Promoting public trust in medical research by acknowledging and reevaluating flawed papers

In 1998, an author published a well-known paper in Lancet that (incorrectly) concluded that vaccination caused autism. Investigators found analytical errors and data falsification in the paper. Since then, many studies have found no evidence of a causal link between vaccination and autism. But unfortunately, the damage was done. Even 25 years after the Lancet paper was published, people believe that vaccinating their child could result in autism and refuse to let their children be vaccinated.

More recently, researchers have found that a significant number of randomized controlled trials published in highly regarded journals have analysis errors resulting in misleading and even wrong conclusions. But how do researchers and medical journals win back public trust after publishing a paper that should not have been published?

Everyone makes mistakes. Economic journals have found a mitigation method in requiring that for a paper to be published in their journals, the authors must make their data (without identifying confidential details) and codes available. That way, other researchers can investigate whether the results can be replicated. Replication papers help prevent mistakes from recurring. They are teaching opportunities.

Florence LeCraw, a physician, and coauthors performed a reevaluation study of a paper published in a highly regarded health policy journal, Health Affairs. The reevaluation showed that the authors of the original study made three serious errors. Two referees of Health Affairs agreed with LeCraw et al, but Health Affairs would not afford LeCraw et al more than a brief letter to appear in the journal.

After several failed attempts to publish their replication paper in a medical journal, the authors published it in an economics journal, Econ Journal Watch. This journal publishes papers that identify mistakes made by researchers with the goal of preventing their recurrence. Dan Klein, an economist who started Econ Journal Watch, explained his goal: “To encourage challenges of published research, to make research more honest and more careful.”

The authors describe the errors made by the original investigators, but more importantly they recount their experience with Health Affairs when the journal discovered the errors. One editor told them that since their readership has little interest in replication papers, their policy is to not publish them. Several other medical journal editors told one of the authors that they did not publish replication papers because they feared it would cause reputational damage.

Unfortunately, ignoring the uncovering of errors in published research seems to be the norm in medical journals. But experts believe that the long-term reputation of a medical journal is damaged by not admitting their peer review errors. They believe that a journal’s reputation will be enhanced, not damaged, by publishing replication papers demonstrating mistakes made by their reviewers and also other medical journals’ review mistakes. Publishing replication papers also helps prevent the mistake from recurring by explaining the error made.

For the public to trust that the conclusions in medical journals’ published papers are valid, it is imperative that medical journal editors encourage submissions of replication papers to their journals and that they be published. Florence LeCraw concludes, “Admitting errors, describing the error made, and what can be done to prevent the recurrence of the error, is the basis of trust. Trust by the public will be key to advancing evidence-based healthcare practices and policies.”

***

Reference

Article Link: https://econjwatch.org/articles/reassessing-the-effects-of-a-communication-and-resolution-program-on-hospitals-malpractice-claims-and-costs

Title of original paper: Reassessing the Effects of a Communication-and-Resolution Program on Hospitals’ Malpractice Claims and Costs

Journal: Econ Journal Watch

Authors: Florence R. LeCraw, MD¹, Daniel Montanera, PhD², and Thomas A. Mroz, PhD³

Affiliations:  

 ¹Andrew Young School of Policy Studies, Georgia State University, Atlanta, GA, USA. [email protected]

²Department of Economics, Grand Valley State University, Allendale, Michigan, USA, [email protected]

³Department of Economics, Andrew Young School of Policy Studies, Georgia State University, Atlanta, GA, USA; Federal Reserve Bank of Atlanta, GA, USA. [email protected]

*Corresponding author’s email: [email protected]

About CANDOR Coalition

The CANDOR Coalition is a group dedicated to promoting candid communication and effective resolution in healthcare through the implementation of Communication and Optimal Resolution (CANDOR) programs. CANDOR aims to create a culture of transparency between patients, physicians, and hospital facilities, as well as promote both internal and external policy and procedure changes to prevent re-occurrences of errors.

Website: https://candorcoalition.org/

About the author

Florence R. LeCraw is a physician with over 35 years of practice experience. She serves as an Adjunct Professor at Andrew Young School of Policy Studies, Georgia State University, Atlanta, Georgia. LeCraw is an advocate for transparency and open communication in the fields of medicine and medical research and has authored and co-authored many publications to this effect. She is also affiliated with Northside Healthcare System.