- Case
Ethical standards in animal research
An author received a manuscript describing the biological behaviour of an infectious agent in an animal model. The manuscript contained new information, but the experimental procedure involved interventions that would not be permitted by UK Home Office regulations. What should the editor do? … _ Use of material from old data could be permitted. _ The committee agreed that this was a diffic… - Case
Plagiarism in a case report
The whole discussion section of a submitted case report was almost identical to the discussion section of a previously reported, similar case written up by another group of authors in another journal. The only difference lay in the patient details. While the other paper had been referenced in the case report, the authors of this case report had not indicated that the whole discussion was identi… - Case
Bizarre treatment of viral disease overseas
A journal received an account by email from outside Britain of how 14 patients infected with a potentially lethal virus had been treated with an unusual non-pharmacological treatment. The treatment seemed bizarre, and furthermore, there was no mention of approval by an ethics committee or of informed consent. The author was twice emailed to ask if he had ethics committee approval and if he had… - Case
Dubious surgery
A paper was submitted, describing surgery on the sexual organs of four women. The paper was poorly written and hard to follow, but it seems that this surgery was undertaken primarily because of the unsatisfactory sexual experiences of the women’s partners. There was no mention of ethics committee approval or of the women having given consent, not only for the surgery but also for taking part in… - Case
Duplicate publication
Sixteen randomly chosen papers were examined from a PubMed search of 370 publications between 1995–2000 by the same author. Two papers were virtually identical, differing only in the form of the introductory paragraph and the list of authors. Neither publication acknowledges the other. Another paper reported a “second ever published case”, and two subsequent papers reported the same “second” ca… - Case
Suspected data fabrication
A manuscript was received from a group of authors who had not submitted to the journal in question before. The review was extremely critical and the paper was rejected. In a covering letter the reviewer said that not only was the experimental design flawed, but he was also convinced that the experiment described had never been done. He had scanned Medline 1997–2001 and found seven other papers… - Case
No ethics committee approval or informed consent
A study was submitted that required the active participation of nearly 500 patients from a local hospital. The paper made no mention of ethics committee approval or informed consent by the patients, and an enquiry revealed that the authors had not obtained these. The chief executive at the hospital was alerted. Have the editors done the right thing? … If the data came from an audit/q… - Case
The doctor with a very strange theory
A doctor submitted a letter for publication describing a strange theory. This theory included treating patients with a particular chronic disease with just a foodstuff. The letter was completely unsuitable for publication in the journal and was also rather disordered. The editor was worried that the doctor might be putting patients at risk, and therefore notified the national regulatory agency.… - Case
The incomplete retraction
A journal published a paper several years ago that subsequently had to be retracted, on the advice of the university where the work had been conducted. The university provided no further details but promised to do so. Two years later they confirmed that the paper should be retracted, but gave no information on exactly what had gone wrong and whether anybody had been punished. Subsequently, one… - Case
The single authored, unbelievable, randomised controlled trial
A randomised controlled trial submitted to a journal showed that a nutritional supplement could dramatically improve one aspect of the health of the elderly. The study was a follow up to a trial reported in an international journal eight years previously. Why had there been so much delay? Why were the results reported in this study not reported in the previous study? There was only one author a… - Case
Alleged plagiarism
Journal A published a review paper. About a year later, the author of a paper published in 1997 in Journal B wrote to say that he had come across the paper in Journal A during a literature search. He pointed out that parts of this paper were virtually identical with his paper in Journal B. Although the author of the article in Journal A had made one reference to his article, this was only to on… - Case
Clinical malpractice
A case report was submitted in which the authors described a patient who had a poor outcome, and where many mistakes had been made during treatment. The authors of the paper were from a tertiary care centre. The poor practice had happened in a secondary care centre. One of the reviewers of the paper thought that the level of practice was so poor that action should be taken. The other reviewer t… - Case
Retrospective correction: how far back do we go?
In 1990 a case report was published in which it was alleged that the use of a particular endotracheal tube had led to tracheal damage, requiring the child to have a tracheostomy and a tracheal reconstruction. This paper was from a specialist surgical unit, and a letter was subsequently received from the paediatricians who had cared for the baby at the referring hospital before and after the tra… - Case
Scientifically meaningless research without consent
A private practitioner submitted a paper in which he had treated a series of patients without ethics committee approval. Many people would regard the treatment used as scientifically dubious. Furthermore, some of the patients had been treated with increasing doses of a new treatment that randomised controlled trials have shown to work. In effect, therefore, the study was a dosage study of the n… - Case
Research involving unethical animal experimentation
A manuscript was submitted which described an intervention that partially corrected the results in stress injury in an animal model. Two reviewers drew attention to the fact that the stress model used in these experiments would not be ethically acceptable in the UK. The editor raised this with the senior author, who responded promptly stating that the work had already been presented at an inter… - Case
Clinical misconduct(?), incidentally discovered
An author submitted a speculative article offering a new explanation for the aetiology of premenstrual syndrome, and a new suggestion for its treatment. The paper was wholly based on a priori reasoning, rather than evidence. It was rejected. The authors appealed, citing as evidence in favour of publishing their paper that they had had successful results treating two patients with the proposed m… - Case
The missing ethics committee and lack of written consent
A study that helps with the microbiological diagnosis of a clinical condition had been peer reviewed and accepted for publication when it was discovered that the study had no formal ethics committee approval and that the patients had given verbal rather than written consent. The journal contacted the authors, who responded by saying that the chairman of the ethics committee in their area did kn… - Case
Authorship dispute
An article was published with three authors’ names. Not all of the authors’ signatures had been included on the original submission letter. A complaint was lodged by Y, who said that X had submitted the paper without either his or Z’s consent or knowledge, and that there were several specific errors and omissions. Y then submitted a statement for publication in the journal dissociating himself… - Case
The hazardous drug used in an unlicensed way
The author (a clinician) sent in a case series, involving two patients. Both patients presented with severe pain, which was resistant to strong analgesics. The author then gave them a drug with potentially very serious sideeffects, including a small risk of disability or death. This drug is only licensed for a small number of indications. Neither of these two patients met the clinical criteria… - Case
A paper describing a case of possible medical negligence
A paper was submitted, describing a doctor who had given an injection of a drug (actually a herbal/homeopathic remedy) to a patient who had already experienced recurrent swelling when given previous injections of the drug. The patient suffered a severe anaphylactic reaction, but survived. The reviewer suggests that it was negligent to give such an injection. It seems at least plausible that thi…