After saying it would retract an article, Cureus changed its mind

Karen Rech, a hematopathologist at Mayo Clinic in Rochester, Minn., was reading a case report about a rare disease when she recognized the patient. 

Although the authors of the paper were affiliated with the University of North Dakota School of Medicine and Health Sciences in Fargo, the patient in the report had gone to Mayo for care, and Rech had made the pathology diagnosis. But the article, “A Diagnostic Dilemma and Classification Conundrum: Atypical Histiocytic Neoplasm Presenting as a Calvarial Mass,” published in Cureus in February, didn’t mention or credit Rech or her colleagues. 

“The ability to make such a unique diagnosis is a direct result of my translational research in histiocytic neoplasms,” Rech wrote in an email to the journal in April. After she made the pathology diagnosis, a hematologist colleague saw the patient, and a group of specialists discussed the case and came to a consensus diagnosis. 

The North Dakota physicians, who had referred the patient to Mayo, were able to access the Mayo physicians’ clinical notes, laboratory data and pathology reports through the electronic medical record and used the information to produce the case report, Rech wrote. She identified incorrect statements about pathology in the article, too, wording that had come from a Mayo hematology fellow’s clinical note. 

“The case report indisputably represents plagiarism,” Rech wrote. “As such, it should be retracted to maintain the integrity of the medical literature.” 

Initially, the journal’s editors agreed with Rech. But after the authors of the paper objected and the editors asked their institutions to investigate, the journal decided not to retract the article. It remains intact, without any notice. The article has received no citations, according to Clarivate’s Web of Science, which recently paused indexing new content from Cureus for quality concerns. 

In May, Graham Parker-Finger, director of publishing and customer success for Cureus, responded to Rech’s email. He told her the journals’ editor in chief “has determined that this article must be retracted due to plagiarism, the presence of several incorrect statements and the seemingly intentional omission of the pathologists from the author list.” 

The journal would retract the article “by the end of the week,” Parker-Finger wrote. 

But four days later, Parker-Finger wrote to Rech and Laura Nichols, the senior author of the paper and an internal medicine physician at Sanford Health and the University of North Dakota: 

Given the circumstances and details presented by both parties in this dispute, the journal has elected not to proceed with immediate retraction and instead request that formal investigations by each of your institutions be conducted in order to resolve this matter. Upon reviewing the results of both investigations, the journal will take the action deemed appropriate in light of the facts presented.

When Rech reminded Parker-Finger of the reasons for retracting the paper he had sent a few days before, he responded: 

Upon further consideration, the journal is treating this only as a disputed authorship at this time. Should investigations by your respective institutions reveal otherwise, we will determine the proper course of action which may include correction or retraction. However, it is not Springer Nature or Cureus policy to intervene and pick sides in authorship disputes.

In July, Parker-Finger informed Rech Cureus editors had reviewed reports on the dispute from Mayo and Sanford and “have determined that no further action will be taken” on the article. He wrote: 

Upon careful review, and taking both reports into consideration, we have determined that the allegations of plagiarism and scientific inaccuracy lack sufficient merit to warrant editorial action such as a correction or retraction.The journal now considers this matter to be closed. Thank you again for your patience and cooperation in this matter.

Nichols told us she stands by her work and its academic integrity. “When this issue surfaced, we fully cooperated with the journal on their comprehensive inquiry,” she said. “The result of the investigation uncovered no evidence of plagiarism or any academic misconduct, and the article was not retracted.” 

In a letter to the journal editors that she also sent to Rech, Nichols wrote she and her coauthors were “significantly involved in the care and workup of the patient that was the subject of the article.” The team had reached out to the pathology department at Mayo to collaborate on the article but “we did not connect with them,” she wrote. 

“Any physician or practitioner who has cared for the patient may write up a case report as information within the medical chart is considered data and not published literature,” Nichols wrote. She also noted the patient had given permission for the authors to publish the case report. “The patient’s private health information is her information, and she has agency to choose with whom and how her information is shared.” 

“Although the author team agrees that in the spirit of collaboration and collegiality, additional attempts should have been made to connect with the other physicians, we unequivocally state that no plagiarism took place,” Nichols wrote. She suggested “exploring the possibility of a correction to the current article with the addition of an acknowledgement of the outside institution physicians.”

In response to our request for comment, Parker-Finger said: 

As a result of the concerns raised, the journal requested institutions investigate and provide their assessment to us. Upon careful review and after taking the reports from Mayo Clinic and Sanford Health into consideration, it was determined that allegations of plagiarism and scientific inaccuracy lacked sufficient merit to warrant editorial action, such as a correction or retraction. The Cureus Editors-in-Chief determined that no further action was warranted.

Rech left a comment on the Cureus web page for the article describing what happened. “It is detrimental to medical progress in rare diseases when novel findings based on the translational research of experts are published with errors by non-experts,” she wrote. 

She told us: 

When Cureus allowed non-experts to publish on a rare histiocytic neoplasm, they introduced inaccurate information into the literature that is detrimental to medical progress. Further, why would they allow someone to take credit for other physicians’ expertise? A patient searching for an expert in the field will be led to the wrong institution based on this article. We need to advocate for patients with rare diseases, not exploit them for a quick publication.

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