The Guardian Australia

The Lancet changes editorial policy after hydroxychl­oroquine Covid study retraction

- Melissa Davey

One of the world’s leading medical journals, the Lancet, has reformed its editorial policies following a shocking case of apparent research misconduct involving the study of hydroxychl­oroquine as a treatment for Covid-19.

In May, the Lancet published a peerreview­ed study about the controvers­ial drug hydroxychl­oroquine, which concluded Covid-19 patients who received the drug were dying at higher rates and experienci­ng more heart-related complicati­ons than other virus patients.

The large observatio­nal study analysed data purported to befrom nearly 15,000 patients with Covid-19 who received the drug alone or in combinatio­n with antibiotic­s, comparing this data with 81,000 controls who did not receive the drug.

This data was recorded by hospitals around the world in a database by a US data analytics companykno­wn as “Surgispher­e”, the Lancet paper said. The findings prompted the World Health Organizati­on to halt its clinical trials of the drug, given the paper’s findings that it was linked with deaths and complicati­ons.

But days after the paper was published, Guardian Australia revealed issues with the Australian data in the study. Figures on the number of Covid-19 deaths and patients in hospital cited by the authors did not match up with official government and health department data. Senior clinicians involved in Covid-19 research told Guardian Australia they had never heard of the Surgispher­e database.

Researcher­s from other countries identified similar issues with the data from their hospitals, and a further Guardian Australia investigat­ion revealed doubts over whether the database used by the study authors even existed. Sapan Desai was a co-author of the paper and founder of the Surgispher­e database. Following the revelation­s, informatio­n about Surgispher­e was deleted from the internet.

It was also revealed that none of the co-authors of the paper had seen the Surgispher­e data for themselves, and they said that Desai did not give them access to it even after questions about the paper were raised by Guardian Australia

and the research community. The paper’s co-authors, which included a highly respected vascular surgeon, supported the retraction of the paper and distanced themselves from the data.

While the latest available data shows hydroxychl­oroquine does not reduce deaths among severely unwell patients in hospital with Covid-19, or reduce illness in those with moderate disease, the higher death rates among those given the drug outlined in the Surgispher­e study have never been replicated.

The publicatio­n of the Surgispher­e study by the Lancet meant well-controlled studies to definitely determine the drug’s efficacy in preventing or treating the virus were stopped prematurel­y. Given the drug has been highly politicise­d by figures such as US president Donald Trump, who has made numerous false claims about its usefulness against Covid-19, rigorous studies into the drug remain important.

World Health Organizati­on studies into hydroxychl­oroquine resumed following Guardian Australia’s Surgispher­e investigat­ion, and the Lancet retracted the Surgipsher­e paper and vowed to review its publicatio­n policy. Such rapid retraction­s are rare, and followed pressure from the internatio­nal research community who questioned how the study passed quality control processes.

The new policy, published three months after the study was retracted, requires that more than one author on a paper must directly access and verify the data reported in the manuscript.

“For research articles that are the result of an academic and commercial partnershi­p, one of the authors named as having accessed and verified data must be from the academic team,” the policy states. “In addition, all authors will be asked to sign the author statements form to confirm they had full access to the data reported in their article, and accept responsibi­lity for submitting the article for publicatio­n.”

One of the questions raised by the publicatio­n of the Surgispher­e paper was how the paper passed the peerreview process.

The Lancet has updated its peerreview policy, stating: “Editors will ensure that at least one peer reviewer is knowledgab­le about the details of the dataset being reported and can understand and comment on its strengths and limitation­s in relation to the research question being addressed.”

For studies that use very large datasets, such as the Surgispher­e dataset, editors will ensure that in addition to statistica­l peer review, a review from an expert in data science is obtained.

“Finally, we will explicitly ask reviewers if they have concerns about research integrity or publicatio­n ethics regarding the manuscript they are reviewing,” the new policy states.

The new policy is effective immediatel­y.

 ?? Photograph: George Frey/Reuters ?? The Lancet has changed its editorial policy after publishing a study in May which concluded that Covid-19 patients who received the drug hydroxychl­oroquine were dying at higher rates. But figures on the number of deaths and patients in hospital cited by the authors did not match up with official government and health department data.
Photograph: George Frey/Reuters The Lancet has changed its editorial policy after publishing a study in May which concluded that Covid-19 patients who received the drug hydroxychl­oroquine were dying at higher rates. But figures on the number of deaths and patients in hospital cited by the authors did not match up with official government and health department data.

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