Macchiarini - peer review cannot deal with lies

[PietKuip]

Maybe you saw the piece about this star surgeon's personal life in Vanity Fair, mythomaniac lies about getting married by the Pope, Putin and the Obamas attending. If it is too good to be true, it probably ain't true.

The guy has a base in Sweden, at Karolinska Institutet, the home of the Nobel prize in medicine. And he has been putting plastic windpipes in people. Pieces of plastic that were immersed in solutions with bone-marrow cells, and then miraculously turn into a functioning trachea, with epithelium and blood vessels.

He convinced an Eritrean engineer who had cancer to consent to have this implant, saying that it worked in pigs. This was not true. But somehow the operation was done in Stockholm, somehow this passed peer review in The Lancet.

But Pierre Delaere in Belgium said that these were lies. Colleagues in Stockholm documented his lies. An Uppsala professor (Gerdin) wrote a report about scientific misconduct. Yet Macchiarini was cleared by Karolinska Institutet. The system does not work.

Only when outsiders (Vanity Fair, and documentary-maker Bosse Lindquist) published, did something start to happen.

 

[billy_joule]

The system does not work.

What system?
I don't think the peer review process is expected to solve medical malpractice cases or root out compulsive liars..

 

[PietKuip]

The whole system: peer review, collegiality, institutional checks and balances, ethics approval, science journalism, investigations into scientific misconduct.

None of this worked.

Extraordinary claims got published without even ordinary evidence.

 

[jim mcnamara]

Okay. We understand what you said. Lots of claims of fraud.

Now. Please cite something. Maybe reputable journal articles or letters to the editor. You decide. Otherwise, without external verification you run the risk of the thread being closed. Note: Vanity Fair does not cut it as a scientific journal.

Without further information and documentation:
Maybe I could liken your tale to the discovery of Helicobacter pylori as a primary causative pathogen for stomach ulcers:
http://discovermagazine.com/2010/mar/07-dr-drank-broth-gave-ulcer-solved-medical-mystery
- as told by the folks who opposed Barry Marshall's hypothesis. Right now I can't discern what is going on.

 

[Orodruin]

Closed for moderation.

 

[berkeman]

Thread closed for Moderation.

@PietKuip -- please report my post and supply the references that have been asked for. If they are valid, the thread may be re-opened. Thank you.

Edit -- beat out by another Mentor...

 

[berkeman]

Thread moved to the Current Events forum and re-opened.

http://www.usnews.com/news/science/...ine-prize-panel-official-resigns-over-inquiry

The Swedish Nobel medicine prize panel says its secretary general Urban Lendahl has resigned because of an investigation into disputed stem-cell scientist Paolo Macchiarini who works at Karolinska University

 

[PietKuip]

Thanks for reopening the thread. A very good summary by Gretchen Vogel was published in Science February 4.

Since then the secretary general of the Nobel committee has resigned, because he assumed that he would be investigated by a special inquiry. That inquiry will be headed by Sten Heckscher it was announced today; he is one of the highest legal persons in Sweden. Although his instruction was not to investigate medical/scientific issues, he chose a Finnish medical professor to join the committee, and also a science journalist. I think these are good people for the job.

 

[russ_watters]

The Vanity Fair article can be found here:
http://www.vanityfair.com/news/2016/01/celebrity-surgeon-nbc-news-producer-scam

There was a fair amount of discussion of this in the moderator's forum before re-opening it. The issue with regard to PF rules is that PF is a place where we discuss mainstream science, based on what the scientific community accepts. We recognize that despite a staff and membership with scientific credentials unmatched outside of professional organizations, we are still not equipped to referee challenges to mainstream science -- so we avoid such issues.

This thread is about a person who apparently fell through the cracks and scammed the system. But it is inaccurate to say "The system does not work" (but accurate to say that in this case it did not work) because mainstream science is far and away the most successful system for producing knowledge about the natural world. The thread can discuss how scientific checks and balances might fail, but has to avoid straying into a broader discussion of tearing down the scientific "system" because it "does not work".

To put a finer point on it, one of the principle elements of the scientific process that has made it so successful is that it doesn't claim perfection but rather is constantly evaluating new theories and self-correcting when an error is made. So, presuming the allegations against Macchiarini are true, he has shown that while you may be able to scam the system for a while, eventually it self-corrects and exposes the scam.

 

[PietKuip]

But in this case, the record was not corrected from within science. Ethics committees gave the ok to Mengele-type experiments. Scientific peers (people in Italy, Delaere, colleagues at KI) tried to sound the alarm about discrepancies, there was an investigation, Gerdin reached clear conclusions of misconduct. But then the Karolinska Institute cleared Macchiarini, and The Lancet published this stunning not-guilty editorial.

Only when outsiders published in mass media, the situation improved. And my feeling is that the Swedish documentary by Bosse Lindquist in itself might not have accomplished this. I believe that the Vanity Fair piece about Benita Alexander was decisive. Of course it was still "he said, she said" but together with the fact-checking in Vanity Fair the public recognized the mythomaniac pattern.

I am afraid that the system is broken in some fields of science. Diederik Stapel was shown to have committed scientific misconduct by his university, but the case has not increased my confidence in the field of social psychology. And now, I am becoming a bit more sceptical about all those medical breakthroughs.

 

[Orodruin]

No system where people are left to judge and make decisions is going to be immune to manipulation, including the scientific peer review process and hiring policies in universities and hospitals. As such, there will likely always be people who manage to cheat the system through deception and lies.

In this particular case, there have been many oversights by people who should have known better (including the KI leadership which apparently never even consulted the ethics commission), but it does not invalidate the peer review process as a concept. Any researcher should be aware of this and know that a paper being peer reviewed is not a guarantee for correctness or accuracy, it only increases the probability that it is not complete garbage by some amount. Usually, it only means it has passed the scrutiny of one or at most a handful of other researchers. With a scientific mind you should keep a healthy amount of skepticism to the accuracy of papers until you have good reasons to believe them. Peer review is a start to that process, but far from the only hurdle.

 

[russ_watters]

But in this case, the record was not corrected from within science.

That doesn't mean it wouldn't eventually have been nor is there any real requirement on how or when errors/fraud eventually come to light.

Ethics committees gave the ok to Mengele-type experiments.

Are you familiar with Goodwin's Law? I realize this issue upsets you, but please dial it back.

 

[PietKuip]

Are you familiar with Goodwin's Law? I realize this issue upsets you, but please dial it back.

Macchiarini operated in violation of the Nuremberg Code and of the Declaration of Helsinki, principles of ethics for medical experiments on humans that were written down as a reaction to what had become known in the doctors' trials after WWII.

 

[russ_watters]

Macchiarini operated in violation of the Nuremberg Code and of the Declaration of Helsinki, principles of ethics for medical experiments on humans that were written down as a reaction to what had become known in the doctors' trials after WWII.

That's not the same as what I objected to - I would expect that the ethics code is much broader than the specifics of what Mengele did. Further, even if it were true that "Mengele type experiments" accurately describes them (and you will need to provide details substantiating the specifics of your characterization), it still wouldn't necessarily be true that they were approved at face value, since the whole point here is that he lied.

 

[PietKuip]

In the decision to clear Macchiarini of misconduct (Swedish text), Karolinska states that the decision to operate on the first patient had been taken "after a clear process in health care including an evaluation by the ethics council of Karolinska Hospital". Macchiarini describes this process in his January comment in The Lancet. (I do not understand how Karolinska can call such informal contacts a "clear process".)

Of course Macchiarini had not told these ethicists that he planned to do Mengele-type experiments. But he was going to do an implant of a plastic trachea in a human without any support of animal experiments. He had told the patient that such experiments had been done, so he lied to obtain consent. I do not know what he told the ethics committees (or their chair persons), but they seem to have given the go-ahead without having seen documentation with published studies.

The outcome was predictable: the plastic tube did not become a functioning trachea; after much suffering, the patient died. Maybe he would have died an unpleasant death anyway, but that is not really the point. (And it is not really clear at all that his cancer had reappeared. Without the implant, he might also have been alive. There is an amazing lack of data.)

 

[russ_watters]

This is not going anywhere productive, so we've decided it will be permanently locked.