After court verdict, BMJ retracts 26-year-old paper

Today, The BMJ retracted a 1989 paper about the role of breastfeeding and formula in infant eczema — 20 years after the data were called into question by a university report.

However, the report was kept secret — due, by some accounts, to alleged threats of a lawsuit. That is, until this year, when author Ranjit Kumar Chandra — who once dubbed himself the “father of nutritional immunology” — lost a $132 million libel case. That case, against the Canadian Broadcasting Company (CBC) for airing a three-part documentary series on allegations of fraud against Chandra, pushed the report by his former employer Memorial University of Newfoundland into the public domain.

At 26 years, the BMJ retraction is a runner up for the longest amount of time a journal has taken to retract a paper. (We know of another retraction that was 27 years in the making, and a scientist who requested the retraction of some passages of a 1955 article in 2007, after the article became fodder for creationists.)

Here’s the first part of the retraction note:

On 28 October 2015, The BMJ retracted this article, published in 1989: Chandra RK, Puri S, Hamed A. Influence of maternal diet during lactation and use of formula feeds on development of atopic eczema in high risk infants. BMJ 1989;299:228-30.

The BMJ has retracted the article after receiving a copy of an inquiry into the research of R K Chandra, which was conducted by the Memorial University of Newfoundland and completed in August 1995. The university did not publish the inquiry report at the time. Nor did it notify the editors of journals that had published articles by Chandra that were considered in the report. The BMJ obtained a copy of the report when it came into the public domain as a result of Chandra taking and losing a legal action against the Canadian Broadcasting Corporation (CBC), which aired television programmes about Chandra in 2006.

The note includes quotes from the university report:

The inquiring committee experienced great difficulty with its work, but its final conclusion was that “scientific misconduct has been committed by Dr Chandra.”

It looked at three studies and found that:

“absolutely no raw data (or files) of any kind were exhibited”

“the Committee cannot identify anyone who did the recruiting, cannot identify anyone who did or remembers a significant amount of work”

“the coauathors had little or very likely nothing to do with the work”

“it is unbelievable that there are essentially no hospital records to support the study in question”

“the committee cannot accept that the Carnation study was done anywhere near to completeness or with the accuracy reported in the Annals of Allergy and Journal of Clinical Nutrition, For that matter, the same can probably be said for the Mead Johnson work published in the British Medical Journal.”

The note concludes with results from the journal’s inquiries about why the report was initially not released:

When asked by The BMJ in 2015 why it had not published the report in 1995, Memorial University of Newfoundland said that the report “was the product of a flawed investigation process and could not be relied upon.” In the CBC programmes, however, a university spokesman said that the university had not acted on the report because of legal threats from Chandra.

The university further told The BMJ: “In the spirit of being helpful, we acknowledge that over the years serious questions have been raised about the 1989 publication, leading to much controversy. If [The] BMJ decides to retract the paper on the basis of evidence apart from the findings of the 1995 report, then we would understand your decision in this regard.”

The BMJ is retracting the paper because of the 1995 report, and because of the convincing evidence given in the CBC television programmes and the court case that the work of R K Chandra is not to be trusted.

The BMJ study followed 221 infants who were at high risk of eczema. The paper concluded that breastfeeding moms should restrict their diets, and those giving formula should stick to hydrolysate forms, both of which were linked to lower rates of the condition. The BMJ published the paper the same year that Chandra was inducted into the Order of Canada. It’s been cited 156 times, including 123 times since the beginning of 1995.

It’s worth noting that back in 1995, retractions were more rare than they are now: In 1995, there were roughly 35 retractions; in 2010, the number rose to at least 400.

These days, of course, they’re common enough to fill this blog. But this retraction is still so notable that, along with the retraction note, The BMJ has rolled out coverage of the surrounding issues: an editorial titled “A major failure of scientific governance,” and a feature titled “Ranjit Chandra: how reputation bamboozled the scientific community.” (Go read the whole thing, it’s fascinating.)

The BMJ paper was among the publications flagged by the CBC documentary in 2006. We asked Richard Smith, the former editor in chief of The BMJ, why the journal didn’t act on the paper sooner, perhaps with an Expression of Concern. He told us that the journal was not aware of problems with the paper until the recent court case:

The BMJ didn’t know about the 1995 report until the court case. We then asked the university for a copy. It wouldn’t give it to the BMJ, but it got a copy through the court. Once the editor read it she decided on retraction, but it seemed to make sense to retract at the same time as the BMJ published the editorial and feature article.

The BMJ asked Memorial University why they did not disseminate the report. The repeated response, which Smith forwarded us, was that the report

was the product of a flawed investigation process and could not be relied upon.

Here’s a PDF of the 1995 report, minus the appendices. The BMJ feature shares some highlights:

This report drew on expert opinion and the testimony of many witness statements but not on Chandra’s raw data because he threw these away after publication.

The report concluded that “scientific misconduct has been committed by Dr Chandra in this matter” and highlighted the “remarkable lack of communication and openness” in Chandra’s research environment, including with his coauthors.

“Dr Chandra’s research activity was very much operated as a pyramid system where only one person at the top had access to all the final raw data,” said the report. “The research personnel functioned mainly as physician-technicians and had, or were shown, little insight into experimental objectives, design, and procedures.”

The editorial, co-authored by Smith and the current editor in chief Fiona Godlee, notes that The BMJ first became suspicious of Chandra 15 years ago:

The BMJ started the process that led to the Canadian programmes when in 2000 it asked Chandra’s university, the Memorial University of Newfoundland, to investigate a study submitted to the journal that the editors thought might be fraudulent.

No action came as a result:

The university said there was no problem with the study Chandra had submitted. The BMJ asked the university what form its investigation had taken and was eventually told that Chandra had resigned from the university and left the country and that the university could do no more. It did not mention its earlier investigation.

There may be more news to come, they note:

Despite Chandra losing the trial, the university and Canadian authorities have still taken no action. The BMJ asked the university to release the report on its investigation from the 1990s, but it has declined, repeating that the investigation process was flawed but not saying why. The BMJ also put 20 questions to the university, but it has declined to answer most of them (the questions and available answers are provided as a data supplement). The university has said, however, that a long process is nearing completion and that there may be news within months. Now that the report from the 1990s is in the public domain, The BMJ has sent copies to the editors of journals that published the relevant studies; it has also sent a copy to the Lancet, suggesting that it look further at its 1992 paper that reported on the same study as the paper retracted from Nutrition.

We’ve contacted Memorial University to get its side of the story.

The feature quotes Smith, who proposes a course of action for Chandra’s studies:

We might need to post expressions of concern about all of [Chandra’s studies], or publish a note or editorial saying that we can’t be sure this research is OK, and retract those looked at in more detail.

That could add up to a lot of expressions of concern; Chandra is now the Chairman of a pharmaceutical company in India called Peridot, and his bio on their website notes how extensively he’s been published:

He has authored over 200 original articles in peer-reviewed publications [such as Science, Lancet, JAMA, PNAS] and 22 books.

Update 10/29/2015, 9:40 am: 

Although I appeared in the documentary, I must confess that I never, as is my custom, watched it. Nor did anybody else from the BMJ.

Here’s a full confession.

I first became aware of the problem when I read the transcript in preparation for the court case in the summer. I realised then that the BMJ needed to do something about the study–but I read the transcript on the train and forgot about it until the court case. We then waited for the case to be finished before asking MUN for the document.

And Memorial University has posted an official response:

Dr. Richard Marceau, Memorial’s vice-president (research), has responded to a request for information from the British Medical Journal (BMJ) about the case of Dr. R.K. Chandra.

Dr. Chandra is a former faculty member at Memorial’s Faculty of Medicine.

The BMJ said it has been investigating Dr. Chandra’s research since 2000.

In an editorial published Oct. 28, 2015, the BMJ states that it has retracted an article written by Dr. Chandra and published in 1989.

Dr. Marceau said Memorial University is confident that its current policies and procedures for preventing, investigating and, if necessary, punishing research misconduct meet the highest possible national standards.

“Memorial University has established a number of policies and procedures that ensure the highest standards of ethical conduct and scholarly integrity are understood and practiced,” he said.  A selection of these policies are outlined in the letter to the BMJ.

“The concerns raised by BMJ over the years in relation to Dr. Chandra’s research underscores the importance of strong institutional processes for addressing allegations of research misconduct,” he said. “We are confident those processes have been put in place at Memorial.”

Dr. Marceau said he regrets that Memorial did not partner with the BMJ to achieve a timely and effective response to the journal’s concerns. He added that the university wishes to be as helpful as it can in addressing events that occurred more than 25 years ago in connection with a faculty member who left the university more than a decade ago.

The university also posted a letter sent to The BMJ editor in chief, Fiona Godlee, in September. In that, they reaffirm that the 1995 report was “the product of a flawed investigation process:”

In view of the foregoing, I must reaffirm the position communicated in the President’s correspondence to you dated August 20, 2015, wherein he advised that the University had made a determination twenty years ago that the 1995 report of the Committee that investigated an allegation against Dr. Chandra was the product of a flawed investigation process and could not be relied upon. He further noted that it would be inappropriate to accommodate BMJ’s request for release of this report. However, in the spirit of being helpful, we acknowledge that over the years serious questions have been raised about the 1989 publication, leading to much controversy. If BMJ decides to retract the paper on the basis of evidence apart from the findings of the 1995 Report, then we would understand your decision in this regard.

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