The ability of editors and the peer review process to uncover research misconduct is controversial. Riis (1994) states that, "Editors have few opportunities both in theory and practice to detect and to prevent fraud." However, Farthing15 writing six years later in the year 2000, has a more optimistic view, which may reflect the much higher profile of the problem and therefore the will to find solutions.
Whilst the peer review process is deemed hightly desirable and is meant to detect weaknesses in design and execution, most research misconduct has only come to light through the offices of "whistleblowers". However, the infamous Pearce paper on embryo implantation was not peer reviewed and the editor of the journal was himself a gift author;9 the second paper deemed fraudulent was peer reviewed, and also reviewed by a statistician and a statistical report received, and it had also been through the LREC. With the gift of hindsight it was obvious that the number of patients reported to have been studied with this particular condition was highly unlikely given the catchment area of the investigator.9 However, although stringent peer review may detect plagiarism and redundancy of publications, the downside of the peer review process is that the reviewers may themselves be guilty of misconduct by plagiarism of ideas or data or failing to declare conflicts of interest, including competitive grant funding in the area of research in question, as well as financial interests such as external consultancy remuneration.
Indeed, editors themselves are not immune from research misconduct with records of fabricated papers, introducing review bias, and a range of inbuilt prejudices.15 However, the relatively recent establishment of the Committee on Publication Ethics (COPE) has been a force for good, where discussion of the issues of prevention are regularly debated.16'17
In the 1995 report from the independent committee of inquiry into the circumstances surrounding the publication of two articles in the British Journal of Obstetrics and Gynaecology, a series of "editorial" recommendations were made to aid in the of prevention of future fraudulent research papers.9 Amongst many recommendations were the following.
Firstly no article should be accepted without a letter of submission signed by all authors, including confirmation that they understood the requirements for authorship and that journals must make these criteria absolutely transparent, in line with the International Committee of Medical Journal Editors (ICMJE) guidelines. Furthermore, they felt that consideration should be given to requesting that each author's role and area of responsibility is clearly specified in the letter of submission.This did not occur with the submission of the embryo implant case report. As discussed earlier, editors should feel free to request sight of raw data, and of the inquiry (the Charity) would not normally suspend the grant. However, if adequate steps are not taken to proceed with the investigation (the Charity) will suspend the grant. If fraud is proven, (the Charity) will terminate the grant immediately. Indeed, the AMRC outlines a viable mechanism for dealing with accusation of scientific fraud and states that it would probably contain the following elements;
1 A guidance document or code of practice on standards of professional behaviour.
2 Provisions for induction and training of staff.
3 Agreed arrangements for monitoring the process.
4 Regulation and procedures for handling allegations.
5 Fair procedures and appropriate protection for both the accused (respondent) and the "whistle-blower" (complainant).
The AMRC's statements are helpful but are not as robust as those within the pharmaceutical industry, where a monitoring and auditing system has long been in place (see below), despite the questions relating to the legality of such procedures.24 Whilst grant-giving bodies such as the MRC have moved forward, a recent survey by the Council of Heads of Medical Schools in the UK revealed that universities have only belatedly begun tackling these issues.
Last year, the NHS has finally responded with the publication of a consultation document: the draft document Research governance framework for health and social care.25 This sets out standards, delivery mechanisms, and monitoring arrangements for all research within the NHS in England and Wales. It also includes collaborative projects with other parties such as universities, charities, research councils, and the pharmaceutical industry. Dr Elizabeth Clough, Deputy Director of Research and Development for the Trent region in the UK and a member of the steering group who developed the framework, said; "There were two main imperatives for developing the framework. First it sets out standards and mechanisms to protect the needs, rights, well-being and safety of research participants. Second, the recommendations are designed to promote excellent quality research and on the flipside to prevent less good practice."
The framework makes the contents of study participants key to how research should be conducted stating, "The rights, safety and well-being of participants must be the primary consideration of any research study" (Box 17.1).
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