Editorial
With unprecedented investments in research and development, China is second only to the USA in terms of scientific publication output in English. According to OECD Science, Technology and Industry Outlook 2014, China is set to overtake the USA, Europe, and Japan to become the world’s leading research and development economy by 2019. However, research integrity has not kept pace, and research misconduct, such as fabrication, falsification, plagiarism, and unattributed ghost-writing threaten to overshadow China’s achievements. In addition to ghost writers, a new phenomenon of ghost reviewers now exists. Between March 26 and 31, BioMed Central retracted 42 papers submitted by medical researchers from China. Publication of these papers was influenced by inappropriate manipulation of the peer-review process by author-suggested reviewers who were fraudulent, either with seemingly valid names (but fabricated email addresses) or with completely fictional names. In the retraction notes, BioMed Central stated that “a systematic and detailed investigation suggests that a third party was involved in supplying fabricated details of potential peer reviewers for a large number of manuscripts submitted to different journals”. Those third-party agencies seemed to have sold language-editing and submission services to the authors, but it was not possible to determine whether the authors were aware that the agencies also proposed fabricated reviewers on their behalf or if the authors had proposed the fake names themselves. Such misconduct is disappointing, not only because of the large number of retractions, but also because many of the retracted papers were from distinguished medical institutes in Beijing, Shanghai, Chengdu, and Xi’an. This episode suggests that misconduct might not be limited to isolated individuals or institutions, but rather that it could have infiltrated the country’s research culture more widely. Although scientific fraud is a global concern, there might be particular aspects that render China especially susceptible. One possible explanation is an evaluation system that relies heavily on research output. Publication pressure, like the Sword of Damocles, hangs over Chinese doctors, since promotions are closely connected with— or even largely decided by—publications. A one-sizefits-all promotion system for all doctors applies from village clinics to tertiary referral hospitals. This situation is compounded by the high clinical workload that many www.thelancet.com Vol 385 April 11, 2015
practitioners face, which means that research may not receive the full attention it requires. The reward and punishment system for publication is another concern. Articles published in Science Citation Index (SCI) journals can earn large bonuses for the authors. The higher the impact factor of the journal, the larger the bonus. Indeed, SCI credits and impact factors are used to judge candidates for graduation, promotion, research grants, and payments in medical institutes across China. Conversely, punishment for being caught in medical research misconduct is too lenient. According to Yang Wei, Director of the National Natural Science Foundation of China, the country needs standards for identifying research misconduct, as well as laws and regulations to punish misconduct. Furthermore, China’s research funding system lacks effective coordination among agencies and transparency in budgeting and expenditure. Current huge investments in biomedical research will not translate into new discoveries or more reliable medical evidence without a sea change in China’s research culture and regulatory systems. The retractions by BioMed Central provide an opportunity for China to reflect on its current procedures and to consider how to rebuild an environment that fosters stronger medical research. The announcement on March 31 that the number of Chinese doctors will almost double by 2020 is welcome news. It will lessen time-pressures on all doctors, and provide an opportunity to create more protected time for research. Change requires determined and collective leadership across the National Health and Family Planning Commission, Ministry of Science and Technology, Ministry of Education, funders, institutions, doctors’ groups, and journals. The research community has a role to train and mentor young researchers in a way that nurtures the highest principles of research integrity. In 2007, The Lancet wrote “China has the opportunity to lead the world not only in research quantity, but also in quality”. This year, collaborating with the Chinese Academy of Medical Sciences (CAMS), The Lancet family of journals invite abstract submissions from China for The LancetCAMS Health Summit held in Beijing, proposing national research collaborations as a way to improve research quality. Through such collaborations with Chinese medical researchers, we hope to promote a trusted and productive future for medical science in China. The Lancet
2/Julie Toy/Ocean/Corbis
China’s medical research integrity questioned
For OECD Science, Technology and Industry Outlook 2014 see http://www.oecd.org/sti/oecdscience-technology-andindustry-outlook-19991428.htm For the BioMed Central retractions see http://www. biomedcentral.com/search/resul ts?page=1&terms=%22retraction +note%22&itemsPerPage=50&sa veHistory=false&citation=true&s ummary=false For the March 31 announcement see http://www. reuters.com/article/2015/03/31/ us-china-healthcareidUSKBN0MR0EU20150331 For more on The Lancet-CAMS Health Summit see Comment Lancet 2014; 384: 732
1365
With unprecedented investments in research and development, China is second only to the USA in terms of scientific publication output in English. According to OECD Science, Technology and Industry Outlook 2014, China is set to overtake the USA, Europe, and Japan to become the world’s leading research and development economy by 2019. However, research integrity has not kept pace, and research misconduct, such as fabrication, falsification, plagiarism, and unattributed ghost-writing threaten to overshadow China’s achievements. In addition to ghost writers, a new phenomenon of ghost reviewers now exists. Between March 26 and 31, BioMed Central retracted 42 papers submitted by medical researchers from China. Publication of these papers was influenced by inappropriate manipulation of the peer-review process by author-suggested reviewers who were fraudulent, either with seemingly valid names (but fabricated email addresses) or with completely fictional names. In the retraction notes, BioMed Central stated that “a systematic and detailed investigation suggests that a third party was involved in supplying fabricated details of potential peer reviewers for a large number of manuscripts submitted to different journals”. Those third-party agencies seemed to have sold language-editing and submission services to the authors, but it was not possible to determine whether the authors were aware that the agencies also proposed fabricated reviewers on their behalf or if the authors had proposed the fake names themselves. Such misconduct is disappointing, not only because of the large number of retractions, but also because many of the retracted papers were from distinguished medical institutes in Beijing, Shanghai, Chengdu, and Xi’an. This episode suggests that misconduct might not be limited to isolated individuals or institutions, but rather that it could have infiltrated the country’s research culture more widely. Although scientific fraud is a global concern, there might be particular aspects that render China especially susceptible. One possible explanation is an evaluation system that relies heavily on research output. Publication pressure, like the Sword of Damocles, hangs over Chinese doctors, since promotions are closely connected with— or even largely decided by—publications. A one-sizefits-all promotion system for all doctors applies from village clinics to tertiary referral hospitals. This situation is compounded by the high clinical workload that many www.thelancet.com Vol 385 April 11, 2015
practitioners face, which means that research may not receive the full attention it requires. The reward and punishment system for publication is another concern. Articles published in Science Citation Index (SCI) journals can earn large bonuses for the authors. The higher the impact factor of the journal, the larger the bonus. Indeed, SCI credits and impact factors are used to judge candidates for graduation, promotion, research grants, and payments in medical institutes across China. Conversely, punishment for being caught in medical research misconduct is too lenient. According to Yang Wei, Director of the National Natural Science Foundation of China, the country needs standards for identifying research misconduct, as well as laws and regulations to punish misconduct. Furthermore, China’s research funding system lacks effective coordination among agencies and transparency in budgeting and expenditure. Current huge investments in biomedical research will not translate into new discoveries or more reliable medical evidence without a sea change in China’s research culture and regulatory systems. The retractions by BioMed Central provide an opportunity for China to reflect on its current procedures and to consider how to rebuild an environment that fosters stronger medical research. The announcement on March 31 that the number of Chinese doctors will almost double by 2020 is welcome news. It will lessen time-pressures on all doctors, and provide an opportunity to create more protected time for research. Change requires determined and collective leadership across the National Health and Family Planning Commission, Ministry of Science and Technology, Ministry of Education, funders, institutions, doctors’ groups, and journals. The research community has a role to train and mentor young researchers in a way that nurtures the highest principles of research integrity. In 2007, The Lancet wrote “China has the opportunity to lead the world not only in research quantity, but also in quality”. This year, collaborating with the Chinese Academy of Medical Sciences (CAMS), The Lancet family of journals invite abstract submissions from China for The LancetCAMS Health Summit held in Beijing, proposing national research collaborations as a way to improve research quality. Through such collaborations with Chinese medical researchers, we hope to promote a trusted and productive future for medical science in China. The Lancet
2/Julie Toy/Ocean/Corbis
China’s medical research integrity questioned
For OECD Science, Technology and Industry Outlook 2014 see http://www.oecd.org/sti/oecdscience-technology-andindustry-outlook-19991428.htm For the BioMed Central retractions see http://www. biomedcentral.com/search/resul ts?page=1&terms=%22retraction +note%22&itemsPerPage=50&sa veHistory=false&citation=true&s ummary=false For the March 31 announcement see http://www. reuters.com/article/2015/03/31/ us-china-healthcareidUSKBN0MR0EU20150331 For more on The Lancet-CAMS Health Summit see Comment Lancet 2014; 384: 732
1365
