Professor Williamson makes a valid point about the term "research fraud" and I agree that the term covers a number of different categories of unethical behaviour. I also pointed out that "Research fraud can take many forms" in the discussion section of my paper. For the purposes of my article I stated that consultants who had answered "Yes" to questions 1,2 or 3 of table 1 had reported "observed misconduct" and I stand by this conclusion. The dictionary on my bookshelf (Concise Oxford Dictionary (6th Ed.)) defines "misconduct" as "improper conduct, esp. adultery; bad management" and I think that what the consultants were reporting in the questionnaire fits this definition. The same dictionary includes in its definition of "fraud" the phrases " use of false representations to gain unjust advantage" and "person or thing not fulfilling expectation or description". The behaviour described in questions 1,2 and 3 (i.e. inappropriate authorship, omission of names of contributors who made a substantial contribution, and the intentional alteration of data for publication) fits this definition. In the article I tried to use the term "fraud" as a more general term than "misconduct" and I apologise if this caused confusion. However, I think that the majority of readers (and certainly the majority of my colleagues) would have had something approaching the above definitions in mind when they read the article (although several colleagues have told me to get a more up to date dictionary!). Whilst I acknowledge that Prof. Williamson makes a valid point, I do think there is a danger of any rational discussion becoming bogged down in semantics and I think that it is clear from my article what the initial data was and how I have derived my variables.

Prof. Williamson dismisses the medical consultants (not cleaners!) who answered yes to questions 1 and 2 as having "more often delusions of grandeur" on their part. That is a point of view - but I suspect the majority of respondents to my questionnaire do not share it. Indeed I think his attitude risks sweeping a very real problem under the carpet and, whilst I am aware of attempts to standardise authorship, I think this is a problem which requires further investigation.

I find the overall tone of this letter and phrases such as "into fairyland" and "give me a break" inflammatory and this, unfortunately, distracts from some valid points.

The main criticism of Prof. Williamson appears to be that he has learnt nothing new from my paper. The original idea for this study came after a lively discussion in a bar about the prevalence of research fraud (a subject of which I knew very little). After this discussion I did a literature search and could find only a few references to research fraud and misconduct. I decided to perform the study in an attempt to answer the questions I had. I wish that Prof. Williamson had been present at the original discussion - he could have saved me a lot of trouble! On a more serious note, I am sure that the Professor is aware that in the "hierarchy of evidence" questionnaire surveys rank higher than anecdotal evidence and personal experience (although only just!). The value of my article is that it adds evidence to a subject in which there is a marked paucity of hard facts.

I am sorry that Prof. Williamson was unimpressed with my paper. Unfortunately, the very nature of the subject of research fraud/misconduct mitigates against good quality research. I am sure that readers would welcome any double-blinded RCTs on the subject and, if the Professor wishes to carry out some research in this area I am sure that the scientific community would welcome it.

Yours sincerely,

Dr David Geggie BSc, MBChB, FRCS(Eng)

I was not impressed by Dr Geggie’s article offering a survey of the attitudes of newly appointed consultants towards research fraud (J. Med. Ethics 2001; 27:344-346). Indeed, by mixing up categories of misconduct from what is at most “bad behaviour” to the very serious, he is not entirely beyond reproach himself. I remind readers that Dr Geggie suggested that 55.7% of the respondents had observed (from the title) “research fraud”.

If the term “research fraud” is to have any meaning, it must be reserved for conduct that consciously and deliberately attempts to impose a fraud on others. The U.S. National Academy of Sciences report “On Being a Scientist: Responsible Conduct in Research” distinguishes clearly between “misallocation of credit, honest errors and errors caused through negligence” and “deception, making up data or results, changing or misreporting data or results, and plagiarism”. The former are “ethical transgressions … that generally remain internal to the scientific community .. dealt with locally through peer review, administrative action and the system of appointments and evaluations”. The latter “strike at the heart of the values on which science is based”. The White House’s Office of Science and Technology Policy reached similar conclusions, restricting research misconduct to “fabrication, falsification and plagarism”. I agree with these assessments.

In Dr Geggie’s paper, deception would include deliberate falsification of data (category 3 of Dr Geggie’s table 1), cheating (4A) and deliberately plagiarising without attribution (4D). We then move into fairyland, because Dr Geggie next asks “have you ever been an author on a paper for which any of the authors have not made a sufficient contribution to warrant credit for the work” or “has your name ever been omitted from a paper for which you had made a substantial contribution”, and, surprise, surprise, over half answered yes. These are examples of, at worst, ethical transgressions (but more often examples of delusions of grandeur on the part of the offended) but are not research fraud.

Those of us who run large research groups know from experience that authorship of any paper poses problems. I have never met anyone, from the cleaner to the director, who undervalued his/her own contribution to the work! The issue arises with such consistency that many labs (including my own) have long documents on how to resolve the problem of who goes on, and who stays off, the authors’ list. But research fraud? Give me a break!

Of those who responded, approximately 10% had personal knowledge of research fraud, and 5% at most (it is not possible to tell if there is overlap between those answering different questions) admitted to acts that could be regarded as research fraud. This corresponds to my own experience. I have spent more than 40 years in human molecular genetics, a very competitive field, of which 25 years has been spent running very large groups. I know the work of over 1000 scientists well. I have personal knowledge of one case of serious research fraud and perhaps three or four cases where the reporting of data was so careless as to verge on misconduct (though without intent to commit fraud). I also know of one case of plagiarism. To blur the boundaries between “research fraud”, “research misconduct”, “possible future misconduct”, and complaining about not getting your name on a paper does no one any good, and certainly does not help any rational discussion about research ethics.

Bob Williamson, MCRI

Sir,

Could I make a request of the newly installed editor, whose first editorial is titled 'Future directions of the journal'? A direction I would not wish to see is towards more and more abbreviations. They serve little purpose other than to save printer's ink. [1] Looking through volume 27, issue 3, there are a number of abbreviations better replaced by the parent phrase or a contraction of it. Embryonic and fetal tissue transplantation can be referred to as 'transplantation' on later occurrences, instead of the awkward EFTT. There is no reason why Parkinson's disease should not be written out each time in full; in other contexts PD means peritoneal dialysis. A topic so central to medical ethics as informed consent must not be contracted to ICP, which in the article stands for informed consent from patients, but is more commonly intra-cranial pressure. Apart from its explanation on first use, AMI for acute myocardial infarction was used only once.

It probably makes sense to use abbreviations for public bodies (eg, NHS, RECs, PCGs, PCTs), and for abbreviations that are familiar throughout medicine (eg, AIDS: although it is SIDA in French). There are some phrases that repeat awkwardly, contract uneasily, and whose abbreviations (eg, QALYs, CPR, DNR) are probably well enough known that readers will not have to try to remember them just for the one article. But otherwise they impede, rather than improve, communication.

To use examples from the new editor's own article, [2] they also generate nonsense. Savulescu writes of "LTOP of pregnancies" and "ETOP of early pregnancies". I am sure he would not have done this if, instead of using the unnecessary abbreviations LTOP and ETOP, he had used the phrases "late termination" and "early termination".

References

(1) Goodman NW, Kay C. Abbreviations impede communication. British Journal of General Practice 1998;48:1204-1205.

(2) Savulescu J. Is current practice around late termination of pregnancy eugenic and discriminatory? Maternal interests and abortion. Journal of Medical Ethics 2001;27:165-71.

Neville W Goodman DPhil FRCA Consultant Anaesthetist Southmead Hospital North Bristol NHS Trust Bristol BS10 5NB