[Fraudulent pain research: a hurt so deep nothing can alleviate it].

Untruthfulness in research is reprehensible. Dr Scott S. Reuben, an anesthesiologist at Baystate Medical Center in Springfield, Massachusetts in the United States, a leader and pioneer in the field of multimodal analgesia, has been accused of fraud, specifically of having falsified results in at least 21 manuscripts published over a period of 15 years. This may come to be seen as one of the largest-scale and longest-running acts of medical research fraud ever. Apart from fabricated data, it seems the author committed other acts of misconduct. His coauthors have not been accused of wrongdoing, as they allege their names were falsely appended to the manuscript. The editors of the 2 most implicated journals, Anesthesiology and Anesthesia & Analgesia, have published editorials retracting the papers they judge to be fraudulent. Because Dr Reuben is a major figure in postoperative multimodal analgesia, many studies by other authors whose hypotheses have emerged from findings announced in the discredited papers may also now be considered contaminated by association. The definitions of scientific misconduct and the procedures for pursuing offenders vary greatly from country to country, creating a certain degree of uncertainty about how to proceed when we confront this problem. Beyond any possible legal liability that might arise, there are the questions of how fraud might affect patients' health or the medical knowledge base. Although the concept of multimodal analgesia may continue to be defended, we cannot be absolutely sure of its benefits without carrying out new clinical trials to repair the damage done by this act of misconduct.