Unethical practices in anesthetic research and publication: Clinical impact, consequences and preventive measures.

Sir,

The editorial, “Serious thoughts about plagiarism from India,” published in the Saudi Journal of Anaesthesia by Dr. Thorakkal Shamim is a bold description of the unethical practices in this part of the world.[1] The editorial, “Caveat Lector” by Dr. Abdelazeem Eldawlatly and Dr. Steven L Shafer had conveyed earlier similar sentiments and the seriousness of this issue that has plagued the academic world.[2] Ethical writing in the medical profession needs a serious re-look as has been described by Dr. P K Bithal in his editorial published in Anaesthesia, Essays and Researches.[3] A similar ground was covered by Dr. Harsoor and Dr. Gangadhar in their editorial published in the Indian Journal of Anaesthesia, highlighting the global prevalence of plagiarism and academic dishonesty.[4] The elaborative description in these Asian journals of such fraudulent activities related to anesthesia practice was due for a long period. These editorials have brought one important observation to the fore, which highlights that almost every nation is gripped with the contagious effect of academic dishonesty, as has been observed in the cases of Dr. Bouldt, Dr. Fujii and Dr. Reuben.[567] The preventive measures mentioned in these editorials are quite comprehensive and it is not a difficult task to write a text book on these fraudulent activities. However, a few more important aspects deserve special mention.

The consequences of such academic dishonesty can prove to be extremely damaging for the patients as they become end targets of this fabricated research during replication of such therapeutic interventions. Although few articles may become apparent, the real and potential danger arises from those articles that remain undetected. These articles may be highly cited and provide the deceived readers a false base on which to formulate their own academic and research activities thus enhancing the damaging effects of such perpetuated fraudulent research. The replication based on this falsified data may involve a large number of patients thus exposing many patients simultaneously to the risks of the unreported side-effects of drugs and techniques.

One of the major limitations for editors and peer reviewers is the lack of substantial facilities to detect such fraudulent activities during the reviewing process. Access to full text articles on PubMed is not available to the majority of the reviewers and to some editors. As a result, the review process somehow cannot be exercised in a fully fledged manner. Therefore, many plagiarized articles go undetected at this stage, which should have actually been rejected. Moreover, majority of the editors and reviewers are not well versed with the biostatistics and their significance and are not able to test the hypothesis and its results during reviewing. These fraudulent publications become a moral burden on the minds of reviewers in general and on the minds of editors in particular. The retraction of the article may be a step toward the rectification of such missed and unseen errors, but it can also damage the reputation of the journal, and puts a question mark on the dedicated efforts and academic functioning of editors and reviewers.

Going in-depth about prevention of this grave issue in the academic society, a few more points need special mention besides those already covered in these beautiful editorials. I will like to add a few more suggestions to the comprehensive recommendations made by these respective editors so as to check plagiarism and academic dishonesty:

The academic regulatory bodies should take firm initiatives in carrying out research activities in the country by outlining the guidelines for every kind of research as major frauds have been reported from Asian countries in these editorials

Strict laws and legislations should be enacted by the court of law globally so that researchers should refrain themselves from such fraudulent activities

The ethics committees of all the institutions should ensure that the research activities and randomized controlled trials are duly carried out as per the CONSORT statement

The details of all research activities and randomized clinically controlled trials should be registered with the Clinical Trial Registry of their respective country

Editors and reviewers should be provided free access to full text articles on PubMed to enable a smooth and fair review process

Publishers should provide statistical services to the journal and editors also can provide the help of a statistician to the reviewers during the peer review stage.

However, all these measures may not prove to be sufficient, but their application in totality can definitely reduce this ever-increasing menace of plagiarism.