When The Lancet and The New England Journal of Medicine pulled an influential pair of Covid-19 papers on June 4, it was a rare event in scientific publishing. For medical researchers, this was like seeing The Washington Post and The New York Times take down related news stories at the same time—a confluence of editorial failures that raises dire questions about what went wrong and why. But how surprising is this scandal, really? Could these be among “the biggest retractions in modern history,” as one observer described the news about the paper in The Lancet? That depends entirely on how you read history. Science meltdowns of this type—and the “biggest” retractions that ensue—occur with shocking regularity.
The latest scandal is, indeed, a bad one. At the moment, we don’t know the full story of what went wrong, beyond that the papers’ authors and the journals’ editors decided that they could no longer trust the underlying data. Both studies purportedly drew from the medical records of 96,000 patients with Covid-19, seen at hundreds of different hospitals around the world. The NEJM article reported that those with cardiovascular disease were at increased risk for death from Covid-19, and that the use of certain heart medications did not appear to compound that risk. The Lancet paper reported that the drugs hydroxychloroquine and chloroquine did not help the 15,000 patients who took them; in fact, these medications seemed to cause significant harm
The NEJM article didn’t make much of an impact, but the Lancet paper was a different matter. Upon publication, the World Health Organization paused an ongoing trial testing the malaria drugs for Covid-19. The trial only started up again when the journal expressed doubts about the validity of the results last week.
Assigning blame in the newest unraveling isn’t hard. The papers’ authors, led by Harvard researcher Mandeep Mehra, shouldn’t have put their names on a paper lacking transparent data. The journals’ editors are on the hook, too, for accepting articles with the same limitations on sharing. And coauthor Sapan Desai, the CEO of Surgisphere—who has written papers in the past on fraud and “moral turpitude” in medical publishing—well, we don’t quite know what he did or didn’t do.
The irony is that both The Lancet and NEJM have been burned before. It was The Lancet, after all, that published Wakefield’s paper linking the MMR vaccine to autism. NEJM was forced to retract a pair of Darsee’s fraudulent articles on heart disease in 1983. Until Thursday, those were two of the just 25 papers NEJM had ever retracted in its 208-year-history. Writing in the wake of the Darsee debacle, Arnold Relman, then the journal’s editor, declared: “Even if coauthors have not actually done any of the laboratory work, they should at least know that the experiments and measurements were carried out as described, and they ought to understand what was done and why.”
Regardless of what we end up learning about the origins of Surgisphere’s data, it’s reasonably clear that Mehra and his colleagues didn’t ask enough questions about the provenance of the findings.
The bigger lesson here—the one that’s been taught repeatedly for decades—is that peer review won’t save us by itself. Even back in 1983, Relman understood that the standard system for evaluating manuscripts was a blind watchman in the fight against scientific fraud. As he noted in his postmortem, the bulk of Darsee’s doctored research appeared in peer-reviewed journals, “and yet in none of the reviews was there enough suspicion to warrant rejection.”