Inquiry at Maimonides triggers two retractions in Chest, and retraining for the researchers

The journal Chest has retracted two publications — a paper and an earlier meeting abstract — from a group of researchers at Maimonides Medical Center in New York City after learning that the investigators mischaracterized the nature of their study. In addition to losing the two publications, the authors were ordered to undergo a refresher in proper research methods.

Here’s the notice for the abstract, which has been cited once, according to Thomson Scientific’s Web of Knowledge:

Notice of Retraction: Invalid Study Design and Inability to Verify Results Due to Missing Data in “Pigtail Catheter Drainage of Transudative Pleural Effusions Hastens Liberation From Mechanical Ventilation [abstract]” (Chest. 2007;132[4]:455)

On discovering that data from the 2007 abstract published in CHEST “Pigtail Catheter Drainage of Transudative Pleural Effusions Hastens Liberation From Mechanical Ventilation [abstract]” (2007;132[4]:455) was utilized mistakenly in a more recent article published in CHEST: “Chest Tube Drainage of Transudative Pleural Effusions Hastens Liberation From Mechanical Ventilation” (2011;139[3]:519-523), Maimonides Medical Center, the institution at which both works were conducted, undertook a thorough investigation. As a result, it was discovered that the description of the study described in the 2007 abstract as a prospective randomized controlled trial was inaccurate. The randomization procedure employed was inconsistent with this study design. In addition, the data and research records associated with this study could not be located. Because of the seriousness of this methodological issue and the inability to locate the relevant data, we hereby retract this abstract. Further, the May 2011 article has been retracted under separate notice.

Said notice for the paper, which has only been cited by the retraction:

It was brought to our attention that the article “Chest Tube Drainage of Transudative Pleural Effusions Hastens Liberation From Mechanical Ventilation” published in the March issue of CHEST (2011;139[3]:519-523) used duplicate data from a 2007 abstract by several of the same authors: “Pigtail Catheter Drainage of Transudative Pleural Effusions Hastens Liberation From Mechanical Ventilation [abstract]” (2007;132[4]:455). After the authors acknowledged that the wrong data set was utilized in the creation of the May 2011 article, an investigation was undertaken by Maimonides Medical Center, the institution at which both works were conducted. The data intended for the May 2011 article was not located. Accordingly, due to its reliance on incorrect data, we hereby retract this article. Further, the 2007 abstract has been retracted under separate notice.

Maimonides gave us the following statement about the incident:

The editors of CHEST informed us that a reader had submitted a question about the data cited in the 2011 article; this prompted our internal investigation. Our findings were that an incorrect data set was used for the 2011 article, and we requested that CHEST retract that article. In addition, we requested that the 2006 abstract by several of the same authors be retracted to prevent reliance on those data for any further research effort. The researchers involved have and will continue to undergo extensive retraining on research study design and methodology. No federal funding was requested or received for either publication.

Yizhak Kupfer, associate director of pulmonary and critical care medicine at Maimonides, told us that the problem was basically a dispute over the definition of randomization:

The  committee that reviewed the data felt that because we didn’t have a computerized generated randomization code, we shouldn’t have called it randomized.  We think that [it was properly randomized], but we had to go along with the committee’s [recommendation].

Kupfer said the 2011 article was retrospective and not intended to be randomized. That jibes with the description of the study on ClinicalTrials.gov, where it is listed as “Observational,” “Case Control” and “Retrospective.”

Kupfer blamed a “computer error” for the mixup with the data set for the 2007 abstract.

When we wrote it, unfortunately we used the wrong data set. Because of that mistake, we had to retract the later paper.

As part of the reeducation, Kupfer said his group has hired a research coordinator to police its efforts. What’s more, Kupfer said Chest has given his group a three-year publishing ban. Richard Irwin, the journal’s editor, declined to talk with us about the matter.

At least one website flagged the 2011 paper as problematic. PulmCCM.org had this to say last March:

Kupfer et al looked retrospectively at 168 vented patients with transudative pleural effusions at Maimonides in Brooklyn. The half that got chest tubes (with an average of 1,200 mL drained) spent 3.8 days on the vent, vs 6.5 days for the group that got only thoracentesis, with no complications reported. That’s interesting, but concluding and titling the paper “Chest Tube Drainage of Transudative Effusions Hastens Liberation from Mechanical Ventilation” without a randomized trial seems a bit, well, hasty.