Correction of the literature

We published two peer-reviewed articles—one protocol and one paper with the results of a comparative analysis comparing a group of people associated with a specific “complementary medicine health care organization” (CMG), with the general population, which concludes that the group has “unusual health indicators” (more favourable than the general population).

The papers originally contained a conflict of interest (COI) statement stating that the authors were “insiders, in that they attend CMG events. However, they have received no funding, reimbursement, or other consideration from CMG or its stakeholders, and no instructions or directions of any kind from CMG or its stakeholders. No other competing interests exist.”

Our freelance copyeditor edited this statement out, to read “Conflicts of interest: None declared”, because “attending events” is not normally something that would be considered a COI. The authors approved the galleys and did not object to these copyediting changes.

Shortly after publication, we received a 12-page letter from a journalist, detailing extensive undisclosed COIs of the authors. The letter was also addressed to another journal which published another protocol from the group, as well as to the university (the lead author is associated with the university). In the letter, the CMG movement is characterized as a controversial, multimillion dollar international enterprise. The healing modalities promoted by CMG do not appear to be evidence based. In the letter, evidence was provided showing that all researchers are long term public promoters of the CMG enterprise, as well as being spiritual adherents to the CMG ‘religion’. One author is a former CMG company director. The letter also says that the lead researcher is the spouse of a current CMG “company director” (which is disputed by the author). The corporation is owned by another corporation which in turned is owned by the founder of the CMG enterprise.

As alleged in the letter (and confirmed by our own internet searches), all authors are influential persons within the CMG spiritual and business community. We confronted the lead author with these allegations and asked the authors to provide a more detailed COI statement for a possible correction of the original papers. In response, the lead author submitted a 1-page revised COI statement detailing that all four authors have varying degrees of association with the CMG and are members of the “Practitioners’ Association” which is the body regulating practitioners who are qualified to practice CMG modalities. Two authors have “occasionally offered paid private healing sessions”. The revised COI by the author also alleged that “all authors have experienced substantial health benefits since they started visiting CMG events”. In addition, they all have published blogs on CMG associated websites. The wife of the lead author is—according to the revised COI—involved in “voluntary activities around producing content for a CMG associated company and is a “company secretary” of the CMG associated company and “does this in an honorary capacity. She is not a director or shareholder” and “does not receive any financial incentives” from CMG.

We consulted the original peer reviewers, showing them the updated COI. They said they would not have accepted the manuscript had they known about these extensive COIs. We suggested to the authors that we feel that both articles should be retracted, and we would prefer to do this with their consent.

The lead author rejected this with the argument that “we originally submitted a COI statement which the journal removed. Subsequently, you falsely asserted that my wife, is a Director and employee of a CMG associated company when she clearly isn’t and has never received any fund from CMG.”

We checked the company registration and the spouse is actually listed as company secretary, which is considered an ‘officer’ of a corporation in the country of registration, so they have many of the same duties and obligations as directors. Our concerns with the COI of the lead author (and his spouse) go beyond financial COIs, as in his blog the lead author describes how meeting the CMG founder “changed our lives profoundly”, and his spouse is describing “seemingly miraculous changes” as a result of CMG. This level of passion for CMG and their involvement may affect the authors’ scientific judgement.

The university has launched an investigation as a result of the journalists’ letter, but the investigation is not complete. Meanwhile, the case has also been picked up by the mainstream media, who is putting pressure on the university to distance themselves from CMG, which is described by the media as a “cult”.

Question(s) for the COPE Forum

• Should we publish the updated COI statement as a corrigendum, perhaps with a notice of editorial concern, and wait for the outcome of the university investigation to decide on further steps.

• Or should we retract the papers due to non-disclosure of COI (and also due to concerns over the content and practices of the CMG enterprise, the scope of which neither reviewers nor editor were aware of when accepting the paper)?

• Is there any third option we have not thought of?
 

A researcher has published a paper in our journal using a scale published in 2008. She wrote to the scale developer in 2014/2015 at least three times (emails are on file) before the start of the project, but the scale developer did not respond despite repeated email reminders. No indication of the need for a license was received. In 2017, when the researcher published the paper using the above scale, she was contacted by a person claiming that he was representing the scale's developer and asked for a retrospective license and license fee, and threatened that if the she did not apply for a retrospective license and pay the license fee, she may need to take legal responsibility and retract the published paper. He also said that if she does not pay the fee, then the team’s lawyer would contact her. The name of the lawyer is given, with a gmail account. No firm name or any other information is provided. The researcher has searched the internet and found examples of this person asking other people to apply for a retrospective license and receiving money.

Eventually an email from the scale developer was received, asking the researcher to comply with what his 'chief investigator' is requesting. Thinking that this might be a scam, the case was presented to the dean of the faculty where the scale developer was based. The response from the dean was that ''I am saddened to learn about what has occurred. Our institution does not hold this license and does not support the actions the scale developer is taking''. The scale was published in 2008 and its development was funded with public funding. The scale was modified from the original scale, which was published in 1986 and its development was also publicly funded. These two scales are in the public domain.

A number of people have paid a fee, often variable and often in the many thousands of dollars. Some institutions have decided to retract the article instead. The team is using bullying and aggressive tactics to persuade the researchers to pay the fee (they have not told the researcher in question what the fee is yet, but through the internet blogs this seems to be a very variable amount). They have also sent emails to the president of the researcher’s university, deputy president and vice president for research, as well as to our journal where the paper is published. They are sending 3-4 threatening emails per day (although this seems to have stopped after a couple of weeks).

Question(s) for the COPE Forum

·      What do I do as an editor? Do I ask the author to produce a license, or otherwise we will need to retract the article? The author has applied for permission to use the publicly available scale three times with no response from the scale’s developer.

·      As this scale is publicly available, is this adequate for someone to use it with the appropriate acknowledgement/reference? There was no mention this was a licensed material in the publications.

An allegation of data fraud was not satisfactorily resolved by correspondence with the authors. We then went to the lead institution and asked for an investigation. Within 10 days we had a report clearing the authors, but interestingly using some of the exact same phrases the authors used in their responses to us. We felt that the report was too superficial and approached the other institution involved.

A new investigation was started; this investigation took many months. The report said there was insufficient justification to take the matter to formal assessment and the institution was not minded to investigate further.

We remain concerned. The second investigation asked the authors to provide some data for re-analysis: that came out close enough for the committee to be reassured. However, provision of the same data for re-analysis is likely to produce the same result. In our previous experiences, only checking of at least some of the case report forms would uncover fraudulent data. We are therefore not reassured that the paper is sound and we have no direct evidence (CRFs) that the data are genuine.

Questions for the COPE Forum
• When two institutional reviews have failed to investigate thoroughly enough to reassure editors, what further investigations might be warranted? And by whom?

• Is there sufficient doubt remaining for an expression of concern? Or should we accept the results of the investigations even if we consider them inadequate?