Respected Anesthesiologist Accused of Wide-scale Scientific Fraud

A shocked scientific and medical publishing community asks “How did this happen? Why did it go undetected for so long? What does this say about the peer-review process?”

The accusation that Scott Reuben, MD, fabricated results in more than 20 papers published in peer-reviewed journals has been widely reported in the last three weeks.

This Boston Globe article offers a good overview of the story as it first made its way through the media. To briefly review: a 2008 evaluation of studies that were to be presented at Reuben’s hospital (Baystate Medical Center in Springfield, MA) revealed that “two abstracts Reuben intended to present had not been approved by an internal hospital review.” A full-scale investigation uncovered 21 papers in which Reuben “made up some or all of the data.”

Anesthesia and Analgesia editor Steven Shafer, MD, said that Reuben’s work and findings in multimodal analgesia had been so respected and had been relied on by so many practicing anesthesiologists and other physicians that the impact of this revelation would be immense, calling it “the largest research fraud in anesthesia.” Shafer’s journal has retracted 10 articles written by Reuben.

Steven Shafer told Anesthesiology News, which was the first media outlet to report the fraud allegations, that “We are left with a large hole in our understanding of this field. There are substantial tendrils from this body of work that reach throughout the discipline of postoperative pain management,” Dr. Shafer said. “Those tendrils mean that almost every aspect will need to be carefully thought through. What do we still believe to be true? Do the conclusions hold up to scrutiny?”

Shafer said that “that although he still believes ‘philosophically’ in multimodal analgesia, he can no longer be absolutely certain of its benefits without confirmation from future studies.

The fallout from Reuben’s alleged fraud may affect more than the clinical research community. The Globe article also notes that “the studies in question involved positive data about drugs made by pharmaceutical giant Pfizer Inc., including Celebrex, Lyrica and Neurontin.” Reuben had received five research grants from Pfizer and was a member of the company’s speakers bureau. A spokeswoman told the Globe that “the clinical trials that led the US Food and Drug Administration to approve Celebrex and Lyrica for pain did not include Reuben’s research.”

Reactions from other physicians and researchers have been a mix of outrage and bewilderment over how Reuben got away with this for so long (some of the retracted studies were published more than 12 years ago) and what would lead him to take such risks.

KevinMD.com wonders whether the pressure is too intense for clinician-scientists, whose jobs are often on the line if they fail to produce results.

Over at the Respectful Insolence blog, in an excellent, in-depth post, proprietor Orac asks “is this the most massive scientific fraud ever?”

Adventures in Ethics and Science notes that, in addition to falsifying data, Reuben also ‘compounded his lies about the data he collected (or in this case, didn't collect) by lying about which other scientists were responsible for the work he reported.”