Joeri K. Tijdink

Publication Pressure and Scientific Misconduct in Medical Scientists

There is increasing evidence that scientific misconduct is more common than previously thought. Strong emphasis on scientific productivity may increase the sense of publication pressure. We administered a nationwide survey to Flemish biomedical scientists on whether they had engaged in scientific misconduct and whether they had experienced publication pressure. A total of 315 scientists participated in the survey; 15% of the respondents admitted they had fabricated, falsified, plagiarized, or manipulated data in the past 3 years. Fraud was more common among younger scientists working in a university hospital. Furthermore, 72% rated publication pressure as “too high.” Publication pressure was strongly and significantly associated with a composite scientific misconduct severity score.

Use of positive and negative words in scientific PubMed abstracts between 1974 and 2014: retrospective analysis

Objective To investigate whether language used in science abstracts can skew towards the use of strikingly positive and negative words over time. Design Retrospective analysis of all scientific abstracts in PubMed between 1974 and 2014. Methods The yearly frequencies of positive, negative, and neutral words (25 preselected words in each category), plus 100 randomly selected words were normalised for the total number of abstracts. Subanalyses included pattern quantification of individual words, specificity for selected high impact journals, and comparison between author affiliations within or outside countries with English as the official majority language. Frequency patterns were compared with 4% of all books ever printed and digitised by use of Google Books Ngram Viewer. Main outcome measures Frequencies of positive and negative words in abstracts compared with frequencies of words with a neutral and random connotation, expressed as relative change since 1980. Results The absolute frequency of positive words increased from 2.0% (1974-80) to 17.5% (2014), a relative increase of 880% over four decades. All 25 individual positive words contributed to the increase, particularly the words “robust,” “novel,” “innovative,” and “unprecedented,” which increased in relative frequency up to 15 000%. Comparable but less pronounced results were obtained when restricting the analysis to selected journals with high impact factors. Authors affiliated to an institute in a non-English speaking country used significantly more positive words. Negative word frequencies increased from 1.3% (1974-80) to 3.2% (2014), a relative increase of 257%. Over the same time period, no apparent increase was found in neutral or random word use, or in the frequency of positive word use in published books. Conclusions Our lexicographic analysis indicates that scientific abstracts are currently written with more positive and negative words, and provides an insight into the evolution of scientific writing. Apparently scientists look on the bright side of research results. But whether this perception fits reality should be questioned.

Publication Pressure and Burn Out among Dutch Medical Professors: A Nationwide Survey

Background Publication of scientific research papers is important for professionals working in academic medical centres. Quantitative measures of scientific output determine status and prestige, and serve to rank universities as well as individuals. The pressure to generate maximum scientific output is high, and quantitative aspects may tend to dominate over qualitative ones. How this pressure influences professionals’ perception of science and their personal well-being is unknown. Methods and Findings We performed an online survey inviting all medical professors (n = 1206) of the 8 academic medical centres in The Netherlands to participate. They were asked to fill out 2 questionnaires; a validated Publication Pressure Questionnaire and the Maslach Burnout Inventory. In total, 437 professors completed the questionnaires. among them, 54% judge that publication pressure ‘has become excessive’, 39% believe that publication pressure ‘affects the credibility of medical research’ and 26% judge that publication pressure has a ‘sickening effect on medical science’. The burn out questionnaire indicates that 24% of medical professors have signs of burn out. The number of years of professorship was significantly related with experiencing less publication pressure. Significant and strong associations between burn out symptoms and the level of perceived publication pressure were found. The main limitation is the possibility of response bias. Conclusion A substantial proportion of medical professors believe that publication pressure has become excessive, and have a cynical view on the validity of medical science. These perceptions are statistically correlated to burn out symptoms. Further research should address the effects of publication pressure in more detail and identify alternative ways to stimulate the quality of medical science.

Emotional exhaustion and burnout among medical professors; a nationwide survey

BackgroundAlthough job-related burnout and its core feature emotional exhaustion are common among medical professionals and compromise job satisfaction and professional performance, they have never been systematically studied in medical professors, who have central positions in academic medicine.MethodsWe performed an online nationwide survey inviting all 1206 medical professors in The Netherlands to participate. They were asked to fill out the Maslach Burnout Inventory, a ‘professional engagement’ inventory, and to provide demographic and job-specific data.ResultsA total of 437 Professors completed the questionnaire. Nearly one quarter (23.8%) scored above the cut-off used for the definition of emotional exhaustion. Factors related to being in an early career stage (i.e. lower age, fewer years since appointment, having homeliving children, having a relatively low Hirsch index) were significantly associated with higher emotional exhaustion scores. There was a significant inverse correlation between emotional exhaustion and the level of professional engagement.ConclusionsEarly career medical professors have higher scores on emotional exhaustion and may be prone for developing burnout. Based upon this finding, preventive strategies to prevent burnout could be targeted to young professors.

Ranking major and minor research misbehaviors: results from a survey among participants of four World Conferences on Research Integrity

BackgroundCodes of conduct mainly focus on research misconduct that takes the form of fabrication, falsification, and plagiarism. However, at the aggregate level, lesser forms of research misbehavior may be more important due to their much higher prevalence. Little is known about what the most frequent research misbehaviors are and what their impact is if they occur.MethodsA survey was conducted among 1353 attendees of international research integrity conferences. They were asked to score 60 research misbehaviors according to their views on and perceptions of the frequency of occurrence, preventability, impact on truth (validity), and impact on trust between scientists on 5-point scales. We expressed the aggregate level impact as the product of frequency scores and truth, trust and preventability scores, respectively. We ranked misbehaviors based on mean scores. Additionally, relevant demographic and professional background information was collected from participants.ResultsResponse was 17% of those who were sent the invitational email and 33% of those who opened it. The rankings suggest that selective reporting, selective citing, and flaws in quality assurance and mentoring are viewed as the major problems of modern research. The “deadly sins” of fabrication and falsification ranked highest on the impact on truth but low to moderate on aggregate level impact on truth, due to their low estimated frequency. Plagiarism is thought to be common but to have little impact on truth although it ranked high on aggregate level impact on trust.ConclusionsWe designed a comprehensive list of 60 major and minor research misbehaviors. Our respondents were much more concerned over sloppy science than about scientific fraud (FFP). In the fostering of responsible conduct of research, we recommend to develop interventions that actively discourage the high ranking misbehaviors from our study.

How do scientists perceive the current publication culture? A qualitative focus group interview study among Dutch biomedical researchers.

Objective To investigate the biomedical scientists perception of the prevailing publication culture. Design Qualitative focus group interview study. Setting Four university medical centres in the Netherlands. Participants Three randomly selected groups of biomedical scientists (PhD, postdoctoral staff members and full professors). Main outcome measures Main themes for discussion were selected by participants. Results Frequently perceived detrimental effects of contemporary publication culture were the strong focus on citation measures (like the Journal Impact Factor and the H-index), gift and ghost authorships and the order of authors, the peer review process, competition, the funding system and publication bias. These themes were generally associated with detrimental and undesirable effects on publication practices and on the validity of reported results. Furthermore, senior scientists tended to display a more cynical perception of the publication culture than their junior colleagues. However, even among the PhD students and the postdoctoral fellows, the sentiment was quite negative. Positive perceptions of specific features of contemporary scientific and publication culture were rare. Conclusions Our findings suggest that the current publication culture leads to negative sentiments, counterproductive stress levels and, most importantly, to questionable research practices among junior and senior biomedical scientists.

Psychotic symptoms after combined metronidazole-disulfiram use.

Margo Dirckx, MSc Jan Van Hecke, MD, PhD Department of Psychiatry ZNA Hospitals Stuivenberg, Antwerp, Belgium Christiaan H. Vinkers, MD, PhD Department of Psychiatry Rudolf Magnus Institute of Neuroscience University Medical Center Utrecht Utrecht, the Netherlands and Division of Pharmacology Utrecht Institute for Pharmaceutical Sciences Utrecht University Utrecht, the Netherlands c.h.vinkers@umcutrecht.nl

Does on-site urine toxicology screening have an added diagnostic value in psychiatric referrals in an emergency setting?

OBJECTIVE The objective was to examine the added diagnostic value of on-site urine toxicology screening (UTS) in the routine assessment of psychiatric patients in an urban emergency setting. METHOD A naturalistic two-step prospective cohort study design was used enrolling all emergency room (ER) patients referred for psychiatric consultation. In two consecutive cohorts, diagnosis of drug use was assessed based on routine psychiatric interview without (n=64) and with on-site UTS (ACON) (n=56). In both cohorts, drug use was also assessed by post hoc laboratory-based urine immunoassay (Triage) as the gold standard. RESULTS Sensitivity and specificity of diagnosis of drug use based on psychiatric interview only varied (0.75 and 1 in the interview-based cohort; 0.5 and 0.75 in the interview+on-site UTS cohort). The sensitivity and specificity of on-site UTS were 0.93 and 0.97. CONCLUSIONS In an ER setting, the validity of the diagnosis of drug abuse exclusively based on psychiatric interview is low. The use of on-site UTS provides accurate data on drug use and is more practical as compared to post hoc laboratory assessment. On-site UTS has an added diagnostic value of drug use with high sensitivity and specificity.

Personality Traits Are Associated with Research Misbehavior in Dutch Scientists: A Cross-Sectional Study

Background Personality influences decision making and ethical considerations. Its influence on the occurrence of research misbehavior has never been studied. This study aims to determine the association between personality traits and self-reported questionable research practices and research misconduct. We hypothesized that narcissistic, Machiavellianistic and psychopathic traits as well as self-esteem are associated with research misbehavior. Methods Included in this cross-sectional study design were 535 Dutch biomedical scientists (response rate 65%) from all hierarchical layers of 4 university medical centers in the Netherlands. We used validated personality questionnaires such as the Dark Triad (narcissism, psychopathy, and Machiavellianism), Rosenbergs Self-Esteem Scale, the Publication Pressure Questionnaire (PPQ), and also demographic and job-specific characteristics to investigate the association of personality traits with a composite research misbehavior severity score. Findings Machiavellianism was positively associated (beta 1.28, CI 1.06–1.53) with self-reported research misbehavior, while narcissism, psychopathy and self-esteem were not. Exploratory analysis revealed that narcissism and research misconduct were more severe among persons in higher academic ranks (i.e., professors) (p<0.01 and p<0.001, respectively), and self-esteem scores and publication pressure were lower (p<0.001 and p<0.01, respectively) as compared to postgraduate PhD fellows. Conclusions Machiavellianism may be a risk factor for research misbehaviour. Narcissism and research misbehaviour were more prevalent among biomedical scientists in higher academic positions. These results suggest that personality has an impact on research behavior and should be taken into account in fostering responsible conduct of research.

Adequate statistical power in clinical trials is associated with the combination of a male first author and a female last author

Clinical trials have a vital role in ensuring the safety and efficacy of new treatments and interventions in medicine. A key characteristic of a clinical trial is its statistical power. Here we investigate whether the statistical power of a trial is related to the gender of first and last authors on the paper reporting the results of the trial. Based on an analysis of 31,873 clinical trials published between 1974 and 2017, we find that adequate statistical power was most often present in clinical trials with a male first author and a female last author (20.6%, 95% confidence interval 19.4-21.8%), and that this figure was significantly higher than the percentage for other gender combinations (12.5-13.5%; P<0.0001). The absolute number of female authors in clinical trials gradually increased over time, with the percentage of female last authors rising from 20.7% (1975-85) to 28.5% (after 2005). Our results demonstrate the importance of gender diversity in research collaborations and emphasize the need to increase the number of women in senior positions in medicine.