Tuesday, August 16, 2011

On the Importance of Being Earnest - Or At Least Honest

I have written a number of times of the importance for chaplains of being “research informed.” I’ve also written of the difficulties with this, and especially of knowing what we’re reading when we’re reading the research of other professions.

Well, this past week various news sources (for example, here and here)have noted a paper whose authors noted a troublesome trend. The paper itself was presented this spring at the Annual Conference of the Association of College and Research Libraries. Titled, “Retracted Publications in Biomedicine: Cause for Concern,” it was written by John M. Budd, Zach C. Coble and Katherine M. Anderson, all of the University of Missouri.

The paper is not that long, and is a straightforward read. I encourage you to read it. However, some of the problematic results are easily presented. The authors identified more than 1100 studies retracted in the twelve years from 1997 to 2099 by various journals (retractions noted in PubMed, the on line citation source of the National Institutes of Health). Of those retracted, fully 55% were for misconduct. Some of these showed up in the news, but most did not. They note that it is a small percentage of all published research, but it's more than enough. More troubling is they're comparison to an earlier study. In that study, using the same methods, Budd et al discovered that in the years from 1966 to 1996 235 articles were retracted, 40% for misconduct. So, in almost a third the time, almost five times as many articles were retracted, and the proportion retracted for misconduct increased by 15%!

The authors go on to point to several related causes for concern. One is just how long it takes for a retraction to be issued. In the study reported this spring, the mean time to retraction was 17 months. On the other hand, for the median (half took less time and half took longer) was 29 months and the range went to 304 months – more than 25 years! (Yes, that’s only one exceptional article; but still….) In all that time people could be and were put at risk, either in larger studies designed on faulty premises, or in treatment programs that proved unsound.

Even more troubling for the authors were the number of times retracted articles were cited after they had been retracted. Citations before retraction might be unfortunate, but they’re not in themselves evidence of poor practice. Citations after retraction, on the other hand, are – or may be. If a researcher is searching an online database, or looking at the online edition of the journal, it may be easy to see that an article has been retracted (if not always why). However, if the researcher is going from one print source to another – say, looking at the hard copy of a journal based on a citation in a book or other printed source – the fact that the article has been retracted won’t be immediately available. Budd et all note that “Finding a retraction statement does require some diligence on the part of authors and editors.” Much depends on how online sources make retractions apparent, and most make some effort. However, the individual researcher needs to check carefully.

We have a lot at stake these days in the quality of research that gets done, and especially, as Budd et al note, in biomedical research. Across the spectrum of healthcare, from providers to payers to patients, quality of care and demonstrated outcomes are critical. But demonstrated outcomes require good research that is careful about methods, resources, and ethics. Mistakes in research are unfortunate, but not entirely avoidable. On the other hand, misconduct in research unethical and sometimes dangerous. Compounding misconduct by poor review processes or slow retractions is also unethical, as is citation of retracted research. We all have a lot at stake in this. We as the recipients of research need to be able to trust that we’re receiving good information; and we who are researchers (and yes, chaplains are researchers, too!) need to be worthy of that trust.

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