Beware the researcher who believes their own hype

IN early 20th century Berlin, crowds were entranced by a horse that could count, do arithmetic, read the time and identify playing cards, tapping out the answers to questions with his hooves.

So famous was Hans the horse that the German board of education set up a special 18-month inquiry to determine if the claims made about him were genuine. No evidence of fraud was found.

Sadly, it eventually emerged that the horse was actually reading microscopic signals unconsciously emitted by his human interrogators. Minute changes in their expression or body language allowed him to identify the correct answer, the one that would earn him a reward.

Mind you, that’s pretty clever in itself and well beyond the capabilities of most of us humans.

Another thing we humans are not all that good at is being sceptical about things we really want to be true, whether it’s a talking horse or a breakthrough cure for cancer.

Too many scientific miracle workers have flared across the horizon, a shining comet of hope, only to disintegrate into a debris of disappointment and damaged reputations. In the case of medicine, they can also leave a trail of damaged patients behind them.

The most recent fall from grace is that of Italian surgeon Paolo Macchiarini, a superstar of regenerative medicine, whose downfall is sending reverberations through some of the world’s most prestigious medical organisations.

The charismatic Macchiarini achieved fame in 2008 after he created a new airway for a young Colombian woman whose bronchus had collapsed as a result of tuberculosis.

The revolutionary procedure used the patient’s own stem cells on a scaffold of the stripped-back trachea from a deceased donor.

New Scientist was just one of the media outlets excited by the breakthrough at the time.

Five years on, Macchiarini and colleagues reported in the Lancet that the transplanted airway was going strong, with the patient enjoying good lung function, no immunological complications and “a normal social and working life”.

Was it too good to be true?

According to media reports, the patient actually suffered extensive complications, culminating in the removal of a lung in 2016.

Macchiarini went on, in 2011, to perform the world’s first synthetic trachea transplant at Sweden’s Karolinska Institute, home of the Nobel Prize for Medicine, this time using a plastic scaffold rather than donor tissue.

Over the next 3 years, he repeated the experimental surgery to considerable acclaim at different clinical centres around the world.

However, once again, all was not quite as it seemed.

Confronted in late 2016 by evidence that normal research and clinical procedures had been ignored and at least six patients had died following the surgery, Macchiarini remained defiant, accusing detractors of plagiarism and misrepresentation.

After initially exonerating the surgeon in the face of questions about the accuracy of his published papers and an apparently reckless disregard for the risks faced by patients, in late 2016, the Karolinska Institute found him guilty of scientific misconduct and declined to renew his contract.

The Macchiarini case shares many attributes with other scientific frauds: a high-profile, charismatic researcher makes extraordinary claims, scientific journals and the general media buy the hype, and whistleblowers are disbelieved or punished.

Other stand-out cases from recent decades include Japanese stem cell researcher Haruko Obokata, the alleged successful re-implantation of an ectopic pregnancy by Britain’s Malcolm Pearce, or the human cloning experiments of South Korea’s Hwang Woo-Suk.

Not to mention our own William McBride, who was revealed to have falsified his research claiming a link between the drug debendox and birth defects.

Like so many others who succumb to the temptations of fraud, McBride’s belief in himself appeared unshaken. When he eventually admitted to falsifying data, he said he had done it “in the interests of humanity”.

The fraudster who believes in his own hype is a dangerous thing. Disgraced doctor Andrew Wakefield continues to put children at risk by peddling his disproven theories about a link between vaccines and autism.

As 19th century Russian doctor and writer Anton Chekhov put it in one of his stories: “It would not have been so bad if he had simply been a quack, of whom there were plenty, but no – he was a quack who believed in himself …”

Jane McCredie is a Sydney-based science and health writer.

 

To find a doctor, or a job, to use GP Desktop and Doctors Health, book and track your CPD, and buy textbooks and guidelines, visit doctorportal.