Misconduct in clinical research--the Scandinavian experience and actions for prevention.

The Nordic countries, Denmark, Norway, Sweden and Finland, started relatively early with the establishment of national committees dealing with scientific misconduct within the health sciences. They originally included slightly different parts of the dishonesty spectrum, when launching their independent control bodies, but have since then converged, with the end result that all four countries now include all aspects of the spectrum. In other words, the ranges now cover alleged fabrication and plagiarism on one side, and quarrels about authorship and terms of procedure within cooperating groups of scientists on the other. The Nordic experiences have made it possible to estimate a prevalence rate of 1-2 presented cases per million inhabitants, of which only approximately 1/5 is serious. The preventive actions have been publications of guidelines for: scientific co-operation; raw data storage; authorship. Further, educational initiatives include postgraduate courses for senior scientists; postgraduate courses for junior scientists; influence via inquiries and investigations. The Nordic experiences point strongly to the necessity of an independent national control body.