Paper used to support WHO guidelines on preventing infections “has no scientific validity”

A surgery journal retracted a 2014 paper last month after discovering that the study has “no scientific validity.”

Mario Schietroma and his coauthors, based at the University of LAquila in Italy, reported that giving patients high concentrations of oxygen during and after colorectal surgery significantly reduced their risk of infections. Although the authors reported significant p-values, the retraction notice states that, “upon recalculation, no p-values were close to significant.” The University of LAquila told Retraction Watch it is investigating, but did not provide details.

The 2014 study in The American Journal of Surgery was one among 11 cited in a World Health Organization analysis used to support its 2016 guidelines recommending supplemental oxygen to prevent surgical infections in adults. (A 2012 paper from the authors was also part of that analysis.)

This is not the first time the statistical analysis in Schietroma’s work has been called into question. Last year, the Journal of the American College of Surgeons retracted a 2015 paper after confirming “the statistical results are incorrect and the data do not support the conclusions of the article.” A few months later, a JAMA journal issued an expression of concern for a 2013 paper after discovering “substantial overlap” with the retracted 2015 paper; the JAMA editors called for the University of LAquila to conduct a formal investigation into the team’s work. Schietroma has had two other papers retracted—one last year and one in 2013—due to “similarities” to previously published work.

Paola Inverardi, rector of the university, told Retraction Watch:

We are still investigating, we will send you the conclusions of the investigation as soon as available. Please take into account that in order to verify the correctness of the research we need to interact with other institutions and this takes time. Moreover we need to follow strict procedural protocols that need to guarantee both our institution and the investigated researcher.

We asked Inverardi who the researcher being investigated is but she did not respond.

Here’s the retraction notice for “High-concentration supplemental perioperative oxygen and surgical site infection following elective colorectal surgery for rectal cancer: A prospective, randomized, double-blind, controlled, single-site trial:”

This article has been retracted at the request of the Editor-in-Chief and Editorial Board of the journal. The study was reviewed by a statistician and a committee of senior editors of the American Journal of Surgery and was found to suffer from a lack of statistical significance of the findings, despite significant p values reported in the tables. Upon recalculation, no p-values were close to significant. The study thus has no scientific validity to support the conclusions of the paper published in AJS and will be retracted.

The paper has been cited 15 times, according to Clarivate Analytics’ Web of Science.

Schietroma told us that he was not given an opportunity to respond to the journal’s concerns before learning the paper was going to be retracted; he said he disagrees with the retraction but did not clarify why nor elaborate on the alleged issues with the analysis. Last year, Schietroma acknowledged he may have misinterpreted the statistical data in the 2015 Journal of the American College of Surgeons paper, though said the issues likely did not extend to the JAMA paper.

Schietroma said that, going forward, his team plans to have an independent statistician “check our data before the submission of articles.”

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