This Week
PIC OF THE WEEK
AUSTRALIA A 15-minute eye operation to insert a tiny tube— slightly thicker than a human hair— to relieve eye pressure is being touted as a safe and effective way of treating glaucoma, the most common cause of irreversible blindness. Once inserted, the Australian-invented 6mm-long collagen device typically can’ t be seen or felt, and patients are generally back to daily activities within a couple of weeks. Trabeculectomy, the traditional mode of surgery for glaucoma, takes 60 minutes, requires 14 post-surgery hospital visits and can leave vision blurry for six weeks.
Photo: Tony Gough / Newspix
Journal Talk
Brett Evans
SNAPSHOT
Source: RACGP Technology Survey 2016
Nothing random about this fraudbuster
IF you’ re a medical researcher who’ s been tempted to fiddle the figures in desperation to get your work into a top-notch journal, then Dr John Carlisle is coming to get you.
Dr Carlisle, a consultant anaesthetist at Torbay Hospital in the UK, is the person who helped to expose Japanese anaesthesiology researcher Dr Yoshitaka Fujii.
Using statistical analysis, Dr Carlisle helped to reveal that data sets underpinning 168 papers published by Dr Fujii were probably concocted. This led to Dr Fujii receiving one of science’ s more dubious honours: a record 182 of his papers had to be retracted.
Now Dr Carlisle is back with a turbocharged version of his data fraudbusting method.
But this time, rather than focus on a single researcher, he has examined 5000 randomised controlled trials published in eight leading medical journals, including the Journal of the American Medical
Association and the New England Journal of Medicine.
The vast majority of RCTs survived the Carlisle test. But in 98 papers, Dr Carlisle’ s method found that the probability their data sets having been genuinely randomised was smaller than one in 10,000— the P-values were less than 0.001.
In 43 papers, the probability of the data being randomised was far more remote— the P-value was smaller than 1 in 10 15.
When it was published in the journal Anaesthesia, Dr Carlisle’ s paper was examined by five peer reviewers and a team of lawyers. The concern was that the researchers behind the suspect papers could be unfairly accused of fraud. As Dr Carlisle himself acknowledged, the P-values might have been the result of a simple mistake, such as a misplaced decimal point.
It is for this reason that the 98 papers have not been publicly revealed.
Australian anaesthetist Dr John
OK COMPUTER More than 70 % of GPs are satisfied with the way they use technology for patient-related work, according to a RACGP survey.
98 % have access to a desktop computer
66 % recommend health apps to patients
Loadsman, from Sydney’ s Royal Prince Alfred Hospital, is one of Dr Carlisle’ s fans.
He says the so-called‘ Carlisle method’ could act as a deterrent to potential fraudsters, in the same way that plagiarism-detecting software is used in scientific publishing.
Identifying data fraud is important because there are real-world consequences, he says, such as metoclopramide being excluded from postoperative nausea and vomiting protocols because of Dr Fujii’ s research.
“ The harm in that particular instance is likely to be very small. It just means there was one particular drug that we didn’ t use. But [ as a result of the fraudulent work ] we have been treating patients based on fraudulent data,” Dr Loadsman says.
“ It’ s a new and potentially useful tool, but it’ s going to take a lot of thought and practise to work out where it’ s going to fit in the scheme of things”, he says. Anaesthesia 2017; online.
40 % use secure messaging programs
25 % use social media for work
QUOTES OF THE WEEK
“ There’ s a whole lot of pressure on them. Let’ s face it, it’ s a highpressure job.”
NSW Minister for Health Brad Hazzard endorses young doctors taking the occasional‘ mental health’ sick day.
“ I’ m aware of specialists who state that this particular procedure has effectively bought them their Porsche.”
SA Senator Stirling Griff asks a Senate Estimates committee why MBS costs for musculoskeletal ultrasound-guided injections have increased
56-fold.
“ If all the men are being called‘ Dr Jones’ and all the women by only their first names, that’ s offensive.”
Mayo Clinic researcher Dr Sharonne Hayes reveals why she is sick of being introduced by her first name at conferences.
“ I note that the doctor involved has said he is leaving to advance his career, that’ s a decision we respect.”
Tasmanian Premier Will Hodgman laments the resignation of Dr Kurien Koshy, the only full-time neurologist in the state’ s north.
www. australiandoctor. com. au 7 July 2017 | Australian Doctor | 33