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Lancet and the perils of peer review

  • 16 June 2020
  When a distinguished journal is caught unawares in its editorial judgment, others will cheer at the burning house. The academic business is a tough one, and at its core is an exaggerated virtue that often conceals core defects. 

Plagiarists, like discreet, discerning murderers, do slip away. Charlatans are celebrated as offering something original when, in truth, the material is merely repackaged. Data can be fabricated, as the journal Science found out in 2006 regarding erroneous claims on stem cell research.

The Lancet has been responsible for some remarkable publications. But it has also had a few frightful slipups. The latest was associated with the drug hydroxychloroquine, of greater interest for the fact that this particular antimalarial drug has refused to leave the tickertape of COVID-19 gossip. At first, it was a great hope, supposedly a shield and cure against the novel coronavirus. US President Donald Trump embraced it, describing it as ‘a gift from heaven if it works’; doctors, certainly in the US, prescribed it, despite having little idea of its efficacy. In Brazil, it was endorsed by President Jaire Bolsonaro even as he expressed doubt about the dangers of COVID-19.

Two other possibilities were also likely: the drug would have no effect at all, or be harmful. This tortured path wound its way to the Lancet when, on 4th June, the journal retracted a paper published the previous month. The premise of that publication was that hydroxychloroquine and chloroquine, its analogue, increased the mortality rate in hospitals for those taking it with COVID-19. With publication still fresh, statistician James Watson commented on the effect size in question. ‘Not many drugs are that good at killing people.’

The New England Journal of Medicine replicated the move regarding a separate study, dealing with cardiovascular disease and the claimed disproportionate effects of COVID-19 upon them. Both articles had relied on data from the same Chicago-based firm, Surgisphere, a company that prides itself on the use of artificial intelligence, machine learning and bid data to assist hospitals in making more informed decisions. ‘We can no longer vouch for the veracity of the primary data resources', claimed the primary authors Mandeep Mehra of Brigham and Women’s Hospital, Frank Ruschitzka of University Hospital Zurich and Amit Patel of the University of Utah.

The Lancet episode is an object lesson in how faith can, at points, substitute hardnosed checking. Surgisphere, run by CEO Sapan Desai, had bold claims, supposedly gathering data from