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