Reprint
Think Tank: A warning shot for the cheats in white coats
The Sunday Times, January 9 2011
Medical fraud could have catastrophic results. Brian Deer, who exposed the MMR case, proposes a way to keep researchers honest
As Britain clamoured for jabs against swine flu last week, another kind of vaccine scare raged across north America, one that on this side of the Atlantic we’ve grown tired of. One of the world’s leading medical journals had given its verdict on the MMR jab, judging the research that had terrified a generation of young parents to have been what they called “an elaborate fraud”.
A minor firestorm gripped the US television networks. “Just hours ago,” announced CNN’s Anderson Cooper, “the British Medical Journal – BMJ – did something extremely rare for a scientific journal. It accused a researcher — Andrew Wakefield — of outright fraud.”
It was the latest chapter of a Sunday Times investigation that, in a series of stories, exposed the doctor behind the scare. “Is it possible that he was wrong, but not dishonest?” the BMJ asked in an editorial published on Thursday.
READ HOW DEER’S WAKEFIELD
INVESTIGATION WAS CHECKED
The journal’s verdict was “No” and, with time only to snatch sleep, it sent me bouncing between American and Canadian broadcasters for days until I lost track of which was next. As my tag team of drivers forced their way through London’s traffic, I pondered what might come of it all.
To reach its conclusion, the BMJ had scaled a mountain: one thrown up by my digging. This was the first time, I believe, that a journalist had been able to burrow beneath the facade of anonymised research, and I had compared Wakefield’s claims that had led to the scare with his patients’ actual histories and diagnoses.
Bringing these to light took a two-year public inquiry by the General Medical Council (GMC). Responding to my first reports, it seized the records of a group of children enrolled in Wakefield’s project. GMC lawyers then read them out at the proceedings, the transcript of which runs to more than 6m words.
But the thing that taxed me last week was what else would tumble out if other scientists were subjected to such scrutiny. People talk of peer review. I’ve been peer reviewed twice: in gastroenterology and developmental paediatrics. Such reviews check plausibility, not the truth of the claims. When I was reviewed, I had to insist that journal staff checked my facts.
If you ask me, Wakefield thought he could get away with it because others had been doing so for so long. Although the medical establishment wants to present him as a “rotten apple”, I would be wary of eating much from its tree.
Should anything come of Wakefield, what I want is this: for cheating scientists to fear they might get nailed. Not merely by a journalist in some high-profile area, but in the dullest, though often most important, corners of inquiry.
My dream is the formation of an Inspectorate of Research Integrity, with powers to examine researchers’ data and methods. They would arrive at a lab without notice, under a research integrity act. They would apologise for the trouble, but require answers to basic questions about the location and status of materials. Then they would secure the premises and return the next day with a team of legally and scientifically trained auditors.
It’s the only thing that will stop wrongdoing: a chance — however small — that somebody will ask to see the data. That would include patient records, such as those I gleaned through the GMC, statistical computations, bench notebooks, emails and proof of any formally asserted fact.
A draconian response? No. Does it imply the inspected is suspected? No. Are we saying all scientists are cheats? Clearly not. But humanity is entering an ageof biology, when medical fraud could have catastrophic results.
Do we think that medical scientists are more honest than sportspeople? We know that sportspeople sometimes cheat. In having random drug testing, we recognise that the integrity of the enterprise needs defending against those who would trick their way to victory.
We’re not whispering “more regulation”, much less supra-national involvement; but if European bureaucrats are looking for something to do, they should start with a cheap and cheerful pilot scheme here.
It was 25 years ago that I did my first fraud story. The culprit was a British professor, Michael Briggs. He used to sit at his typewriter and fabricate studies showing the contraceptive pill was safe. He made them up as he went along, guessing what his results would have been if he’d found the time and money to obtain them.
A lot has changed. Today a cheat would use a laptop or a handheld device.
But it was journalism that (finally) succeeded over the MMR debacle, not learned journals or academic institutions. Ours was the largest medical investigation since this paper’s inquiries of the 1970s into thalidomide. That scandal led to the first British law requiring medicines to be licensed as safe. If any good were to emerge from Wakefield, it would be a drug test for drug testers — and all those whose medical research we can’t check.
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