On January 13, 2012, it came to the attention of the Editorial Board of the Saudi Journal of Anaesthesia that the journal had published a fraudulent manuscript.1 The article described a study performed by Drs. Jaydev Dave and Sandip Vaghela at MP Shah Medical College in Jamnagar, India, assessing the effects of dexmedetomidine and propofol in children undergoing magnetic resonance image scanning. Figure 1 shows the demographic table from the article. With the exception of MRI duration, the data reported by Drs. Dave and Vaghela are identical to those from a 2006 manuscript in Anesthesia & Analgesia with an identical title by Koroglu and colleagues2 (Fig. 2).
Drs. Jaydev Dave and Sandip Vaghela claimed to have performed a study at MP Shah Medical College that they did not perform. This is more than simple plagiarism. Plagiarism is the use of another author's words or ideas without attribution. Describing a clinical study that the authors did not perform is fraud. It is no different than fabricating data. The manuscript by Drs. Jaydev Dave and Sandip Vaghela has been retracted for plagiarism and fraud.
We have reviewed the handling of this submission to the Saudi Journal of Anaesthesia. The article underwent plagiarism checking using a free web site service. Unfortunately, minor changes by the authors permitted it to pass plagiarism screening. Anesthesia & Analgesia uses CrossCheck from iThenticate. Based on our experience, it is likely that CrossCheck would have caught the plagiarism. The article subsequently underwent peer review. The reviewers supported publication with revision. After typical cycles of revision, response, and re-review, the manuscript was accepted and published.
This is the latest installment in the ongoing saga of misconduct from MP Shah Medical College. In 2009, Vandana Trivedi, one of only 2 Professors of Anaesthesia at MP Shah Medical College,a submitted 5 manuscripts to Anesthesia & Analgesia. Four of these submissions were rejected for egregious plagiarism: (1) Impact of Anaesthesia on Global Warming, Greenhouse Effects, & Its Prevention, (2) Continuous Suprascapular Nerve Block for Major Scapula Surgery—As a Sole Anaesthetic & Post-Operative Analgesic: A Novel Better Alternative to G/A: A case Report, (3) Continuous Maxillary Nerve Block for Maxillary Sinusotomy and Septoplasty: A Useful Technique for High Risk Patients—A Case Report, and (4) Complementary & Alternative Medicine (CAM) for Chronic Pain—An Overview.
Dr. Trivedi's fifth manuscript, Clinical Evaluation of Glossopharyngeal Nerve Block for Preemptive Analgesia After Tonsillectomy (A Study of 50 Cases), was different. Like Drs. Dave and Vaghela, in her fifth submission, Dr. Trivedi reported data previously published by other investigators as her own. It was rejected for fraud. Attempts to bring this misconduct to the attention of MP Shah Medical College failed. Professor Trivedi stopped returning e-mails, and efforts to identify and contact senior faculty at MP Shah Medical College were unsuccessful.
In 2010, Dr. Trivedi published a case report in the Indian Journal of Anaesthesia describing 3 patients undergoing continuous cervical epidural for thyroplasty.3 Of the 3 cases presented, only 1 patient is possibly from her own practice. The 2 other patients are taken verbatim from previously published case reports.4,b A paragraph in the Introduction is copied verbatim from the British Journal of Anaesthesia.5 The figures are taken from 2 web sitesb,c and a previously published article from the University of Pittsburgh6 (which likely explains why the words “Univ of Pittsbu” appear in the figure). Because this case series reports patients who never existed at MP Shah Medical College, it is also fraud. The fraud was reported to the Indian Journal of Anaesthesia. Rather than retract the paper, a correction7 was issued stating that the article is retracted for plagiarism (fraud is not mentioned). However, because the retraction notice appears as a “correction,” the article does not appear retracted on the journal's web site or in PubMed. The “retraction” is only evident if the diligent reader happens to click on the “correction” when accessing the paper. This does not conform to the guidelines for retraction published by the Committee on Publication Ethics.d
That same year, 4 articles by Professor Trivedi were retracted by The Internet Journal of Anesthesiology for plagiarism, inconsistencies with data management, lack of IRB approval, and lack of patient consent.8–11 Professor Vyas, at the time Professor and Head in Anaesthesia at MP Shah Medical College, was first author of one of these retracted papers. Retraction of a fifth article by The Internet Journal of Anesthesiology12 by Professor Trivedi was accompanied by the following note from the publisher:
“This article was retracted by the publisher due to inconsistencies with data management, lack of IRB approval, lack of patient consents, involvement of at least one child without parental consent, and other less severe concerns.”
Last year, evidence of repeated fraud, plagiarism, studying patients without informed consent, and at least 1 case of including a child in a study of adult patients was brought to the attention of Professor Vikas Sinha, Dean of MP Shah Medical College. In response to these concerns, Professor Trivedi was removed from the academic council of MP Shah Medical College for 6 months, and instructed not to use the MP Shah Medical College name in any publication for 6 months.
Research fraud is a serious offense requiring commensurate disciplinary action. We believe the 6-month sanction by MP Shah Medical College was not commensurate with the author's misconduct. In response to this recent case of fraud, Dr. Dave has been banned for 5 years from publication or presentation. Our understanding is that this same sanction has been applied to Dr. Trivedi. These sanctions were only applied after we brought these cases to the attention of the Society for Scientific Values.e The disciplinary action taken (sanctions against future publications) suggests to us that faculty at MP Shah Medical College can engage in fraud without placing their academic careers at risk. An institution that tolerates fraud jeopardizes the integrity of the scientific literature, the well-being of patients, and imposes considerable burden on editors and readers to separate the fraudulent submissions from the honest ones.
How should journals respond when an institution will not firmly address repeated academic misconduct? We don't know. Existing guidelines address how journals should handle fraudulent manuscripts if institutions fail to investigate. These guidelines do not discuss how editors should respond to repeated misconduct from an institution. This is terra incognita. We considered banning all submissions from MP Shah Medical College. There is ample precedent for applying sanctions to an entire institution.13 However, based on feedback from members of the World Association of Medical Editors, we have decided against a ban on all papers from MP Shah Medical College. Instead, we have expressed our concerns to the Indian Council of Medical Research and the Medical Council of India, and await their reply.
The ongoing saga of repeated fraud from MP Shah Medical College ends with a simple warning: caveat lector.f
Name: Abdelazeem Eldawlatly, MD.
Contribution: This author helped write the manuscript.
Name: Steven L. Shafer, MD.
Contribution: This author helped write the manuscript.
a http://mpsmc.in/data/index.php?dept=1. Accessed February 27, 2012.
b http://www.medicine.uiowa.edu/otolaryngology/cases/thyropla/thyropl1.htm. Accessed March 3, 2012.
c http://stanfordhospital.org/clinicsmedServices/clinics/otolaryngology/laryngology/clinicalPicturesMovies.html. Accessed March 3, 2012.
d e.g., http://publicationethics.org/resources/guidelines. Accessed March 3, 2012.
e http://www.scientificvalues.org. Accessed March 3, 2012.
f Let the reader beware.
1. Dave J, Vaghela S. A comparison of the sedative, hemodynamic, and respiratory effects of dexmedetomidine and propofol in children undergoing magnetic resonance imaging. Saudi J Anaesth 2011;5:295–9
2. Koroglu A, Teksan H, Sagir O, Yucel A, Toprak H, Erosy O. A comparison of the sedative, hemodynamic, and respiratory effects of dexmedetomidine and propofol in children undergoing magnetic resonance imaging. Anesth Analg 2006;103:63–7
3. Trivedi V. Continuous cervical epidural analgesia for Isshiki type-I thyroplasty. Indian J Anaesth 2010;54:52–5
4. Lam PK, Wei WI. Medialisation thyroplasty for unilateral vocal fold paralysis associated with chronic pulmonary tuberculosis. Hong Kong Med J 2007;13:327–9
5. Razzaq I, Wooldridge W. A series of thyroplasty cases under general anaesthesia. Br J Anaesth 2000;85:547–9
6. Rosen CA, Anderson D, Murray T. Evaluating hoarseness: keeping your patient's voice healthy. Am Fam Physician 1998;57:2775–82
7. Erratum. Indian J Anaesth 2011;55:121
8. Trivedi V, Doshi R, Dhuniya K. Evaluation of sedation characteristics with intranasal midazolam versus sublingual midazolam in paediatric patients undergoing magnetic resonance imaging. Internet J Anesthesiol 2010;27(2)
9. Trivedi V, Patil B. Evaluation of airway blocks versus general anesthesia for diagnostic direct laryngoscopy and biopsy for carcinoma of the larynx: a study of 100 patients. Internet J Anesthesiol 2010;26(1)
10. Trivedi V. A comparative clinical study of tramadol v/s pentazocine for sedation and analgesia as premedication (a study of 60 cases). Internet J Anesthesiol 2010;26(1)
11. Vyas A, Trivedi V, Dhuniya K. Suprascapular nerve block in the treatment of frozen shoulders: a clinical evaluation—study of 80 cases. Internet J Anesthesiol 2010;26(1)
12. Trivedi V, Patil B. A clinical comparative study of evaluation of ProSeal LMA v/s I-GEL for ease of insertion and hemodynamic stability: a study of 60 cases. Internet J Anesthesiol 2011;27(2)
13. Steinbrook R. Protecting research subjects: the crisis at Johns Hopkins. N Engl J Med 2002;346:716–20