When economist Jason Hockenberry looked at data comparing some of the financial issues facing different U.S. hospitals, he was surprised by what he saw.
Hockenberry was examining the effects of a recently introduced U.S. program that penalizes hospitals with relatively high rates of readmissions for certain conditions by reducing Medicare payments. Although Hockenberry expected hospitals that serve low-income and uninsured patients to have more readmissions (and therefore more penalties), he saw these so-called “safety-net hospitals” had been steadily improving their performance since the program began in 2012, and had faced fewer penalties over time.
The results were so striking, they ended up in JAMA on April 18, 2017. But within one week after publication, Hockenberry learned outside researchers had raised questions about the analysis.
The outside researchers thought the authors had incorrectly categorized some of the safety-net hospitals. After looking into their concerns, Hockenberry — based at Emory University in Atlanta — realized the analysis did contain errors that affect the findings. This week, he and his co-authors retracted the article, replacing it with a corrected version. The new paper still reports that the gap between the penalties faced by safety-net and non-safety-net hospitals is closing — but not for the reasons they initially thought.
Last week, JAMA issued some unusual notices, letting readers know they should use caution when reading an editorial and letters associated with now-retracted articles by a bone researcher in Japan.
The notices — for papers by Yoshihiro Sato, now up to 14 retractions — remind readers not to heed the results of the now-retracted papers, and alert them to read any associated materials (specifically, an editorial in JAMA and letters in JAMA Internal Medicine) with caution.
The text of the notices describes them as “formal correction notices;” we asked Annette Flanagin, executive managing editor at The JAMA Network, why they chose that approach, instead of an expression of concern or retraction:
A few months ago, a researcher told Evelien Oostdijk there might be a problem with a 2014 JAMA study she had co-authored.
The study had compared two methods of preventing infection in the intensive care unit (ICU). But a separate analysis had produced different results.
Oostdijk, from the University Medical Center Utrecht in The Netherlands, immediately got to work to try to figure out what was going on. And she soon discovered the problem: The coding for the two interventions had been reversed at one of the 16 ICUs. This switch had “a major impact on the study outcome,” last author Marc Bonten, also from the University Medical Center Utrecht, wrote in a blog post about the experience yesterday, because it occurred at “one of the largest participating ICUs.”
When Oostdijk and a researcher not involved in the study analyzed the data again, they discovered a notable difference between the revised and original findings: The new analysis revealed that one of the interventions had a small but significant survival benefit over the other.
Oostdijk and Bonten, who supervised the re-analysis, notified their colleagues of the revised study outcomes and contacted the journal requesting a retraction and replacement, which was published yesterday in JAMA.
Authors have retracted a JAMA article summarizing the evidence behind the benefits of a supplement, after the systemic review upon which it was based was withdrawn.
The 2014 paper, “Oral Zinc for the Common Cold,” drew from a 2013 Cochrane Review, considered the gold standard for rigorous analyses of clinical treatments. That Cochrane review was withdrawn last year, a decision that the editors upheld this past September. Both were co-authored by Rashmi Ranjan Das, of the All India Institute of Medical Sciences, in Bhubaneswar, and Meenu Singh, of the Post-Graduate Institute of Medical Education and Research, in Chandigarh, India.
Although previous research has suggested peer reviewers are not influenced by knowing the authors’ identity and affiliation, a new Research Letter published today in JAMA suggests otherwise. In “Single-blind vs Double-blind Peer Review in the Setting of Author Prestige,” Kanu Okike at Kaiser Moanalua Medical Center in Hawaii and his colleagues created a fake manuscript submitted to Clinical Orthopaedics and Related Research (CORR), which described a prospective study about communication and safety during surgery, and included five “subtle errors.” Sixty-two experts reviewed the paper under the typical “single-blind” system, where they are told the authors’ identities and affiliations, but remain anonymous to the authors. Fifty-seven reviewers vetted the same paper under the “double-blind” system, in which they did not know who co-authored the research. We spoke with Okike about some of his unexpected results.
The original paper concluded that in “families who moved out of high-poverty neighborhoods, boys experienced an increase and girls a decrease in rates of depression and conduct disorder,” according to a press release issued by the journal along with the paper (which also got some press attention from Reuters). But part of that conclusion is wrong.