Scientific fraud

SummaryThere is a heightening debate about the integrity of science, fuelled by a series of widely publicized cases of scientific fraud. Such cases have involved plagiarism, falsification of data, issues of reproducibility, study design (controls, blinding), sponsoring, ghost-writing, improper peer-review or publication procedures. Scientific publishers have also been criticized. In the biomedical sciences, these issues are equally relevant to both basic and clinical research. This article will describe challenges in evaluating and weighing the evidence from clinical studies. As a prominent example, meta-analyses of studies on chronic pain and its treatment by opioid analgesics will be described, because this topic is receiving increasing public attention. Both the medical community and policy makers have recognized that opioid use in chronic pain needs to be scrutinized with regard to analgesic effectiveness and adverse side effects, and clinical guidelines need to be revised. The development of an evidence-based guideline, reactions to its results by the media and by the opioid-producing pharmaceutical industry, as well as implications for scientific integrity will be discussed.