Scientific Fraud at London University

The University of London (UL) is a complex, federal institution including University College London (UCL) the LSE, King’s College London and the London Business School. The University is the world’s oldest provider of academic awards through distance and flexible learning, dating back to 1858. The UL website proudly announces that it: “has been shortlisted for the International Impact Award at the 2018 Times Higher Education Awards, known as the ‘Oscars’ for higher education.

The academic context of an institution of the size and complexity of the UL is one of intense external and internal competition. These colleges compete fiercely for resources on a national and international stage. Many of them do exceedingly well. They are obsessed by their positions in various public league tables.  For example, the Times Higher Education (2018) World University Rankings for 2019 place Imperial College, UCL, LSE and King’s at 9th, 14th, 26th and 38th places respectively in a table of 1250 universities. These rankings matter and the only game in town is to move up the table. Oxford and Cambridge are in first and second place, with Stanford, MIT, CalTech and the Ivy League universities not far behind.

Within UL itself, there is intense rivalry between the member colleges,  the Medical Schools, the Schools and departments within those colleges, research groups and units within departments, and finally, between individual academics. The  white heat of competition needs to be directly observed or experienced to be believed. Academics at every level are under huge and intense pressure to obtain research funding and to publish peer-reviewed papers in high-impact journals to raise the perceived status of their schools and departments, and to secure funding in the form of research grants and to do all of these things as quickly as possible. As a consequence, simply to stay in the race, each and every method that produces the most outstanding results will be tested and tried. Unfortunately, from time to time, this inevitably means that academics resort to fraudulent practices.

This always does harm; it harms patients, biomedicine and science.  It also harms the reputations of the individuals concerned and their institutions. For this reason, information about scientific misconduct seldom finds its way into public arenas, yet it is a notable part of ‘behind the scenes’ academic history. In “Scientific misconduct and the myth of self-correction in science”, Stroebe, Postmes and Spears (2012) discuss 40 cases of fraud that occurred between 1974 and 2012. The majority occurred in Biomedicine and the only two UK cases were at UL. Academic institutions prefer to keep scientific fraud committed by their employees behind closed doors. Then with the inevitable leaks, news of ‘scandals’ creates headlines in the mainstream media. This means that academic responses  to fraud are driven by scandals. To quote Richard Smith (2006): “They accumulate to a point where the scientific community can no longer ignore them and `something has to be done’. Usually this process is excruciatingly slow.”

There have been several examples of proven scientific misconduct involving fabrication and fraud at several esteemed colleges within London University. London University has been blighted with a high proportion of ‘celebrity’ fraud cases, a few of which are summarised below.

UNIVERSITY COLLEGE LONDON – BURT SCANDAL

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Sir Cyril Burt at University College London claimed a child’s intelligence is mainly inherited and social circumstances play only a minor role. Burt was a eugenicist and he fabricated data in a manner that suggested the genetic theories of intelligence were confirmed.   Burt’s research formed the basis of education policy from the 1920s until Burt died in 1971. Soon afterwards evidence of fraud began to seep out, as if from a leaky bucket.

Notable exposures were by Leon Kamin (1974) in his book, The science and politics of IQ and Oliver Gillie (1976, October 24) who claimed that “Crucial data was faked by eminent psychologist” in the Sunday Times 

Burt was alleged to have invented results, assistants and authors to fit his theory that intelligence has primarily a genetic basis.  It is widely accepted today that Burt was a fraudster although he still has defenders.

ROYAL FREE HOSPITAL – WAKEFIELD SCANDAL

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A fraudulent article in The Lancet falsely linked the MMR vaccine to autism. The publicity about this scared large numbers of parents.  Dr. Andrew J Wakefield and a team (1998) at the Royal Free Hospital and School of Medicine, UL,  falsified their findings. This resulted in a substantial drop in vaccinations causing unnecessary deaths among thousands of unprotected children (e.g., Braunstein, 2012; Deere, 2012). In spite of significant public and scientific concerns, the Wakefield paper was not retracted until February 2010,  12 years after the original publication.  The paper received 1330 citations in the 12-year period prior to retraction and 1260 citations since the retraction. The false evidence that MMR vaccine causes autism is widely cited to the present day, and the paper forms the backbone of an international anti-vaxxing campaign which Wakefield leads from Austin, Texas (Glenza, 2018).

ST GEORGE’S MEDICAL SCHOOL – PEARCE SCANDAL

Dr. Malcolm Pearce of St George’s Medical School, LU, claimed that a 29-year-old woman had given birth to a healthy baby after he had successfully relocated a five-week-old ectopic foetus into her womb (Pearce et al., 1994).  The report excited worldwide interest and hope to thousands of women who are prone to pregnancies that start outside the uterus and end in miscarriage. However, Dr Pearce’s patient records had been tampered with, colleagues knew nothing of this astonishing procedure, and the mother could not be tracked down. Pearce had falsified his evidence. The GMC ruled that fraud had happened and struck off his name from the register. His fraud actually ended two careers.

BIRKBECK COLLEGE AND UCL SCANDAL

Turner (2018) describes a “a major research scandal, after an inquiry found that scientific papers were doctored over an eleven year period.” Professor David Latchman, Master of Birkbeck College and one of the country’s top geneticists, was accused of “recklessness” by allowing research fraud to take place at UCL’s Institute of Child Health. The report states that UCL launched a formal investigation after a whistleblower alleged fraud in dozens papers published by the Institute.

It is alleged that a panel of experts  found that two scientists, Dr Anastasis Stephanou and Dr Tiziano Scarabelli, were guilty of research misconduct by manipulating images in seven published papers. Professor Latchman, a former Dean of the Institute, is cited as an author on all seven of the papers.  In a paper published in the Journal of the American College of Cardiology, the panel said there was “clear evidence” of cloning, where parts of an image were copied and pasted elsewhere.

KING’S COLLEGE LONDON – PETERS AND BANERJEE SCANDAL

Another college in UL tainted by fraud is King’s College. According to the King’s College’s website (https://www.kcl.ac.uk/lsm/about/history/index.aspx) the College was founded in 1829 as a university college “in the tradition of the Church of England”. The first King’s Professor to gain prominence as a fraudster was Professor Timothy Peters, professor of clinical biochemistry at King’s College School of Medicine and Dentistry, who was found guilty of serious professional misconduct in 2001. He was given a severe reprimand by the General Medical Council (GMC) for failing to take action over falsified research published by a junior doctor he was supervising (Dyer, 2001).

Professor Peters had been the research supervisor of Dr Anjan Banerjee, a junior doctor at King’s College Hospital between 1988 and 1991. Dr Banerjee, aged 41, was suspended from practice by the GMC for 12 months in December 2000 for publishing fraudulent research (BMJ 2000;321:1429). When the GMC suspended him, he had already been suspended from his job as consultant surgeon at the Royal Halifax Infirmary as a result of unconnected allegations concerning financial fraud, and he resigned after the GMC suspension. In spite of everything, Dr Banerjee was awarded fellowships at three Royal Colleges and also the MBE!  Nice work, if you can get it.

KING’S COLLEGE LONDON –  HANS J EYSENCK AND R GROSSARTH-MATICEK SCANDAL

A recent publication in the Journal of Health Psychology, ‘Personality and fatal diseases: Revisiting a scientific scandal’ by Anthony Pelosi and editorial, ‘The Hans Eysenck affair: Time to correct the scientific record’ have triggered an investigation into 61 publications by the late Professor H J Eysenck and R Grossarth-Maticek.

Hans Eysenck did his doctorate at UCL under the supervision of Cyril Burt (see section above about the Burt Scandal).

My Open Letter to the President of King’s College, London, Professor David Byrne, draws attention to the 30-year old scandal concerning the dodgy data, impossible claims and dirty tobacco money that are the foundation of multiple dubious publications by Professor H J Eysenck and R Grossarth-Maticek’s.  An investigation by KCL of these events is long overdue and a report of a review by KCL is currently awaited. Watch this space…

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<Prof Hans J Eysenck                                                                          Roland Grossarth-Maticek>

UNIVERSITY COLLEGE LONDON – AHLUWALIA  SCANDAL

The Ahluwalia scandal is described in detail by Dr Geoff. It involved multiple acts of fraud. Jatinder Ahluwalia was obviously a very shrewd operator. In spite of getting found out on more than one occasion, Ahluwalia was able to gain employment in several prestigious institutions including Cambridge University,  Imperial College London, UCL and the University of East London.

These cases indicate the relative ease with which the academic fraudster can accomplish fame and fortune at some of the most prestigious institutions in the land.  The extremely poor record of the authorities at colleges in London University in discovering and calling out fraud is something to behold.

To be continued…

Food, Diets and Dieting

Inequities

The world is full of contradictions, inconsistencies and inequities. On the one hand, it has been reported by the Food and Agriculture Organization of the United Nations (FAO, 2015) that 805million people are estimated to be chronically undernourished. Yet, it has been estimated that the volume of food produced is more than one and a half times what is needed to provide everybody on the planet with a nutritious diet (Weis, 2007). It is not about lack, it is about inequity. While 805 million starve, we also know that 1460 million are overweight or obese, and that number is increasing.

There is also water scarcity with 1.2 billion people lacking access to clean drinking water and 2.5 billion people having no access to a toilet, less than the number of people with a mobile phone (United Nations, 2015). As the world population increases from 7.3 billion today to around 9.6 billion in 2050 (+31.5%), the supply of fresh drinking water available will remain about the same. Yet, around 70 per cent of the world’s water is used in agriculture. Annual grain crops are planted on about 70 per cent of the world’s cropland and provide 80per cent of the world’s food (Pimentel et al., 2012), 70 per cent of which is stock feed for farm animals, which in turn produce dairy and meat.

Over the next 25 years, a lot more food will be needed for the extra 31.5 per cent and the only way it can be produced is through agriculture, creating a vicious circle. The FAO (2015) predicts that the global demand for livestock products will increase by 70 per cent by 2050 with an estimated 1 billion poor depending on livestock for food and income. The livestock sector contributes to human-induced Greenhouse Gas emissions for 14.5 per cent and is a large user of natural resources, especially water.

As Father Time waves his sickle over the remaining decades of this century, there will be a worsening water scarcity. Thanks in part to a ready supply of beef burgers, fried chicken, milk, eggs and cola. Many recent editorials in medical and scientific journals have addressed issues relating to food, diets and dieting (e.g. Drewnowski, 2014; Edmonds and Templeton, 2013; Fitzgerald, 2014; Gold and Graham, 2011; Ndisang et al., 2014; Pagadala and McCullough, 2012; Potenza, 2014; Sniehotta et al., 2014; Stuckler and Basu, 2013; The PLoS Medicine Editors, 2012; Yanovski, 2011).

Special Issue

The Special Issue on ‘Food, Diets and Dieting’ provides a state-of-the-art overview of psychological studies by international researchers on this topic area. The Call for Papers for a Special Issue on ‘Food, Diets and Dieting’ was timely; we received unprecedented interest with many high-quality submissions. Following peer review, the number of accepted papers finally reached the total of 42. The contributions have been divided into two sets for publication in the May and June 2015 issues of Special Issue: Food, diets and dieting. These publications in Journal of Health Psychology are complemented in our companion, open access journal, Health Psychology Open, by a theoretical review paper and a series of commentary papers (Marks, 2015).

According to the McKinsey Global Institute (2014) obesity is responsible for around 5 per cent of global deaths and the global economic impact is US$2.0trillion, or 2.8per cent of global gross domestic product (GDP), roughly equivalent to the impact from smoking or armed violence, war and terrorism. In the United States, in 2004, direct and indirect health costs associated with obesity were US$98 billion. That figure probably has doubled by now.

Depending on the source, it is reported that the direct medical cost of overweight and obesity combined has been estimated to be 5–10per cent of the US health care spend. 42million children under the age of 5 were overweight or obese in 2013. Prevalence of overweight or obesity in adults doubled from 6 per cent in 1980 to 12 per cent in 2008. By 2050, it is predicted that obesity will affect 60 per cent of adult men, 50 per cent of adult women and 25per cent of children making the United States, Britain and much of Europe a mainly obese society.

Globalization is Driver

The main driver of the obesity epidemic and increased prevalence of other non-communicable diseases is unregulated corporate globalization (Swinburn et al., 2011). From the point of view of human health, globalization flies a banner of progress and freedom yet brings illness and an early death to millions of people with non-communicable ‘diseases of affluence’. Transnational corporations are scaling up their promotion of tobacco, alcohol, cola and other sugary beverages, ultra-processed food and unhealthy commodities generally throughout low- and middle-income countries. Moodie et al. (2013) have observed that sales of unhealthy commodities across 80 low- and middle-income countries are strongly interrelated. They argue that wherever there are high rates of tobacco and alcohol consumption, there are also a high intake of snacks, soft drinks, processed foods and other unhealthy food commodities. Moodie et al. (2013) argued that the alcohol and ultra-processed food and drink industries are using similar strategies to the tobacco industry to undermine effective public health policies and programmes. Furthermore, it is suggested that unhealthy commodity industries should have no role in the formation of national or international policy for non-communicable disease policy. Therefore, it follows that the only evidence-based mechanisms that can prevent harm caused by unhealthy commodity industries are public regulation and market intervention.

Food Affordability

The work of Drewnowski and others has demonstrated a strong relationship between affordability of food and beverages and their energy density measured in terms of fat and sugar (Drewnowski, 2014; Drewnowski and Specter, 2004). A systematic review of 27 studies across 10 countries showed that a healthful diet costs around US$550 per year more than an unhealthy one (Rao et al., 2013). In England, another study suggested that the healthiest dietary pattern costs double the price of the least healthy, costing £6.63/day and £3.29/day, respectively (Morris et al., 2014). That is a difference of £1219 per annum.

The inverse relationship between income and prevalence of overweight and obesity follows from two related facts: (a) cheaper foods and drinks are energy-dense and (b) a healthful diet is unaffordable for the majority of people. In 2008, an estimated 1.46 billion adults worldwide had a body mass index (BMI) of 25kg/m2 or greater, and of these, 205million men and 297million women were obese. Taking into account, the rate of increase in obesity, this half-billion figure is projected to increase at least 30 per cent by 2050. The World Health Organization (WHO) (2014) estimates that around 3.4million adults die each year as a result of overweight or obesity. The WHO (2013) published a plan to halt the rise in diabetes and obesity as a part of a vision: ‘A world free of the avoidable burden of noncommunicable diseases’. WHO interventions revolve around ‘mobilizing sustained resources Marks 471 … in coordination with the relevant organizations and ministries’ which consists of high-level meetings between governmental representatives and publishing position statements.

Evidence and logic suggest that economic prosperity is the enabler for obesity and, furthermore, leading authorities have concluded that Obesity is the result of people responding normally to the obesogenic environments they find themselves in. Support for individuals to counteract obesogenic environments will continue to be important, but the priority should be for policies to reverse the obesogenic nature of these environments. (Swinburn et al., 2011) Policy reversals to reduce obesogenicity by regulation face robust resistance from the food and drinks industry. Yet without regulation to change the price imbalance between unhealthful and healthful foods, the obesity epidemic is unlikely to go away. In the meantime, hundreds of millions of individuals continue inexorably along the path of overweight and obesity, with the associated unpleasant illnesses and an early death. It follows that health care systems must be competent to offer effective interventions to prevent, treat and ameliorate the impact of overweight or obesity. Authorities decree that a ‘balanced diet’ with regular physical activity is of crucial importance to a healthy body. Yet, in spite of thousands of studies, hundreds of campaigns and scores of dedicated institutes and journals based on this creed, there are currently no validated public health interventions able to achieve sustained long-term weight loss. Today, the muchtouted idea of the ‘balanced diet’ seems little more than worn out myth. Some basic questions require answers: What is causing the obesity epidemic? What can be done about it? and What is the role of health psychologists (if any)? (Marks et al., 2015; Marks, in press). The obesity epidemic is comparable in importance to the smoking epidemic. Arguably, it will prove to be even more significant in human history than smoking. It took 50 years of consolidated pressure to reduce the prevalence of smoking related diseases. Progress has been frustratingly slow. Still, in 2015, only one industrialized country in the world has plain or standard packaging of cigarettes (Australia) with a second one planning to follow next year (England). With no significant interventions on the horizon for obesity prevention, for example, unhealthful food taxation, the obesity epidemic can continue unabated to run its course, until food and water shortages have their ultimate impact on human society.

Enough Knowledge Now to Tackle Obesity

There is enough knowledge now to tackle the obesity epidemic. Unfortunately our political leaders lack the spine to do what is necessary. Our market-led governance is in the pocket of the paymasters who influence the election of our presidents and prime ministers. If the food chain could be rationally developed, the food and water crises could be curbed within two decades from now. This Special Issue contains a collection of in-depth psychological studies on food, diets and dieting. These studies are relevant to the issue of why certain foods are eaten or avoided by individual consumers and how the choices of consumers are influenced by family, social and economic conditions. Diets and dietary changes involve complex systems of variables which operate on a mass scale. Improved understanding of psychological functioning around food, diets and dieting holds one key to improving nutritional health. A better understanding of behaviour alone is not enough; changes to the food environment are also necessary. Our governmental leaders need to wake up, loosen their ties to their industrial paymasters and take effective action.

References

Drewnowski A (2014) Healthy diets for a healthy planet. The American Journal of Clinical Nutrition 99(6): 1284–1285.

Drewnowski A and Specter SE (2004) Poverty and obesity: The role of energy density and energy costs. The American Journal of Clinical Nutrition 79(1): 6–16.

Edmonds EW and Templeton KJ (2013) Childhood obesity and musculoskeletal problems: Editorial Clinical Orthopaedics and Related Research 471(4): 1191–1192.

Fitzgerald DA (2014) Mini-symposium: Childhood obesity and its impact on respiratory wellbeing: Editorial title: Childhood obesity is the global warming of healthcare. Paediatric Respiratory Reviews 15(3): 209–284.

Food and Agriculture Organization of the United Nations (FAO) (2014) The State of Food Insecurity in the World: Strengthening the Enabling Environment for Food Security and Nutrition. Rome: FAO. Available at: http:// http://www.fao.org/3/a-i4030e.pdf

Food and Agriculture Organization of the United Nations (FAO) (2015) Livestock and the environment. Available at: http://www.fao.org/ livestock-environment/en/

Gold MS and Graham NA (2011) Editorial: Hot topic: Food Addiction & Obesity Treatment Development (Executive Guest Editors: Mark S Gold and Noni A Graham). Current Pharmaceutical Design 17(12): 1126–1127.

McKinsey Global Institute (2014) Overcoming obesity: An initial economic analysis. Discussion paper. London. Available at: http://www. munideporte.com/imagenes/documentacion/ ficheros/025183D9.pdf

Marks DF (2015) Homeostatic theory of obesity. Health Psychology Open. Marks DF, Murray M, Evans B, et al. (2015) Health Psychology: Theory, Research and Application (4th edn). London: SAGE.

Moodie R, Stuckler D, Monteiro C, et al. (2013) Profits and pandemics: Prevention of harmful effects of tobacco, alcohol, and ultraprocessed food and drink industries. The Lancet 381(9867): 670–679.

Morris MA, Hulme C, Clarke GP, et al. (2014) What is the cost of a healthy diet? Using diet data from the UK Women’s Cohort Study. Journal of Epidemiology and Community Health 68(11): 1043–1049.

Ndisang JF, Vannacci A and Rastogi S (2014) Oxidative stress and inflammation in obesity, diabetes, hypertension, and related cardiometabolic complications. Oxidative Medicine and Cellular Longevity 2014: 506948.

Pagadala MR and McCullough AJ (2012) Editorial: Non-alcoholic fatty liver disease and obesity: Not all about BMI. The American Journal of Gastroenterology 107: 1859–1861.

Pimentel D, Cerasale D, Stanley RC, et al. (2012) Annual vs. perennial grain production. Agriculture, Ecosystems & Environment 161: 1–9.

Potenza MN (2014) Obesity, food, and addiction: Emerging neuroscience and clinical and public health implications. Neuropsychopharmacology 39(1): 249–250.

Rao M, Afshin A, Singh G, et al. (2013) Do healthier foods and diet patterns cost more than less healthy options? A systematic review and metaanalysis. BMJ Open 3: e004277.

Sniehotta FF, Simpson SA and Greaves CJ (2014) Weight loss maintenance: An agenda for health psychology. British Journal of Health Psychology 19: 459–464.

Stuckler D and Basu S (2013) Getting serious about obesity. BMJ: British Medical Journal 346: f1300.

Swinburn BA, Sacks G, Hall KD, et al. (2011) The global obesity pandemic: Shaped by global drivers and local environments. The Lancet 378(9793): 804–814.

The PLoS Medicine Editors (2012) PLoS Medicine series on Big Food: The food industry is ripe for scrutiny. PLoS Medicine 9(6): e1001246.

United Nations (2015) Water Scarcity. Available at: http://www.un.org/waterforlifedecade/scarcity. shtml

Weis T (2007) The Global Food Economy. London: Zed Books. World Health Organisation (WHO) (2014) Obesity and overweight. Fact Sheet No 311. Available at: http://www.who.int/mediacentre/factsheets/ fs311/en/http://www.who.int/mediacentre/ factsheets/fs311/en/

World Health Organization (WHO) (2013) Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020. Geneva: WHO.

Yanovski SZ (2011) Obesity treatment in primary care – Are we there yet. New England Journal of Medicine 365(21): 2030–2031.

First published in the Journal of Health Psychology 2015

Cochrane Catastrophe

Peter Gøtzsche’s Expulsion Triggers Mass Resignation

The Board of a prestigious scientific organisation, The Cochrane Collaboration,  recently suffered a mass resignation.  This post documents the reasons why, using the words of the organisation itself. The board has been reduced from 13 to 6 members, following a vote to expel a founding member  for the first time in its 25-year existence.

On 14 September, Peter Gøtzsche, director of the Cochrane’s Nordic Centre and a member of its governing board, posted a statement on the centre’s website. This announced that he had been expelled as a member of the Cochrane Collaboration, after a vote by 6 of 13 of the board’s members.

A further four elected members of the board — which also has appointed members — stepped down in protest. To maintain a balance between appointed and elected members, the board also asked two appointed members to resign.

Gøtzsche claims no justification was given for his expulsion except that he was accused by the board of bringing the organization into “disrepute”. The organization — which carries out systematic reviews of health-care interventions — told Nature it had received “numerous complaints” about Gøtzsche after the publication earlier this year of a critique he co-authored, entitled ‘The Cochrane HPV vaccine review was incomplete and ignored important evidence of bias’ and published in the BMJ Evidence-Based Medicine.

Who or What is Cochrane?

I quote from the Cochrane website:

“Cochrane is for anyone interested in using high-quality information to make health decisions. Whether you are a doctor or nurse, patient or carer, researcher or funder, Cochrane evidence provides a powerful tool to enhance your healthcare knowledge and decision making.

Cochrane’s 11,000 members and over 35,000 supporters come from more than 130 countries, worldwide. Our volunteers and contributors are researchers, health professionals, patients, carers, and people passionate about improving health outcomes for everyone, everywhere. Our global independent network gathers and summarizes the best evidence from research to help you make informed choices about treatment and we have been doing this for 25 years.

We do not accept commercial or conflicted funding. This is vital for us to generate authoritative and reliable information, working freely, unconstrained by commercial and financial interests.

Our Strategy to 2020 aims to put Cochrane evidence at the heart of health decision-making all over the world.”

The Strategy to 2020 has hit a stumbling block. GOAL 4 is or was: “Building an effective sustainable organization.”

“To be a diverse, inclusive, and transparent international organization that effectively harnesses the enthusiasm and skills of our contributors, is guided by our principles, governed accountably, managed efficiently, and makes optimal use of its resources.”

In light of the torpedo the shambolic Governing Board has fired at its own organisation, the expulsion of Peter Gøtzsche, Goal 4 of the Strategy now reads like an ill-timed joke. The statement that spells the end of Cochrane is quoted below.

Bizarre Situation

The Cochrane website is currently as bizarre as can be. A Screen Shot taken this morning 2018-09-27 at 07.05.55 shows an announcement of Peter Gøtzsche’s expulsion immediately followed by the announcement of the 25th Anniversary event to celebrate Peter’s Nordic Cochrane Centre and the foundation of the Cochrane Collaboration:

Screen Shot 2018-09-27 at 07.05.55

Statement from Cochrane’s Governing Board

Statement made by the Governing Board at Cochrane’s 2018 Annual General Meeting, 17th September, at the Edinburgh Cochrane Colloquium

“Dear Cochrane members,

These are extraordinary times and we find ourselves in an extraordinary situation. Your Board is always happy to answer questions about our decisions, and today is no different. We want to explain how we got here today. This wasn’t our original plan because we wanted to behave fairly and with integrity, in a process that respected the privacy of an individual, whilst taking place over a number of days. Days, which unfortunately span this special Colloquium.

This is about the behaviour of one individual. There has been a lengthy investigation into repeated bad behaviour over many years. It is exceptionally unusual for a Board to have to do such an investigation.

Last Thursday, the Board took a decision which divided the Board. Subsequently, four Board members chose to resign. At the same time, others contributed to a public and media campaign of misinformation.

We recognize that the last 24 hours have been exceptionally difficult and as a result, we as a Board have decided to share with you information about the decision that was made, the process by which it was made, and where we are now, in order to act in the best interests of Cochrane.

We now want to put before you as much evidence as we can, so you know what is going on. We cannot tell you everything. All of you will understand why individuals have a right to privacy and confidentiality. We ask that you all respect this, because we may not be able to tell you everything, for legal reasons and reasons of privacy.

By way of background, we are a global organization which operates under British law because we were founded as a UK charity. Our mission is to benefit the public. We are governed by our Articles of Association.

As the Board, we are in fact the employers of the Cochrane staff. All our staff, and our members, have the right to do their work without harassment and personal attacks. We are living in a world where behaviours that cause pain and misery to people, are being ‘called out’. This Board wants to be clear that while we are Trustees of this organization, we will have a “zero tolerance” policy for repeated, seriously bad behaviour. There is a critical need for ALL organizations to look after their staff and members; once repeated, seriously bad behaviour had been recognized, doing nothing was NOT an option.

So, here are the facts as we are able to report them. We may be able to tell you more later, we may not. Time will tell.

This Board decision is not about freedom of speech.
It is not about scientific debate.
It is not about tolerance of dissent.
It is not about someone being unable to criticize a Cochrane Review.

It is about a long-term pattern of behaviour that we say is totally, and utterly, at variance with the principles and governance of the Cochrane Collaboration. This is about integrity, accountability and leadership.

In March this year, we received three complaints about an individual. These were not the first complaints that had ever been received. In fact, the earliest recorded goes back to 2003. Many have been dealt with over the years. Many disputes have arisen. Formal letters have been exchanged. Promises have been made. And broken. Some disputes have been resolved, some have not.

It was clear to the Co-Chairs that the Board had to reach a decision about these most recent complaints. The individual then made serious allegations against one of the Senior Management Team and shared those with the Board. We seemed to be in an impossible situation. How could the Board now reach a decision about the complaints in a fair way? How could we fulfil our responsibilities as employers of the Senior Management Team? Or alternatively, act to admonish that member of the Senior Management Team if they had done wrong?

With guidance from a Trustee with extensive experience of complaints, we proposed asking a totally independent person to undertake a review. The report was to be confidential to the Board.

After failing to get agreement from the individual to an independent review, we then sought legal advice on behalf of Cochrane. We asked the lawyers, what should a Charity such as Cochrane do in this situation? We were advised that various legal consequences flowed from the events – the complaints and the accusations – and that Cochrane should take them seriously.

We asked the lawyers to take particular note of Cochrane’s commitment to transparency. They noted that, but also stressed the importance of confidentiality.

They advised that an independent review was both a sensible and proportionate response.

At the Governing Board Teleconference on 13th June 2018, all Board members read the letter from our lawyers. The lawyers stated that given the serious legal concerns about this matter they strongly recommended an independent review by a very senior lawyer. The Board approved a motion to accept the lawyer’s advice and establish the independent review.

Our lawyers identified a senior independent lawyer (QC) and he was instructed on 2nd July 2018. As part of the process, he invited written submissions from both individuals concerned. He invited both to be interviewed. The lawyer was asked to work to a deadline of the Board Meeting on Thursday last week, 13th September. And, we did in fact receive his preliminary report in time for that meeting. The report completely exonerated the member of the Senior Management Team but did not exonerate the other individual.

Whilst the review was underway, and as a completely separate matter, a paper was published in the journal BMJ-EBM co-authored by the individual concerned on July 27th 2018. The publication of this paper has proved controversial. As a result, the Board received a number of letters of complaint. Each was sent to the individual to allow a written response. In order to avoid any misunderstanding, the Board want you to be clear that this was a matter that arrived very late in this whole process.

So, at the Board Meeting on Thursday September 13th, the trustees reviewed the lawyer’s report of his independent review, and all the material related to the recently published paper. After they had reviewed and discussed this at length, the Trustees exercised their judgement, and looking across a broad range of behaviours, the Board came to a decision to invoke Article 5.2.1. relating to termination of membership. This was not unanimous.

As a result, Article 5.3 was triggered, and the member has been invited to make a written response within seven days.

At this point in time, this person remains a member of the Cochrane Collaboration. We are waiting for the process to be completed. We will report back to you about the outcome as soon as we are able to.

Let us repeat, this is an extremely rare and unusual thing to do. We hope never to have to do this again.

Cochrane Governing Board
Edited (without prejudice): 19th September 2018

Wednesday, September 19, 2018″