BMJ Responds to Appeals About Norway’s CBT-Music Therapy Study

By David Tuller, DrPH

Earlier this week, I sent a nudge to Professor Imti Choonara, editor-in-chief of BMJ Paediatrics Open, and Fiona Godlee, editorial director of BMJ, about a problematic “feasibility study” published a few months ago. That followed a letter two weeks ago, to which I had not received a response. Previous posts on this issue are here and here.

This morning, I received a message from BMJ’s “research integrity coordinator.” Hm. That seems like an important position at BMJ, given what appears to be a major lack of research integrity in some of the papers I have examined.

Anyway, the research integrity coordinator promises to have an answer in two weeks! That would be nice. Before I get too excited, however, I need to remind myself that it took BMJ a year to figure out what to say about the Lightning Process study–including how to correct/clarify it without having to retract it. So I’ll withhold judgment until we see what happens.

Below is the letter I received, followed by my response. I cc’d my co-signatories on the original letter, along with Professor Choonara and Dr Fiona Godlee.

**********

Dear David Tuller, 

We are writing to confirm receipt of your below complaint. We are looking into your concerns with the appropriate contacts and we will get back to you within the next two weeks with a formal response. If the discussion is still ongoing at this point, so that a formal response is not yet possible, we will be in touch to confirm that this is the case. 

Kind regards, 
Simone Ragavooloo
Research Integrity Coordinator

**********

Dear Ms Ragavooloo–

I appreciate your response to the concerns my colleagues and I have raised about the (so-called) “feasibility study” by Wyller et al. I look forward to hearing within two weeks how BMJ has resolved this matter. Given that the facts are straightforward, deciding what to do in a way that conforms to BMJ’s research integrity guidelines should be easy. 

In recent years, many have vented about the problems arising from outcome-switching–one of the serious issues I have documented in Wyller et al. But this BMJ Paediatrics Open paper is the first I’ve read that engages in what I guess one could call “trial-status-downgrading”–that is, presenting a fully powered trial that failed to meet expectations as if it were a feasibility study designed to provide data to support a fully powered trial.
 
I have not seen discussion of this phenomenon alongside the discussion of outcome-switching. Perhaps that’s because it never occurred to anyone–at BMJ or elsewhere–that serious investigators would engage in such behavior.

This is also the first time I have read a peer review in which the reviewer frankly admitted they had not read the paper they were asked to review. In this case, BMJ Paediatrics Open has not only published a study that appears to have violated core scientific principles, it published the study in violation of its own obligation to submit research to rigorous peer review. 

Given BMJ’s obligation to safeguard the health of children with serious illness–a very vulnerable population–I look forward to a quick decision on this unfortunate matter. I have cc’d my colleagues on this response, as well as Professor Choonara and Dr Godlee.

Best–David

David Tuller, DrPH
Senior Fellow in Public Health and Journalism
Center for Global Public Health
School of Public Health
University of California, Berkeley