Sunday, August 14, 2011

"A scar on the moral body of science"

Within an article in the Wall Street Journal, GAUTAM NAIK asserts that the level of fraud in science papers has increased. Naik did not mention the well-known frauds of Jan Hendrik Schon and Hwang Woo Suk, but did get into the paper in Lancet by Naoyuki Nakao, which asserted benefits in treating hypertension with a combination of an ACE inhibitor and an ARB. As background, IPBiz notes Captopril was the first ACE inhibitor; others include Quinapril (one tradename: Accupril) and Lisinopril (Listril/Lopril/Novatec/Prinivil/Zestril). ARBs (angiotensin receptor blockers) include Valsartan (one tradename Diovan) and Losartan (one tradename Cozaar). [In passing, Metoprolol (Toprol) is is a selective β1 receptor blocker]

The WSJ article got to the science point: High blood pressure can lead to kidney damage, and each of the two common drugs reduces a sign of impending kidney disease—the loss of protein through the urinary system.

A Japanese researcher, Naoyuki Nakao, wondered if using both drugs at once would be even better at reducing this sign of kidney trouble.

And of the relevance to everyday life, the WSJ noted: The Lancet published his study, dubbed "Cooperate," in January 2003. It jumped to the No. 2 spot among the most-cited papers published by the Lancet that month and created a buzz at medical conferences.

Doctors increasingly prescribed the dual therapy. By 2008, about 140,000 patients in the U.S. were on it, according to SDI, the research firm.

But some scientists thought the results were too good to be true and urged in 2006 that Lancet look into the matter. By December 2006, an independent reviewer informed Lancet: "it was impossible to tell whether data in the [original paper] were the result of fraud or incompetence." In May 2008, the Lancet published a "letter of concern" from the concerned scientists of 2006. In October 2009, Lancet retracted the paper published in January 2003. By the time of the retraction, issues arose about potential harm to patients who got the combination therapy asserted to be beneficial in 2003.

In the Nakao matter, the initial red flags arose from third party scientists who were skeptical of the high level of benefits, not from the peer reviewers. In both the Jan Hendrik Schon fraud and the Hwang Woo Suk fraud, the initial tips of the fraud came from insiders, who tipped off third parties. Also, there were patent applications involved in the Schon and Suk frauds, but there seem to be no PCT patent applications to Naoyuki Nakao.


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