Can you trust what biomedical researchers have to say about your health?

There are plenty of people out there who say no, including anti-vaccinators, mega vitamin proponents, lovers of non-Western medicine and those who see a pharmaceutical company plot behind every drug, device or genetically altered seed. Few of these skeptics have any sound evidence to offer on behalf of their distrust. Often their opposition is based more on ideology or politics than it is solid evidence for doubt.

But, that does not mean that biomedical science should ignore problems that do undermine public trust in what they have to say. One of the most important and disturbing is fraud. 

A study published Monday in the very trustworthy journal Proceedings of the National Academy of Sciences shows that fraud is a real problem in scientific publications.  This study is both a reason for concern and, ironically, a reason to trust what scientists and doctors say.

The study reviewed 2,047 retracted biomedical and life-science research articles dating back to 1973 and found that the biggest reason for their retraction wasn't honest error but fraud.  More than 40 percent of the retractions were due to the discovery of outright fraud and another 23 percent to plagiarism. The rate of retractions of published articles, while a tiny percentage of all papers published in biomedical journals — 2,000 out of tens of millions published in the past four decades -- is growing. The rate has jumped 10 fold in the past 37 years.   

It’s an unsettling trend. A teeny number of fraudulent articles can do an enormous amount of harm. Prominent cases of fraud certainly and rightly make the public wonder about the credibility of biomedical claims. Why, however, does this study and its findings have a silver lining?

Let me ask you a simple question: When is the last time you heard critics of vaccines or GMO food admit that there is fraud on their side? In my experience, the answer is never. Those who tout the benefits of chelation, megavitamins or cleansing enemas never confess to any degree of fraud among their number. Strange as it may seem, what makes mainstream biomedicine trustworthy is its willingness to admit that there are frauds and charlatans out there and that efforts need to be made to catch them.

Real trustworthy science knows that error happens, that sometimes the error is malicious, that there are bad apples out there and that you have to try and weed error out.  If you are not ready to admit these truths then you are not trustworthy at all.

That said why is fraud on the rise?  The study authors are not sure. 

I suspect the increasingly competitive nature of science, the drive to secure more grants, patents and equity by individual scientists and the huge proliferation of journals that are not doing a good job peer-reviewing articles are all to blame.  So are scientists who have agendas. 

The biggest fraud mentioned in the study is Dr. Andrew Wakefield. Wakefield is no friend of vaccination. His bogus paper reporting a link between autism and vaccines had a huge and devastating impact on the health and well-being of babies and kids all over the world. Even though it was retracted and he was discredited, many still continue to believe he was right.  

Biomedicine needs to do more to stop the growing trend of fraud.  More education of young researchers, tougher penalties for fraud, and increased resources and rewards for peer reviewing will help. The fact that biomedicine is willing to look hard and publicly at its “bad apples” shows that there is every reason to think that scientists and doctors ought to continue to be trusted.

Arthur Caplan is the head of the Division of Medical Ethics at NYU Langone Medical Center.

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