Medical literature: Time for Absolving the Burden of Fraud.

By Artemis Vekrakou

Artemis Vekrakou is a trainee in Anaesthesiology in Aretaieion University Hospital and a Phd candidate in the University of Athens.

Medical literature. A constantly growing field of discoveries.

Hard to tell how much of it is true.

There is an ongoing, international questioning of the quality and validity of current literature.

It seems that research, under the pressure of a variety of factors, has lost its primary purpose: to expand science.

In the field of medicine, every year one or more cases of lesser or bigger fraud is exposed. Scientific fraud or misconduct includes fabrication, falsification or plagiarism in proposing, performing and reviewing scientific research or in reporting research results. Fraud is unethical and in many cases illegal. If proven, it can terminate the careers of those engaged in it. However, fraud is frequent.

But what urges scientific community in fraud?

It is easy to think of the companies that produce drugs or equipment to have benefit over certain publications and this is one of the reasons that the effect of drugs or other interventions over a disease may be exaggerated or many publications may be ghost-written in order to bring results that seem objective.

But it is not only about the companies.

It is also about the journals. The journals seem to have as their major purpose the augmentation of their impact factor. Publications with more considerable results are more likely to be cited and thus are more preferable than others. Unfortunately, many studies fail to prove results of great importance and often their results are modified in order to become more attractive. In general, journals are more reluctant in publishing studies with negative results or results that are not important.

Academic Institutions have their share in promoting scientific fraud.

Researchers are under constant pressure of producing studies, trials and publications in order to promote their career and the prestige of their institutions. Antagonism rather than true teamwork is cultivated in most academic institutions. As a result, it becomes more difficult to organise and conduct a study but much easier to falsify or even fabricate data. This fact is aggravated by two more factors: a) most universities don’t have functional inspection mechanisms and b) if fraud is exposed it is very difficult for them to acknowledge it. Their validity is harmed.

But it is also the researchers themselves.

The community of researchers deeply knows that science in this form is hypocritical, not functional, and in many cases harmful. But the bigger part of this community is reluctant and is hesitating to take the first step in changing this situation. They hesitate to become the mentors that the new generation of scientists needs, the mentors that have seen a non-functional model of research and publication and can create the means to change it.
The unwillingness of stakeholders to face the problem becomes even more obvious by the fact that the tools and structures to address it are already there and ready to use. For example, in the USA the existence of ORI (Office of Research Integrity) could play an important role in averting young scientists from engaging in scientific fraud. However, such actions should take place and such organizations should exist in every country and every institution which performs scientific research.

It is important, however, that the scientific community seems to be very sensitized over scientific fraud and this fact can create the conditions for the way out of this situation, the way to conserve the principles and goals of medicine and science.

On the other hand, when such research practices occur in medicine, a science working on human health and the treatment and prevention of disease, the phenomenon would naturally raise concerns on the conduct of research in other fields of science where its impact is considered less determinative.

For more information on medical literature practices contact Artemis Vekrakou at