions, that’s why I asked you what your definition was. Now I know. Am I racist because I believe black people have more soul and white people can’t run, and black people can do “it” (you know “get down”)better? Are you saying, as a white male statistician, that average group differences are illusory? Or rather are you saying that the differences (significant ones) do exist but they aren’t based on “race” but rather SES or culture or some such things? Could it be that when people talk about race what they really mean is SES or culture? Is the problem really that race is “fixed” (you’re stuck with it), while SES and culture aren’t (to the same degree). Is it possible that the reason black folks get so steamed up about the issue is that they suspect public policies are going to be affected that will adversely impact them. (I have a theory about why white people get steamed up but I suppose being a white person you already know).
    I’m not trying to be a smarty-pants. I just really think the racist name-calling isn’t helpful to the healing.

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