A rheumatologist was suspended from a professional society and his license to practice medicine was threatened after he raised concerns about data manipulation in a published study for which he recruited patients, according to documents seen by Retraction Watch.
The study, “Added Value of Anti-CD74 Autoantibodies in Axial SpondyloArthritis in a Population With Low HLA-B27 Prevalence,” was published in Frontiers in Immunology in 2019 and has been cited 13 times, according to Clarivate’s Web of Science. In its acknowledgements, it listed Fouad Fayad, a rheumatologist at the University of Saint Joseph and Hotel-Dieu de France University Medical Center in Beirut, as one of the researchers who recruited patients for the trial.
Fayad alleged that the researchers tested patient samples multiple times and used a mix of old and new values in their analysis. After he reported his concerns to the journal and then the university, which both concluded that they could not confirm or refute his allegations, he has faced apparent retaliation, including the suspension of his membership in the Lebanese Society of Rheumatology.
In comments to Retraction Watch, the corresponding author for the study noted that the two investigations did not find data manipulation, and said the issue was “based on a background of personal and professional conflicts.”
In an April video recorded with Nassim Nicholas Taleb, a former quant trader and retired distinguished professor of finance and risk engineering at New York University’s Tandon School of Engineering, Fayad explained that he was originally an author on the paper, but after expressing concerns about the methodology to the other authors, they didn’t respond to him and his name was dropped from the author list without warning or explanation.
Taleb also detailed the issues with the study, showing graphs that indicate “very poor correlation” between the old and new test results from participant samples.
In October 2019, Fayad contacted Frontiers in Immunology with his concerns. But the journal’s investigation was inconclusive, and a staffer on the research integrity team told him in July 2020 to contact his institution to investigate, according to emails seen by Retraction Watch.
Fayad did so, but the University of Saint Joseph “rushed an incomplete investigation,” he said. It began in September of 2021 and concluded two months later that the investigation committee could not confirm or disprove Fayad’s allegations of data manipulation, according to a copy of the report seen by Retraction Watch. He said that their statistical reviewer did not receive all of the relevant documents, although he had provided them to the university.
A university official sent the findings from the investigation to the Lebanese Order of Physicians – Beirut, which decided to suspend Fayad’s membership in the Lebanese Society of Rheumatology. It’s “needless to explain the damage resulting from this suspension,” Fayad said.
The Beirut organization wrote to the Lebanese Order of Physicians – Tripoli, the body with which Fayad’s license is registered, informing them of the decision. In a copy of the letter seen by Retraction Watch, the Beirut organization cited the university investigation finding Fayad’s allegations to be invalid, as well as a letter in which he alleged mismanagement of the rheumatology society, as reasons for the decision, and referred the matter to the Tripoli organization for further investigation.
Fayad told us that the letter asking the Tripoli organization to investigate him could have led to the suspension of his license to practice medicine:
My license is registered with the Lebanese Order of Physicians – Tripoli. So legally speaking, it is only Tripoli organization that can suspend my license / permit to practice. Beirut Organization has tried to summon me to their investigation committee, but my license (being registered in Tripoli Organization) does not fall under Beirut’s jurisdiction; in other words Beirut Organization violated the law; they can not approach me directly, they have to go through the Tripoli Organization.
As such, and since Beirut organization could not suspend my license (as they did for my membership in the Lebanese Society of Rheumatology) they sent the letter to Tripoli organization asking them to investigate the matter and take necessary disciplinary action. This was a threat to suspending my license to practice medicine. Should Tripoli Organization have used the [University of Saint Joseph] letter & investigation report without conducting their own international investigation, my permit to practice would have been suspended.
The Lebanese Order of Physicians – Tripoli conducted its own investigation (with multiple expert reviews) and confirmed “the existence of manipulation in the study data and failure to respect the data integrity,” according to an official translation of the investigation report seen by Retraction Watch. The Lebanese Order of Physicians – Tripoli decided after its investigation that Fayad’s suspension from the rheumatology society was invalid.
The lead author of the study in question, Nelly R. Ziade of Saint Joseph University and Hotel-Dieu de France Hospital in Beirut, told Retraction Watch that the investigation by the Lebanese Order of Physicians – Tripoli “cannot be considered as final or official” and that she was “never approached, interviewed or asked to provide any documents related to this complaint.”
She continued:
I will always be available to give any scientific clarification requested by the Order of Physicians in Beirut where a serious investigation giving equal voice to both parties is currently conducted.
Kindly note that the concerned journal has already conducted an internal investigation where both parties provided all documents and it was concluded that there was no scientific foundation for the accusations.
Again, a similar investigation was conducted by the Saint-Joseph University in Beirut (where myself and the other party work). Both parties presented study documents to a committee including the president of the IRB, the vice president of the University, the medical director of the University Hospital, experts in musculoskeletal system and biostatistics. In brief, the case against the authors was dismissed, no data manipulation was found and the colleague from Tripoli also was submitted to University sanctions. The report of the University can be shared with you should you need it.
I’m afraid that this issue is based on a background of personal and professional conflicts.
(Fayad was not sanctioned, but after the university investigation was assigned as the head of Academic Department of the Rheumatology department.)
Fayad added:
The beauty of Science is that the truth will always prevail and cannot be obscured for long time.
Update, 2030 UTC, 8/5/22: Updated to note that Fayad was not sanctioned, as Ziade incorrectly suggested.
Update, 1830 UTC, 8/12/22:
Update: After publication, the president of the Lebanese Order of Physicians in Beirut Youssef Bakhach sent us a statement that said Fayad’s suspension from the Lebanese Society of Rheumatology “was solely based on his disciplinary misconduct towards the LOP bylaws.” It also said:
Dr. Fouad Fayad was registered as a member of the Lebanese Society of Rheumatology (LSR), a Scientific Society exerting under the LOP Beirut bylaws. The LOP board decided to suspend his membership to the LSR as a disciplinary sanction in response to an infraction to the LOP bylaws and unethical conduct.
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Is the lead author bragging about the retaliation?
Why would someone be sanctioned for starting an investigation?