The origins of peer review can be traced back over 350 years to the launch of the Philosophical Transactions of the Royal Society in London, where the founding editor was Henry Oldenburg (seen right). He introduced the practice of sending a manuscript to experts who could judge the quality of science before publication. When journals with high impact factors such as The Lancet or the New England Journal of Medicine (NEJM) publish a paper on an important topic like screening for breast cancer, the scientific community sits up and takes notice. In the era of COVID-19, these two journals have let us down badly.
On 1 May 2020, the NEJM published a paper by Mandeep Mehra, a leading cardiologist at Harvard (seen below left), regarding the impact of blood pressure drugs on COVID-19 patients. Then on 22 May, Mehra published another paper, this one in The Lancet, which concluded that COVID-19 patients taking hydroxychloroquine were more likely to show an irregular heart rhythm – which could result in death. A co-author on both papers was Sapan Desai (seen below right), CEO of Surgisphere, the company that provided the data for the two studies.
Within the past few days, the NEJM and The Lancet have each issued an “Expression of Concern,” noting serious scientific questions with the two papers. Yesterday’s edition of Science described it as “the pandemic’s first major research scandal.” How could this have happened, especially with such prestigious medical journals? Where was peer review? We can only assume that the reviewers – under the pressure of time – did not do their homework properly and ask pointed questions about the source of the data.
James Watson, a professional statistician, has written an open letter to The Lancet – co-signed by 140 scientists, including seven from the University of Cape Town – that questions how any research organisation could have obtained detailed records for so many African patients so rapidly. Another statistician, Peter Ellis, has written a lengthy commentary in which he stated, “I believe with very high probability the data behind that high profile, high consequence Lancet study are completely fabricated.”
Of concern, Lee Wallis, who is head of emergency medicine at the Universities of Stellenbosch and Cape Town, is collaborating with Desai on another COVID-19 study. Wallis is satisfied “that all the necessary ethical and data-ownership requirements have been met.” As highlighted in both The Scientist and The Guardian, Desai and Surgisphere have a chequered past, a fact that should probably have been flagged by the peer reviewers, given the importance of the subject matter. Henry Oldenburg is probably rolling in his grave! [Update: both papers have just been retracted, with the links found here: NEJM and The Lancet].