Talk about missing the trees for the, ahem, forest plots. A researcher is accusing an Elsevier journal of refusing to retract a study that depends in large part on a flawed reference.
The paper, “The effect of Acupressure and Reiki application on Patient’s pain and comfort level after laparoscopic cholecystectomy: A randomized controlled trial,” appeared in early April in Complementary Therapies in Clinical Practice and was written by a pair of authors from universities in Turkey.
The article caught the attention of José María Morán García, of the Nursing and Occupational Therapy College at the University of Extremadura in Caceres, Spain. Morán noticed that what he considered a critical underpinning of the paper was a 2018 meta-analysis (also by authors from Turkey) with a major flaw: According to Morán and a group of his colleagues, the meta-analysis — also in Complementary Therapies in Clinical Practice — showed the opposite of what its author stated. Indeed, they’d made the case to the journal back in 2018, when the meta-analysis first appeared in a paper titled “Misinterpretation of the results from meta-analysis about the effects of reiki on pain.”
Morán said he brought his concerns to the journal, but was brushed off. He then submitted a letter to the editor, which was accepted.
As Morán told us in an email earlier this week:
I have contacted the Editor-in-Chief (Dr. Alyx Taylor) several times and she indicates that intends to make a decision on the matter (I understand to retract the paper). But as you can see the story goes back a long way, the journal was notified of the problem as soon as it was published and they ignored it. The Editor-in-Chief tells me that shares my point of view, hence they have published the second comment, but they continue to do nothing about it. Meanwhile the meta-analysis continues to be cited in the literature and to do irreparable damage to the body of knowledge. In my last communication with the Editor-in-Chief (just yesterday) I have told him that if they do not intend to do anything about it (at least an expression of concern to serve as a warning to readers) I will escalate the problem to the Ethics Department at Elsevier publishing. So far there has been no response.
To be fair, “a long way” in the case of the new article is only about six weeks, so we’re not ready to say the journal has been dragging its yoga mat. And, although it has definitely acted slowly with regard to the 2018 meta-analysis, we applaud the editors for agreeing to publish Morán’s critique, which we reads in part:
[C]omplementary Therapies in Clinical Practice has ignored our efforts to request the retraction of the manuscript for its obvious errors as the meta-analysis is clearly flawed [2] and in no way justifies the conclusion shown in it. The meta-analysis continues to be cited again and again as scientific evidence when it is actually the opposite.
After reiki treatment, the main outcome measured in the meta-analysis is the change in a VAS scale. Comparing the reiki group (n = 104) with the control group (n = 108), the standardised mean difference was found to be − 0.927 (95% CI -1.867 to 0.0124), representing indeed a non-statistically significant result, opposite to what was indicated by the author. The forest plot shown in Fig. 2 of the meta-analysis also represents a non-statistically significant result. Repeatedly the author fails to correctly interpret the forest plot and indicates that Reiki was observed to cause a statistically significant decrease in VAS score, incorrectly. Here, as the vertical line is crossed by the diamond, the overall (combined) result is not statistically significant, meaning that the overall outcome rate in the reiki group is very similar to that of the control group [3]. So it is the case in Fig. 2 of Dogan’s manuscript [2]. Regrettably, the reported results are opposite of the author’s conclusion.
Taylor did not respond to a request for comment.
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