Giáo sư Scott S. Reuben, 50 tuổi, là một chuyên gia và giám đốc bộ môn gây mê của Trung tâm Y khoa Baystate (bang Illinois, Mĩ), và trường Y thuộc Đại học Tufts. Ông là một “ngôi sao” trong chuyên ngành gây mê, với những công trình nghiên cứu giảm đau sau phẫu thuật. Ông đã công bố 72 công trình nghiên cứu khoa học trên các tập san y khoa hàng đầu trong ngành gây mê như Anesthesiology, Anesthesia and Analgesia, Journal of Clinical Anesthesia, v.v… Do đó, không ngạc nhiên khi thấy những công trình nghiên cứu này gây tiếng vang và ảnh hưởng đến chuyên ngành gây mê ở Mĩ.
Một trong những lĩnh vực nghiên cứu ông theo đuổi và có ảnh hưởng lớn là “trường phái điều trị đa phương” bằng cách sử dụng nhiều thuốc chống đau để giảm tối đa những phẫu thuật mang tính xâm phạm. Từ năm 2000, bằng các nghiên cứu của mình, ông thuyết phục các bác sĩ giải phẫu chấn thương chỉnh hình sử dụng các thuốc như Celebrex, Vioxx, và Bextra để giảm dau (thay vì sử dụng NSAIDS như trước đó). Ông còn cho rằng phối hợp các thuốc trên và thuốc can thiệp hệ thần kinh (neuropathic agents) có hiệu quả cao hơn thuốc mô phỏng theo thuốc phiện (opioids). Có người cho rằng nhờ những nghiên cứu của Reuben mà những thuốc giảm đau như Celebrex, Vioxx có thị trường hàng tỉ đô-la mỗi năm.
Giới khoa học xem đây là một trường hợp gian lận khoa học lớn nhất trong lịch sử y khoa Mĩ. Thật vậy, hiếm thấy trong lịch sử y khoa có một nhà khoa học nào ngụy tạo số liệu trong một thời gian dài như thế, và nhờ những ngụy tạo đó mà “leo” đến chức giáo sư y khoa! Chẳng những ngụy tạo dữ liệu, giáo sư Reuben còn ngụy tạo cả … tác giả. Theo giáo sư Evan Ekman (chuyên gia phẫu thuật chấn thương chỉnh hình ở Columbia) cho biết tên của ông xuất hiện trong 2 bài báo của Reuben, nhưng ông Ekman chẳng biết gì cả! Thật là hi hữu!
Còn nhớ trước đây, vào năm 2004, tiến sĩ Hwang woo-suk tuyên bố rằng ông đã thành công tạo ra dòng tế bào gốc từ phôi thai nhân bản, đem lại biết bao hi vọng cho bệnh nhân nan y, nhưng đến cuối năm 2005, qua nhiều tháng điều tra chúng ta biết rằng ông chỉ ngụy tạo dữ liệu! Năm ngoái, cũng ở Hàn Quốc, giáo sư Kim Tae kook cũng bị phát giác là ngụy tạo dữ liệu và phân tích dữ liệu trong hai công trình công bố trên tập san Science vào năm 2005 và Nature Chemical Biology vào năm 2006.
Nhìn người lại nghĩ đến ta. Ở VN chưa có trường hợp gian lận khoa học dưới hình thức giả tạo số liệu được phát hiện, nhưng điều này không có nghĩa là các nhà khoa học nước ta đều "thánh thiện" cả. Chợt nhớ đến vấn đề nghiên cứu về chất độc da cam, một nhà nghiên cứu Mĩ nhận xét về các nghiên cứu ở VN đại khái như sau: không hiểu họ làm nghiên cứu như thế nào, mà kết quả lúc nào cũng "positive". Trong khoa học, đặc biệt là y học, không bao giờ có những kết quả hoàn hảo. Chúng ta vẫn hay nghe nghiên cứu A nói uống trà xanh tốt cho xương, nhưng nghiên cứu B cho thấy ngược lại. Hiếm có vấn đề nào mà kết quả nhất quán 100%. Do đó, cách nói của người đồng nghiệp Mĩ là một cách nói lịch sự: "tôi không tin vào nghiên cứu của anh".
Gian lận khoa học xảy ra bất cứ ở đâu và lúc nào. Cái khác là có nước có cơ chế xử lí và qui chế quản lí vấn đề. Còn ở nước ta, theo tôi biết chẳng có cơ chế nào hay qui chế nào để quản lí vấn đề gian lận và vi phạm đạo đức khoa học cả. Đã đến lúc cơ quan chức năng có một cơ chế để giải quyết vấn đề khi chuyện không hay xảy ra.
NVT
Danh sách 21 bài báo của Gs Reuben mà dữ liệu là hoàn toàn giả tạo.
http://www.sciam.com/article.cfm?id=a-medical-madoff-anesthestesiologist-faked-data
A Medical Madoff: Anesthesiologist Faked Data in 21 Studies
A pioneering anesthesiologist has been implicated in a massive research fraud that has altered the way millions of patients are treated for pain during and after orthopedic surgeries
By Brendan Borrell
Over the past 12 years, anesthesiologist Scott Reuben revolutionized the way physicians provide pain relief to patients undergoing orthopedic surgery for everything from torn ligaments to worn-out hips. Now, the profession is in shambles after an investigation revealed that at least 21 of Reuben's papers were pure fiction, and that the pain drugs he touted in them may have slowed postoperative healing.
"We are talking about millions of patients worldwide, where postoperative pain management has been affected by the research findings of Dr. Reuben," says Steven Shafer, editor in chief of the journal Anesthesia & Analgesia, which published 10 of Reuben's fraudulent papers.
Paul White, another editor at the journal, estimates that Reuben's studies led to the sale of billions of dollars worth of the potentially dangerous drugs known as COX2 inhibitors, Pfizer's Celebrex (celecoxib) and Merck's Vioxx (rofecoxib), for applications whose therapeutic benefits are now in question. Reuben was a member of Pfizer's speaker's bureau and received five independent research grants from the company. The editors do not believe patients were significantly harmed by the short-term use of these COX2 inhibitors for pain management but they say it's possible the therapy may have prolonged recovery periods.
Baystate Medical Center in Springfield, Mass., began investigating Reuben's findings last May after its chief academic officer, Hal Jenson, discovered during a routine audit that Reuben had not received approval from the hospital's review board to conduct two of his studies. Reuben "violated the trust of Baystate, the community and science," Jenson says. The story of the investigation was first reported by Anesthesiology News late last month.
Reuben, 50, has been stripped of his research and educational duties and has been on medical leave since May. He received his medical degree from the State University of New York at Buffalo School of Medicine & Biomedical Sciences in 1985 and did his residency at the Mount Sinai Medical Center in New York City. In 1991, he joined Baystate, which serves as the western campus for Tufts University School of Medicine, and has worked as a staff anesthesiologist and the director of acute pain management.
His lawyer, Ingrid Martin of Dwyer & Collora, LLP, in Boston, told ScientificAmerican.com that Reuben has cooperated with the investigation and that he "deeply regrets that all of this happened." She added that "with the [investigating] committee's guidance, he is taking steps to ensure this never happens again." She declined to answer any further questions, and Reuben did not respond to an e-mail request for comment.
Beginning in 2000, Reuben, in his now-discredited research, attempted to convince orthopedic surgeons to shift from the first generation of nonsteroidal anti-inflammatory drugs (NSAIDs) to the newer, proprietary COX2 inhibitors, such as Vioxx, Celebrex, and Pfizer's Bextra (valdecoxib). He claimed that using such drugs in combination with the Pfizer anticonvulsant Neurontin (gabapentin), and later Lyrica (pregabalin), prior to and during surgery could be effective in decreasing postoperative pain and reduce the use of addictive painkillers, such as morphine, during recovery. A 2007 editorial in Anesthesia & Analgesia stated that Reuben had been at the "forefront of redesigning pain management protocols" through his "carefully planned" and "meticulously documented" studies.
Many orthopedic surgeons, however, were slow to adopt COX2 inhibitors due to animal studies that showed short-term use might hinder bone healing. Then, in 2004, Vioxx and Bextra were pulled from the market because of their link to an increased risk of heart attacks and strokes, leaving Pfizer's Celebrex as the only COX2 inhibitor available. Celebrex sales plunged 40 percent after a study that same year suggesting that it, too, posed a heart attack risk. Despite this, Reuben continued to present "findings" in research funded by Pfizer that trumpeted Celebrex's alleged benefits and downplayed its potential negative side effects.
He apparently hoped to erase doubts by persuading orthopedic surgeons to co-author papers with him based on his bogus data. In 2005 he and Evan Ekman, an orthopedic surgeon at Southern Orthopaedic Sports Medicine in Columbia, S.C., published a study on the use of Celebrex to control pain in back surgery patients. "The short-term administration of celecoxib," they wrote in the paper published in The Journal of Bone and Joint Surgery, "results in no significant deleterious effect on bone or ligament healing or cardiovascular outcomes."
Three years later, Reuben's career would begin to unravel as Ekman began to suspect foul play. In addition to collaborating with Reuben on the now-retracted Celebrex study, Ekman agreed to review a Reuben manuscript on surgery on the anterior cruciate ligament (ACL) in the knee. But when he asked the anesthesiologist for the name of the orthopedic surgeon on the study, Reuben ceased communication with him.
Then, last year, Ekman was invited by Pfizer to give a talk. While there, he was handed a version of the very manuscript Reuben had asked him to review, which had subsequently been published in Anesthesia & Analgesia. To his surprise, and horror, he was listed as a co-author: Reuben had forged his signature on the submission form, Ekman says.
By then, Editor in Chief Shafer had already put several Reuben manuscripts on hold after learning that Baystate had initiated a probe into the validity of his research. The investigation later identified 21 articles based on patient data that had been partially or completely doctored. Although Pfizer funded Reuben's research between 2002 and 2007, Baystate has no records of those payments and says that the research funds could have been paid directly to Reuben. Such an arrangement would be "highly unusual," Shafer notes. "It's just a little frustrating," Baystate spokesperson Jane Albert says. "I don't know how many dollars went to Dr. Reuben or his group."
Pfizer spokesperson Sally Beatty insists the grants were properly disbursed to Baystate in accordance with Pfizer policy. "Pfizer is not familiar with the records retention policies of Baystate Medical Center," she says, "However, independent investigator-initiated research grant agreements were executed between Pfizer and Baystate Medical Center." Beatty was unable to provide information on the dollar amount of the grants, but editor White says they typically range between $10,000 to $100,000.
The question is: Why did it take 12 years before a "routine audit" revealed Reuben's widespread data fabrication? "Baystate publishes about 200 [studies] every year, and of those [articles], the audit rate might only be 5 percent," Baystate's Jenson says, acknowledging that ultimately "Baystate is responsible" for making sure that research done there is properly conducted and reported. He says that the hospital has been trying to strengthen its oversight program over "the past few years" and that it is in the process of applying for accreditation from the Association for the Accreditation of Human Research Protection Programs (AAHRPP) in Washington, D.C., which provides an independent evaluation of an organization's ethical standards and oversight. The lack of accreditation is not unusual because the nonprofit program was not established until 2001 and only recently has grown to include 159 hospitals, academic institutions and other organizations.
In hindsight, Anesthesia & Analgesia editors Shafer and White admit that it should have been a "red flag" that Reuben's studies were consistently favorable to the drugs he studied. White, who has also received drug company educational grants, says that such funding comes with "subtle pressure" to give the companies the results they want. For now, at least, neither the drug companies nor Reuben's co-authors are officially sharing in the blame, but that's expected to change. "There's a lot of responsibility to pass around," White says, "It's all being focused on Scott Reuben, but the reality is there are many other responsible parties."
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