Legal threats once again force corrections over a scale measuring medication usage

Donald Morisky

A journal is warning contributors that they should avoid using a controversial scale for assessing adherence to medication regimens or they might wind up wearing an omelette on their faces.

The chicken here, of course, is the Morisky Medication Adherence Scale. The instrument was developed by a UCLA professor named Donald Morisky, who with a colleague named Steve Trubow threatens to sue anyone who they believe misuses the tool after failing to obtain a license.

As we have detailed on this blog and in Science, many researchers report that Morisky and Trubow seem to set traps for them, ignoring their requests for a license then hammering them with demands for citations, money — often tens of thousands of dollars or more — or both once their work has been published. Failure to comply, the pair assert, could lead to a lawsuit. (Morisky sometimes fails to note his own financial conflict here, as he did in this 2017 paper in PLOS One touting the accuracy of his tool.)

That appears to be the case with a 2016 article in the Journal of Medical Internet Research. The paper, by a group from Harvard led by Timothy Hale, was titled “A remote medication monitoring system for chronic heart failure patients to reduce readmissions: a two-arm randomized pilot study.”

According to a recently-posted correction:

The authors of “A Remote Medication Monitoring System for Chronic Heart Failure Patients to Reduce Readmissions: A Two-Arm Randomized Pilot Study” (JMIR 2016;18(4):e91) have made the following changes to the text, tables, references, and supplemental files.

These changes reflect replacing the Morisky Medication Adherence Scale with the Medical Outcomes Study adherence measure. As the outcomes from the two measures are similar, this change will not substantially impact the interpretation of the findings and conclusions for this study.

The correction notice details the changes, then pivots to an editor’s note that takes a shot or two at Morisky and Trubow while noting that the latest case is the third it has dealt with so far involving the pair:

Authors and journal had to publish this correction due to legal threats by Steven Trubow and Donald Morisky from the company MMAS Research LLC, the copyright holder of the instrument. This is unfortunately not an isolated case, as the developers of this scale are known to comb the literature and ask those who used the scale for research to pay for a retroactive license which may cost thousands or tens of thousands of dollars, and to add references to their work [1]. This is now the third correction JMIR has to publish related to studies using the MMAS instrument.

The Committee on Publication Ethics (COPE) has recently discussed the ethics of this type of behavior by copyright holders of scales (“holding authors to ransom in this way”) and recommends to emphasize “the fact that this is not good for the advancement of scientific knowledge or in the public interest” [2]. As open access and open science publisher we remind our authors of our policies and preference for public and free availability of research tools, including questionnaires [3]. We actively discourage use of instruments which are not available under a Creative Commons Attribution license, and encourage our authors to use or develop/validate new instruments. We continue with our special call for papers for short paper instruments or electronic tools licensed under Creative Commons or available under an Open Source license that can be used as a free alternative to measure medication adherence, and will waive the article submission fee for such development and validation papers.

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