An Open Letter to the BMJ Editorial Board

 
to: Editor in chief, Kamran Abbasi, kabbasi@bmj.com

     Executive editor, Theodora Bloom, tbloom@bmj.com
     Head of research, Elizabeth Loder, eloder@bmj.com

     Head of journalism, Rebecca Coombes, rcoombes@bmj.com

     Publication ethics and content integrity editor, BMJ Journals, Helen Macdonald, hmacdonald@bmj.com

     Handling academic editor, Juan Franco, juanfranco@bmj.com

 
Dear Editors

We are writing to ask the BMJ to respond swiftly to the numerous issues with the article by Attar et al: Prevention of acute myocardial infarction induced heart failure by intracoronary infusion of mesenchymal stem cells: phase 3 randomised clinical trial (PREVENT-TAHA8) BMJ 2025; 391 doi: https://doi.org/10.1136/bmj-2024-083382 and retract this article without further delay. Although an Expression of Concern was added to the online version of the article on 12 November, this is not included in the PDF version, so readers who rely on the PDF will be unaware of the concerns. In contrast to the substantial publicity for the original article, no mention of the Expression of Concern has been posted by the BMJ on X, Bluesky or Facebook. 

The article was published on 29th October 2025. On 1st November, Dorothy Bishop looked at the associated dataset deposited on Figshare and immediately spotted that the reported ages for participants were not consistent with the inclusion criteria, which specified age below 65. 127 of 396 participants in the dataset had ages 65 and above, with the oldest being 86. A check of the means/SDs reported for age in the article showed them to be consistent with the dataset. Thus, this dataset, with one third of participants aged over 65, appears to be the one used to produce the results that were reported in the article. These concerns were immediately posted on PubPeer and reported to the editor, Dr Juan Franco.

On 2nd November, Nick Brown added a comment on PubPeer showing repeating patterns in the deposited dataset. These are incontrovertible evidence of fabricated data, as such repetitive patterns are vanishingly unlikely to have occurred by chance. Dorothy Bishop wrote again to Dr Franco, drawing attention to this new evidence.

The lead author, Dr Armin Attar, replied on PubPeer to say 

"During an internal audit, we have noticed some inconsistencies in the baseline demographic data of the study. Our team is currently conducting a detailed review to identify the source of these discrepancies. This process is expected to take approximately two to three weeks."

A few days later, he wrote:  

"... we have initiated a full technical audit of our data assembly and analysis pipeline. We are specifically investigating the reported 101‑record cycles, systematic trends in WBC/Hb/Plt, and baseline age discrepancies across outputs, and will document root causes and corrections where needed. The complete audit package will be posted within 2–3 weeks, and any confirmed errors will be transparently corrected via the journal."

At the time of writing, some 8 weeks later, no audit package has been publicly posted. And indeed, it does not appear to be possible for an “audit” to rescue the situation. It is not a case of a few odd datapoints, but rather that the dataset used for the analyses in the article shows numerous hallmarks of fabrication.  If the dataset is "corrected" then the analyses in the article will be false.

Over the next couple of weeks, additional concerns were raised by different commenters on PubPeer  and in letters and rapid replies to the BMJ. Alison Avenell emailed a full summary of all issues from PubPeer, BMJ rapid responses, submitted letters and additional concerns to Drs Abbasi and Franco on 3rd December, but no acknowledgement has been received. In brief, as well as numerous additional signatures of fabricated data, the following points were noted:

• The review record shows that reviewers commented only on the first version of the article, even though some substantial issues were raised, particularly by reviewer Manoj Lalu.
• The deposited dataset was added only after final acceptance, so not reviewed.
• Problems with the registration, subsequently dealt with by adding a new protocol to the final version of the article. A citation to the original protocol was removed from the final version of the paper.
• Numerous changes to the actual study start date in the clinical trial registry (https://clinicaltrials.gov/study/NCT05043610), which were undisclosed and post-dated study completion. According to the original trial registration and all versions until version 4, dated October 7th 2024 (close to manuscript submission), as well as to the published protocol (doi: 10.1186/s13063-022-06594-1), the trial was retrospectively registered. The authors altered the actual study start date and misleadingly presented the trial as prospectively registered. It is not possible in 2024 to realize the trial actually started in September 2021, not January 2021. The BMJ as well as all ICMJE journals explicitly don’t publish retrospectively registered randomized trials.
• Secondary outcomes added after data collected
• Changes to the author list. In particular, addition of two authors (Anthony Mathur and Sheik Dowlut) who are listed as "involved in conceptualisation, methodology, patient management, procedures, administration, and supervision", despite not being listed on the original study registration, and being based in the UK.
• Undisclosed financial COIs by co-author Anthony Mathur.
• Undisclosed COI by co-author Massoud Vosough
• Inconsistencies for sample size, randomisation block size and period of follow-up between registration documents, published protocol and paper.
• Concern about retrospective ethical approval and potential medical risks of the procedure for delivering cells.

Most of these points were posted prior to an Editorial written by the Editor-in-Chief about this case.

While we appreciate that journal editors and publishers must follow clear processes that take into account the authors' viewpoint, it should be amply evident to anyone with expertise in this area that the problems with this article go way beyond anything that could be dealt with by a correction. For summary see comment 64 in the PubPeer chain. It should have been clear just on the basis of the first two PubPeer comments (reported by email to the editor) that there were serious issues with this article, and yet here we are, over two months later, with no retraction.

 

The Editorial concluded: 

"We’re in this together, and we welcome your ideas. The goal is to act in the best interests of the public, to devise more robust processes and new solutions that indeed allow evidence and data to rebuild confidence." 

In response to this invitation, our ideas are:

• The BMJ should monitor PubPeer comments on articles and take action when credible concerns are raised.
• The BMJ should honor its own commitment to the ICMJE prospective registration mandate, as a founding member of ICMJE. It is unfortunate that a retrospectively registered clinical trial made it through peer-review in 2024.
• The BMJ should adhere to COPE Guidelines, which state: 

"To minimise harmful effects and uptake (eg, citation of erroneous work, acting on their findings, or drawing incorrect conclusions), retraction notices should be published as soon as the editor is confident that the publication is seriously flawed, misleading, or falls into any of the categories described above. If there is a delay in making that determination, editors should publish an expression of concern [...]. When an editor has lost confidence in the results or conclusions of an article, they should not delay retraction solely because the authors or their institutions are not cooperative or responding promptly." 

We believe it is particularly important to retract this paper immediately, not just to maintain integrity of the scientific record, but because replication by other clinicians could carry serious risks for patients.

Yours sincerely,

Dorothy Bishop, Emeritus Professor of Developmental Neuropsychology, University of Oxford

Alison Avenell, Clinical Chair in Health Services Research, University of Aberdeen, UK

Mark Bolland, Associate Prof of Medicine, University of Auckland.

Nicholas J L Brown, Department of Psychology, Linnaeus University, Sweden

Ioana Alina Cristea, Associate Professor of Clinical Psychology, University of Padova

Sophie Hill, PhD student, Department of Government, Harvard University

Ian Hussey, Senior Lecturer, University of Bern

Thomas Kesteman, Oxford University Clinical Research Unit, Vietnam

Patricia Murray, Professor of Stem Cells and Regenerative Medicine, University of Liverpool, UK

Maarten van Kampen, ASML BV, The Netherlands

Peter Wilmshurst, Cardiologist

 

 P.S. 

5th Jan 2026

We've had a prompt response from the EIC:

Dear All,

Thank you for writing to us. We continue to investigate a range of issues related to this paper.

We will make a full decision once we have completed our due process.

Yours sincerely,

Kamran Abbasi FRCP Edin Lon
Editor in chief, The BMJ

 

 

Does Elsevier's negligence pose a risk to public health?

 

Yesterday, Retraction Watch published a piece about a notorious 2020 article by Gautret et al that had promoted the idea that hydroxychloroquine could treat COVID-19. Despite numerous concerns, the article has not been retracted from the International Journal for Antimicrobial Agents, a journal that is co-owned by the publisher, Elsevier, and The International Society of Antimicrobial Chemotherapy (ISAC).

On June 3rd, a group of concerned scientists wrote to Elsevier asking for the paper to be retracted in light of the evidence that the paper was flawed and had serious consequences for public health. The fact that the article pops up in the Web of Science database with a trophy symbol denoting it as a 'highly cited paper' just adds to concerns that it is still being taken seriously, giving credence to those who continue to promote an ineffective drug, hydroxychloroquine, to treat COVID-19.

Elsevier's response? They are "reopening the investigation" into the paper. This is the investigation that previously decided nothing needed to be done, despite a damning report by a group of respected experts. In their reply to the letter they stated:

"We cannot currently provide further detail as to the particulars of this investigation as it remains ongoing, and is necessarily confidential while we allow time to discuss our concerns with the authors as part of due process and in line with COPE recommendations. I will however be more then glad to keep you appraised of any final decisions in due course."

As one experienced in these communications, I can confirm that this is the kind of reply you get by a publisher who is kicking the issue into the long grass in the hope that you will forget about it and go away. The wonderful phrase "it remains ongoing" typically refers to something that goes on, and on, and on, and "due course" can take years.

A pertinent question is what COPE recommendations are being followed: there are a whole range of flowcharts provided by COPE for different circumstances. The most relevant in this case would appear to be this one on "Concerns about risk in published data".

Early on in the flowchart, the decision tree asks "Based on the initial assessment, should the dataset be removed or restricted during the investigation to mitigate potential risk?" If the answer is YES, then the appropriate action is "Remove public access to the dataset while following up on the concerns."

Given that the article is still freely available on the web, we have to ask ourselves, is Elsevier being negligent here? Have they decided that there is no risk, despite the evidence that we and others have provided that public health is endangered by publicising misleading data on an ineffective drug? Or do they agree that there is risk, but deem it inconvenient for them to take action?

An (intellectually?) enriching opportunity for affiliation

Guest Post by Nick Wise 

 

A couple of months ago a professor received the following email, which they forwarded to me.

 

"Dear esteemed colleagues,

We are delighted to extend an invitation to apply for our prestigious remote research fellowships at the University of Religions and Denominations (URD). These fellowships offer substantial financial support to researchers with papers currently in press, accepted or under review by Scopus-indexed journals. We welcome scholars from diverse academic disciplines to seize this intellectually enriching opportunity.

Fellowship Details:
Fellowship Type: Remote Short-term Research Fellowship.
Research Focus: Diverse fields, spanning humanities, social sciences, interdisciplinary studies, and more.
Research Output: Publication of research articles in Scopus-indexed journals.
Affiliation: Encouragement for researchers to acknowledge URD as their additional affiliation in published articles.
Remuneration: Project-based compensation for each research article.
Payment Range: Up to $1000 USD per article (based on SJR journal ranking).
Eligibility: Papers in press, accepted, or under review by Scopus-indexed journals.

Preference: Priority for indexing before December 30, 2023.

Application Process:   

To express your interest in securing a fellowship, kindly submit your curriculum vitae to  Ahmad Moghri at moghri.urd@gmail.com. When emailing your application, please use the subject line: "Research Fellowship, FULL NAME."

Upon Selection:
Successful applicants will receive formal invitations to join our esteemed fellowship program. Invitation letters and collaboration contracts will be dispatched within a maximum of 5 days.

We firmly believe that this fellowship program provides an invaluable platform for scholars to make substantial contributions to their fields while collaborating with the distinguished University of Religions and Denominations. We encourage all eligible individuals to seize this exceptional opportunity.

For inquiries or further information, please do not hesitate to contact moghri.urd@gmail.com.

Warmest Regards,”

Why would the institution pay researchers to say that they are affiliated with them? It could be that funding for the university is related to the number of papers published in indexed journals. More articles associated with the university can also improve their placing in national or international university rankings, which could lead directly to more funding, or to more students wanting to attend and bringing in more money.

The University of Religions and Denominations is a private Iranian university specialising, as the name suggests, in the study of different religions and movements. Until recently the institution had very few published papers associated with it according to Dimensions and their subject matter was all related to religion. However, last year there was a substantial increase to 103 published papers, and so far this year there are already 35. This suggests that some academics have taken them up on the offer in the advert to include URD as an affiliation.

Surbhi Bhatia Khan is a lecturer in data science at the University of Salford in the UK since March 2023 and a top 2% scientist in the world according to Stanford University’s rankings. She published 29 research articles last year according to Dimensions, an impressive output, in which she was primarily affiliated to the University of Salford. In addition though, 5 of those submitted in the 2nd half of last year had an additional affiliation at the Department of Engineering and Environment at URD, which is not listed as one of the departments on the university website. Additionally, 19 of the 29 state that she’s affiliated to the Lebanese American University in Beirut, which she was not affiliated with before 2023. She is yet to mention her role at either of these additional affiliations on her LinkedIn profile.

Looking at the Lebanese American University, another private university, its publication numbers have shot up from 201 in 2015 to 503 in 2021 and 2,842 in 2023, according to Dimensions. So far in 2024 they have published 525, on track for over 6,000 publications for the year. By contrast, according to the university website, the faculty consisted of 547 full-time staff members in 2021 but had shrunk to 423 in 2023.  It is hard to imagine how such growth in publication numbers could occur without a similar growth in the faculty, let alone with a reduction.

How many other institutions are seeing incredible increases in publication numbers? Last year we saw gaming of the system on a grand scale by various Saudi Arabian universities, but how many offers like the one above are going around, whether by email or sent through Whatsapp groups or similar?

The Committee On Publication Ethics held a forum on claiming institutional affiliations in December 2023, in recognition of the fact that guidance for what merits affiliation to an institution is lacking and there are no accepted standards for how many affiliations an author should give. It looks like such guidance can’t come soon enough.

Nick Wise is a researcher at the University of Cambridge, UK.

Note: Comments are moderated to prevent spam and abuse, so please be patient if you post a comment and it does not appear immediately

P.S. 3rd Feb 2024

Someone on social media queried the "top 2% rating" for Khan. Nick tells me this is based on an Elsevier ranking for 2022: https://elsevier.digitalcommonsdata.com/datasets/btchxktzyw/6

PEPIOPs – prolific editors who publish in their own publications

I recently reported on a method for identifying authors who contribute an unusually high proportion of papers to a specific journal. As I noted in my previous blogpost, one cannot assume any wrongdoing just on the grounds of a high publication rate, but when there is a close link between the author in question and the journal's editor, then this raises concerns about preferential treatment and integrity of the peer review process.

In running my analyses, I also found some cases where there wasn't just a close link between the most prolific author in a journal and the editor: they were one and the same person! At around the time I was unearthing these results, Elisabeth Bik tweeted to ask if anyone had examples of editors publishing in their own journals. I realised the analysis scripts I had developed for the 'percent by most prolific' analysis could be readily adapted to look at this question, and so I analysed journals in the broad domain of psychology and behavioural science from six publishers: Springer Nature, Wiley, Taylor and Francis, Sage, Elsevier and American Psychological Association (APA). I focused on those responsible for editorial decisions – typically termed Editor-in-Chief or Associate Editor. Sometimes this was hard to judge: in general, I included 'Deputy editors' with 'Editors-in-Chief' if they were very few in number. I ignored members of editorial boards.

Before reporting the findings, I thought I should consult more widely about whether people think it is appropriate for an editor to publish in their own journal.

As a starting point, I looked at guidelines that the Committee on Publication Ethics (COPE) has provided for editors  

Can editors publish in their own journal? 
While you should not be denied the ability to publish in your own journal, you must take extra precautions not to exploit your position or to create an impression of impropriety. Your journal must have a procedure for handling submissions from editors or members of the editorial board that will ensure that the peer review is handled independently of the author/editor. We also recommend that you describe the process in a commentary or similar note once the paper is published.

They link to a case report that notes how this issue can be particularly problematic if the journal is in a narrow field with few publication outlets, and the author is likely to be identifiable even if blinding is adopted.

I thought that it would be interesting to see what the broader academic community thought about this. In a Twitter poll I asked specifically about Editors-in-Chief:

The modal response was that it was OK for an Editor-in-Chief to publish in their own journal at a modest rate (once a year or less). There was general disapproval of editors publishing prolifically in their own journals – even though I emphasised that I was referring to situations where the editorial process was kept independent of the author, as recommended by COPE.

My poll question was not perfectly phrased - I did not specify the type of article: it is usual, for instance, for an editor to write editorials! But I later clarified that I meant regular articles and reviews, and I think most people interpreted it in that way.

The poll provoked some useful debate among those who approved and disapproved of editors publishing in their own journals.

Let's start with some of the reasons against this practice. I should lay my cards on the table and state that personally I am in agreement with Antonia Hamilton, who tweeted to say that as Editor in Chief of the Quarterly Journal of Experimental Psychology she would not be submitting papers from her lab to that journal during her term of office, citing concerns about Conflict of Interest. When I was Editor-in-Chief of Journal of Child Psychology and Psychiatry, I felt the same: I was concerned that my editorial colleagues would be put in a difficult position if they had to handle one of my papers, and if my papers were accepted, then it might be seen as involving a biased decision, even if it that was not the case. Chris Chambers, who was among the 34% who thought an Editor-in-Chief should never publish in their own journal, expressed concerns about breaches of confidentiality, given that the Editor-in-Chief would be able to access identities of reviewers. Others, though, questioned whether that was the case at all journals.

Turning to those who thought it was acceptable for an Editor-in-Chief to publish in their own journal, several people argued that it would be unfair, not just on the editor themselves, but also on members of their research group, if presence of an editorial co-author meant they could not submit to the journal. How much of an issue this is will depend, of course, on how big your research group is, and what other publication outlets are available.  Several people felt there was a big difference between cases where the editor was lead author, and those where they played a more minor role. The extreme case is when an editor is a member of a large research consortium led by someone else. It would seem unduly restrictive to debar a paper by a consortium of 100 researchers just because one of them was the Editor in Chief of the journal. It is worth remembering too that, while being a journal editor is a prestigious role, it is hard work, and publishers may be concerned that it becomes a seriously unattractive option if a major outlet for papers is suddenly off-limits.

Be this as it may, the impression from the Twitter poll was that three papers or more per annum starts to look excessive. In my analysis, shown here I found several journals where the Editor-in-Chief had coauthored 15 or more articles (excluding editorials/commentaries) in their own journal between 2015 and 2019.  I refer to these as PEPIOPs (prolific editors who publish in their own publications). For transparency, I've made my methods and results available, so that others can extend the analysis if they wish to do so: see https://github.com/oscci/Bibliometric_analyses. More legible versions of the tables are also available.

Table 1 shows the number of journals with a PEPIOP, according to publisher. 

Table 1: Number of journals with prolific authors. Columns AE and EIC indicate cases where Associate Editor or Editor-in-Chief published 15+ papers in the journal between 2015-2019

The table makes it clear that it is relatively rare for an Editor-in-Chief to be a PEPIOP: there were no cases for APA journals, and the highest number was 5.6% for Elsevier journals. Note that there are big differences between publishers in terms of how common it is for any author to publish 15+ papers in the journal over 5 years: this was true for around 25% of the Elsevier and Springer journals, and much less common for Sage, APA and Taylor & Francis. This probably  reflects the subject matter of the journals - prolific publication, often on multiauthored papers, is more common in biosciences than social sciences.

Individual PEPIOPs are shown in Table 2. An asterisk denotes and Editor-in-Chief who authored more articles in the journal than any other person between 2015-2019.

These numbers should be treated with caution – I did not check whether any of these editors had only recently adopted the editorial role - largely because this information is not easy to find from journal websites*. I looked at a small sample of papers from individual PEPIOPs to see if there was anything I had overlooked, but I haven't checked every article - as there a great many of them.  There was one case where this revealed misclassification: the editor of Journal of Paediatrics and Child Health wrote regular short commentaries of around 800 words summarising other papers: this seems an entirely unremarkable thing for an editor to do, but they were classified by Web of Science as 'articles' which led to him being categorised as a PEPIOP.  This illustrates how bibliometrics can be misleading.

Table 2: Editors-in-chief who published 15+ papers in own journal 2015-2019

In general I did not find any ready explanation for highly prolific outputs.  And I where I did spot checks I found only one case where there was an explanatory note of the kind COPE recommended (in the journal Maturitas) - on the contrary, in many cases there was a statement confirming no conflict of interest for any of the authors. Sometimes there were lists of conflicts relating to commercial aspects, but it was clear that authors did not regard their editorial role as posing a conflict. It was also worth mentioning there were cases where an Editor-in-Chief was senior author.

The more I have pondered this, the more I realise that the reason why I am concerned particularly by Editor-in-Chief PEPIOPs is because this is the person who is ultimately responsible for integrity of the publication process. Although publishers increasingly are alert to issues of research integrity, journal websites typically advise readers to contact the Editor-in-Chief if there is a problem. Complaints about editorial decisions, demands for retractions, or concerns about potential fraud or malpractice all come to the Editor-in-Chief. That's fine provided the Editor-in-Chief is a pillar of respectability. The problem is that not all editors are the paragons that we'd like them to be: one can adopt rather a jaundiced view after encountering editors who don't even bother to reply to expressions of concern, or adopt a secretive or dismissive attitude if plausible problems in their journal are flagged up. And there are also cases on record where an editor has abused the power of their position to enhance their own publication record. For this reason, I would strongly advise any Editor-in-Chief not to be a PEPIOP; it just looks bad, even if a robust, independent editorial process has been followed. We need to have confidence and trust in those who act as gatekeepers to journals.

My principal suggestion is that publishers could improve their record for integrity if they went beyond just endorsing COPE guidelines and started to actively check whether those guidelines are adhered to. 

*Note: 21st Aug 2020: A commenter on this blogpost has noted that Helai Huang fits this category - this editor has only been in post since 1 Jan 2020, so the period of prolific publication predated being an editor-in-chief.