We can all agree — we hope — that fraud is bad, whether it’s in government, sports, or academia. But it can sometimes be easy to forget that fake scientific data can have real consequences for public health.
Perhaps that’s because many biomedical papers retracted for fraud involve early-stage science — bench work in cells — rather than patients, and are published in journals with esoteric names like Biochemical and Biophysical Research Communications. Whatever the reason, it’s unfortunately instructive when real-world examples arrive to help illustrate the point.
Take a new study in the Journal of the American Medical Association this week. Researchers looked at measles cases in the US since 2000, when the World Health Organization declared the virus eliminated in North America. According to the study, of the 1,400-odd cases of measles since then, more than 56 percent were in people with no evidence of having been immunized against the astonishingly infectious and potentially deadly disease. (Notably, 14 percent of cases occurred in people who reportedly received at least one scheduled inoculation against the virus.)
Why weren’t they vaccinated? In most cases (71 percent), they had sought exemptions for religious or philosophical reasons.
That’s where the link to scientific fraud comes in. You may recall a 1998 study led by Andrew Wakefield, a UK physician, which was published in the Lancet. That paper — retracted in 2010 after it became clear that the findings were bogus — suggested a link between autism and the MMR vaccine. And it’s not too great a leap to assume that some, and possibly most, MMR refuseniks have the autism story in mind when they opt out.
The JAMA researchers — who also looked at cases of pertussis, or whooping cough — do not discuss why people are refusing immunization. Saad Omer, of Emory University, who led the study, told us that’s because the article only had room to talk about consequences, not causes. But Omer and his colleagues do hint at Wakefield, et al., when they write that “immunization policy makers must also address the reasons for vaccine hesitancy, which may include parental perceptions regarding the risk and severity of vaccine-preventable diseases, the safety and effectiveness of routine immunizations, and confidence in medical professionals, corporations, and the health care system.”
“There’s no question whatsoever that you can attribute this — at least in part, and probably in significant part, to Wakefield’s paper,” said Seth Mnookin, author of “The Panic Virus,” a book about the vaccine-autism controversy. Those fears have since been fanned by Jenny McCarthy and others.
Although most people who contract measles do fine, many suffer serious harm from the virus, including muscle and brain damage. And some die: The numbers here aren’t clear, but one researcher estimates that at least 11 people in the United States have died from measles since 2000.
But Wakefield’s was just one study. We also have the case of Anil Potti, in which cancer patients’ treatment was guided by what turns out to have been faked data. And that of Joachim Boldt, a high-profile anesthesiology researcher who had an impressive — in the bad sense of the term — 94 papers retracted that had made the therapy he was studying — for heart surgery — seem safer than it actually was.
Sadly it seems that patients often suffer from these research misdeeds. A 2011 analysis found that more than 6,500 patients had received treatments in studies later retracted for fraud. When researchers counted all of the volunteers in trials that somehow drew on that fraudulent research, the figure was a staggering 400,000.
So the next time you read about academic fraud, in these pages or others, and it seems a purely academic issue, think of all those patients — and all that avoidable suffering.