Editorial
Retractions: the lessons for research institutions Rafe Swan/CULTURA/Science Photo Library
Last week Nature retracted two papers that attracted much excitement but also incredulity almost immediately after publication in January this year. Researchers based at the RIKEN research centre, Kobe, Japan, in collaboration with colleagues from the USA claimed to have shown a much easier way to transform adult cells into pluripotent stem cells, a technique that became known as stimulus-triggered acquisition of pluripotency. A subsequent investigation by RIKEN concluded inadequacies in data management, oversight, and record-keeping, and found one researcher guilty of misconduct. What are the lessons of such cases? Editors at Nature undertook their own investigation into their peer review processes and concluded in an editorial that editors and peer reviewers had taken the findings on trust and “could not have detected the problems that fatally undermined the papers”. Nevertheless, they announced that they are reviewing their practices of screening for image manipulation. Editors and peer reviewers are rarely in a position to detect fraud and fabrication and yet have the important role to safeguard
the scientific record and ensure its validity. But so do institutions, including those that collaborate with other researchers. And institutions are in a much better position to prevent such questionable research practices. Especially in fast-moving and exciting fields, in which the pressure to be the first to arrive at breakthrough findings is high, institutions need to have their own safeguards in place during the planning and conducting of research. Risk management is rarely regarded as important by institutions at the stage of research planning and conduct. And yet, their reputation will be severely tarnished when retractions become necessary. RIKEN has announced a series of preventive measures, such as rewriting internal regulations and guidelines and enhancing support of young researchers. Such cases are rarely the consequence of an isolated researcher’s wrongdoings. All institutions— not just those reacting to a case of misconduct—need to critically look at the environment in which research is done. Transparency, positive and open support, and true scientific enquiry rather than a race to innovation that cuts corners are the key to trust in research. The Lancet
King’s College London
The realities and needs of children living with ADHD
Simon Wessely
For the report on attentiondeficit/hyperactivity disorders and substance abuse see http:// pediatrics.aappublications.org/ content/134/1/e293.full
104
The new President of the Royal College of Psychiatrists, Simon Wessely, recently signalled his concerns about overmedicalisation in children. In an interview with The Times newspaper in the UK, he said that “Medicalisation is not often done by doctors...Now we see a huge rise in support groups, we see pressure brought to bear to bring in labels...You get obvious pressure from parents... It’s psychiatry which is against the medicalisation of normality.” Specifically in relation to attention-deficit hyperactivity disorders (ADHD), he went on: “It’s the same with Ritalin. It’s probably over-prescribed, but it’s also under-prescribed because we don’t have good enough services.” On June 30, the American Academy of Pediatrics added to this debate by publishing a clinical report online in Pediatrics. The report presents strategies for reducing the risk of developing a substance-use disorder in children and adolescents with ADHD, and provides recommendations for safe prescription of stimulant medication. To reduce stimulant misuse, the report recommends that diagnosis
of ADHD should be made cautiously and be confirmed using agreed clinical criteria. Diagnostic rating scales completed by carers and teachers, reviews of school records, and parent interviews can help in the assessment. Older children and adolescents should be screened for use of alcohol, marijuana, and other drugs. Children and young people with ADHD should be provided with guidance regarding proper use of stimulant medication. ADHD can be a controversial diagnosis. But it is clear that some children and young people do have substantial social and educational difficulties because of ADHD. In some cases, problems with attention and impulsivity might be helped by pharmacological treatment. This approach should always be only one part of a holistic management plan developed in the context of the family and social environment. The new guidance from the American Academy of Pediatrics is therefore very helpful. And we also agree with Simon Wessely that mental health services for children and young people need to be substantially strengthened. The Lancet www.thelancet.com Vol 384 July 12, 2014
Retractions: the lessons for research institutions Rafe Swan/CULTURA/Science Photo Library
Last week Nature retracted two papers that attracted much excitement but also incredulity almost immediately after publication in January this year. Researchers based at the RIKEN research centre, Kobe, Japan, in collaboration with colleagues from the USA claimed to have shown a much easier way to transform adult cells into pluripotent stem cells, a technique that became known as stimulus-triggered acquisition of pluripotency. A subsequent investigation by RIKEN concluded inadequacies in data management, oversight, and record-keeping, and found one researcher guilty of misconduct. What are the lessons of such cases? Editors at Nature undertook their own investigation into their peer review processes and concluded in an editorial that editors and peer reviewers had taken the findings on trust and “could not have detected the problems that fatally undermined the papers”. Nevertheless, they announced that they are reviewing their practices of screening for image manipulation. Editors and peer reviewers are rarely in a position to detect fraud and fabrication and yet have the important role to safeguard
the scientific record and ensure its validity. But so do institutions, including those that collaborate with other researchers. And institutions are in a much better position to prevent such questionable research practices. Especially in fast-moving and exciting fields, in which the pressure to be the first to arrive at breakthrough findings is high, institutions need to have their own safeguards in place during the planning and conducting of research. Risk management is rarely regarded as important by institutions at the stage of research planning and conduct. And yet, their reputation will be severely tarnished when retractions become necessary. RIKEN has announced a series of preventive measures, such as rewriting internal regulations and guidelines and enhancing support of young researchers. Such cases are rarely the consequence of an isolated researcher’s wrongdoings. All institutions— not just those reacting to a case of misconduct—need to critically look at the environment in which research is done. Transparency, positive and open support, and true scientific enquiry rather than a race to innovation that cuts corners are the key to trust in research. The Lancet
King’s College London
The realities and needs of children living with ADHD
Simon Wessely
For the report on attentiondeficit/hyperactivity disorders and substance abuse see http:// pediatrics.aappublications.org/ content/134/1/e293.full
104
The new President of the Royal College of Psychiatrists, Simon Wessely, recently signalled his concerns about overmedicalisation in children. In an interview with The Times newspaper in the UK, he said that “Medicalisation is not often done by doctors...Now we see a huge rise in support groups, we see pressure brought to bear to bring in labels...You get obvious pressure from parents... It’s psychiatry which is against the medicalisation of normality.” Specifically in relation to attention-deficit hyperactivity disorders (ADHD), he went on: “It’s the same with Ritalin. It’s probably over-prescribed, but it’s also under-prescribed because we don’t have good enough services.” On June 30, the American Academy of Pediatrics added to this debate by publishing a clinical report online in Pediatrics. The report presents strategies for reducing the risk of developing a substance-use disorder in children and adolescents with ADHD, and provides recommendations for safe prescription of stimulant medication. To reduce stimulant misuse, the report recommends that diagnosis
of ADHD should be made cautiously and be confirmed using agreed clinical criteria. Diagnostic rating scales completed by carers and teachers, reviews of school records, and parent interviews can help in the assessment. Older children and adolescents should be screened for use of alcohol, marijuana, and other drugs. Children and young people with ADHD should be provided with guidance regarding proper use of stimulant medication. ADHD can be a controversial diagnosis. But it is clear that some children and young people do have substantial social and educational difficulties because of ADHD. In some cases, problems with attention and impulsivity might be helped by pharmacological treatment. This approach should always be only one part of a holistic management plan developed in the context of the family and social environment. The new guidance from the American Academy of Pediatrics is therefore very helpful. And we also agree with Simon Wessely that mental health services for children and young people need to be substantially strengthened. The Lancet www.thelancet.com Vol 384 July 12, 2014
