After retracted study’s cited, editors ask, “time to add scientific integrity to the downside of print on paper?”

As we — and others — have written, retracted articles don’t necessarily creep off to some little island somewhere never to be heard from again. After all, the electronic versions of about a third of retracted papers aren’t marked as retracted. Sometimes, like Napoleon, those papers return from exile to wreak havoc: They get cited as if they had never been retracted.

To wit: The Journal of Neurosurgical Anesthesiology has published a letter to the editor regarding a 2012 article by a group of Italian researchers. The topic of the paper in question was “Perioperative pregabalin for postoperative pain control and quality of life after major spinal surgery.”

That happens to have been an area of interest for one Scott Reuben, a Massachusetts anesthesiologist and pain specialist turned federal inmate who was, for a brief while anyway, the unofficial record holder for most retractions by a single author. Before he was eclipsed by another anesthesiologist, Joachim Boldt. Before he was eclipsed by a third anesthesiologist, Yoshitaka Fujii. (In fact, we can’t really say Reuben was the record holder because, although he has more than 20 retractions to his name, we started this blog in the wake of his misconduct and so have a rather limited time horizon.)

Sure enough, the Italian group cited one of Reuben’s retracted papers on the treatment of pain after spine surgery, a 2006 article titled “The analgesic efficacy of celecoxib, pregabalin, and their combination for spinal fusion surgery,” which appeared in Anesthesia & Analgesia.

That prompted the following letter from David Polaner, an anesthesiologist at the University of Colorado:

I was very interested to read the paper by Gianesello et al on the use of pregabalin to attenuate postoperative pain and improve the quality of life after spine surgery. I am surprised and concerned, however, that one of the citations in the manuscript (and one that is commented on at some length in the discussion) was a paper by Reuben and colleagues that has been retracted. The increased visibility of fraudulent, falsified, or unethically conducted studies appearing in the medical literature in recent years has been sufficiently discussed and needs no further comment; however, we as authors, investigators, and editors need to be vigilant that we do not taint our own properly conducted research by citing the work done by others that has been discredited.

In response, the editors of the JNA — James Cottrell and John Hartung — wrote of a key weakness in the defenses against these invidious returns: Paper journals on bookshelves and in library stacks that gather dust but don’t update.

We agree completely with Dr. Polaner’s concern, and we wish to raise an additional concern: does the accelerating rate of retractions mean that readers (authors, investigators, editors, reviewers, and regular readers alike) should stop accessing medical journals by pulling off printed versions from the shelves? Unlike PubMed versions, print versions are not accompanied by retraction notices or reference to follow-up commentary. In addition to environmental concerns, is it time to add scientific integrity to the downside of print on paper?

Perhaps. But while we’re not arguing for killing more trees, it’s not clear how the Italian group accessed the retracted Reuben article. If it was indeed a paper copy, a watermarked electronic version — which this one was — wouldn’t have done much good. But if it was a PDF downloaded before the study was retracted, just to sit in someone’s personal repository, that wouldn’t have helped, either, whether or not a dead tree version was buried in the stacks.

At the end of the day, it’s not the presence of an outdated version that leads to problematic citations, it’s whether or not authors check the most recent electronic version — a task with which CrossMark, as we’ve suggested elsewhere, can help.