One of my children is irate at my deletion of an important school email. I claim that so many useless emails rain into my inbox that some useful ones will surely be missed. This excuse attracts zero sympathy but prompts me to comb through the hundreds of deleted emails. They are from every part of the world – Lisbon to London, Athens to Ankara – and almost all of them are an invitation to shine at a research publication.
In recognition of your scholarly achievements and contributions to the advancement of knowledge in your field, we request you to submit a research paper on a topic of your choice.
The writer promises expert editorial assistance, rapid publication and professional distinction.
An offer to bridge the gap between science and society sounds interesting until I read that the finely honed editorial process will just need my name, not my time. There’s a follow-up email, “just in case this went to spam”.
Next is an invitation to submit an abstract to a “prestigious conference” (is there another kind?) in return for free nights in (sigh) Vienna. Also, a somewhat testy reminder that I am “intentionally ignoring” an invitation to write an editorial on advances in prostate surgery and a slightly disappointed tone that I have been silent on a 30% waiver on the “article processing fee” for writing about the origins of psychosis, both topics about which I know almost nothing.
There is an intriguing contract to author an entire book on cancer to create “a global legacy” through sales on every platform but the catch for the writer in me is that I don’t need to pen the words that will “accurately depict” my “scientific insights”.
But my favourite might just be the offer of membership to research societies “over a century old” to garner professional recognition through mingling (online) with “similarly distinguished” scientists. This reliably raises my anxiety in the way of Groucho Marx who worried, “I wouldn’t want to belong to any club that would have me as a member.”
With every year, the pace of fraudulent publishing rises. People who must live by “publish or perish”, whose promotion is tied to research output or whose funding is linked to citations are most likely to be swayed by these get-rich-quick schemes.
Ask most medical researchers about fraudulent research and they will insist that it is an isolated thing related to a few bad apples. For most, research and integrity go hand in hand.
But, as an extensive study by Northwestern University states, “large-scale, systematic fraud is happening on an industrial-sized level”. The researchers quote the rising prevalence of paper mills that mass-produce fake or manipulated research papers to academics; brokers who go between academics and publishers; and “predatory” journals whose main aim is to churn out papers regardless of their quality.
According to the researchers, if the doubling time of scientific papers is 15 years, that of fraudulent scientific papers is just one and a half years. They state that at least 400,000 (no, this is not a typo) papers published between 2000 and 2022 are suspect, the vast majority a product of fraud or plagiarism.
I’m an oncologist, so it is their next claim most alarms me. Labelling cancer as the most vulnerable field for fraudulent research, they state: “A huge fraction of the cancer literature is completely unreliable.”
Given the hundreds of types of cancer and the thousands of molecules and combinations used to treat it, it is thought to be relatively easy to pick and choose figures and images to make up a plausible manuscript. The arrival of artificial intelligence has lowered the entry barrier to construct a bogus paper and put it online.
Obviously, even an attentive gatekeeper can be fooled – the world’s foremost journals have been forced to retract publications. But when the people perpetuating fake science are the same people publishing the fake science, what was once a side issue is now a real problem.
How does this affect the average cancer patient?
“I have done my own research” is a statement I hear all too often from my patients. Given a reduced trust in science and funding cuts to trusted institutions, the average patient turning to the internet cannot distinguish evidence from gloss.
Every self-aware oncologist knows that no one is an expert on everything. Some patients who do their own research produce insightful questions and push their doctor to think harder and do better. This is welcome because there is no shortage of the ways in which doctors fail patients, especially when it comes to defending quality of life.
But it is the other patients I worry about. The ones who have read (in an online article allegedly peer-reviewed) that an alkaline diet, light therapy, organic spinach or turmeric has been proven to cure cancer. The ones who paint “neutralising potions” on their visibly enlarging lumps and argue that I am the one who hasn’t seen the latest research. They borrow phrases that sound scientific and mean nothing (“My antibodies are migrating”).
Having exhausted the alternatives and becoming much sicker, they end up needing more extensive and expensive care, a consequence of fraudulent research that affects every taxpayer.
It is easy to dismiss the patients as naive but the fraudulent publishing industry has a lot to answer for. Suggestions to contain the damage include better funding to support good research, vigilance and collaboration from reputable publishers, and raising public awareness about the massive scale of fraud disguised as cancer research.
I will be telling my patients that doing their own research is not a bad thing. But where they do that research needs much more thought than they have reason to imagine.
