Cases of scientific misconduct in research papers published in reputed scientific journals is not uncommon, and neither are retractions. But when questions are raised over possible misconduct in a publication, the corresponding author of which happens to be heading a prestigious medical education and research institution, it comes as a shocker.
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A peer-reviewed research paper, with then Ophthalmology Department HoD and currently Director of the prestigious Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh Dr Jagat Ram as corresponding author, published in Indian Journal of Ophthalmology (IJO), has come under the scanner over possible distortion of historical facts along with falsification and fabrication of patient’s data.
LifeInChandigarh.com is in the possession of the mid-aged male patient’s records of treatment for glaucoma in both eyes at the PGIMER since 2013. Glaucoma is a group of eye conditions which damages optic nerve and is a leading cause of blindness.
These records, gathered during a sustained investigation spread over several months, during which the Advanced Eye Centre of PGIMER declined to furnish relevant information sought by the news website under the RTI Act, 2005, apparently raise fingers on some of the assertions made in the short description accompanying a case photograph in the research paper titled “Double dialysis of the iris”, with authors Sonam Yangzes, Simar Rajan Singh and Jagat Ram, published in the “Ophthalmic Images” category of the May 2019 edition of IJO.
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Right from the age of the patient from Punjab, which has been mentioned as 45 years in the research paper, whereas as per PGIMER records his age was 30 years in 2013 and 35 years in 2018, discrepancies are galore in the research paper, and in the 2018 treatment records, as compared to the treatment records in 2013.
The research paper mentions that the male patient presented to the ophthalmologist with decreased vision in his right eye and that “There was history of blunt trauma to the eye 6 months back” (at the time of treatment in 2018). But actually during treatment both in 2013 and 2018 the history of blunt trauma to the right eye of the patient has been recorded in the Discharge And Follow-up cards as “in childhood”.
Another discrepancy is in the timeline of the eye findings as well as diagnosis. The findings in the photograph accompanying the published paper, claimed to be as a result of trauma suffered 6 months back (in 2018), whereas these findings were recorded even in 2013 and the diagnosis then was Axenfeld-Reiger Anomaly, which can clinically present just like the image shown in the 2019 publication.
Axenfeld-Reiger Anomaly/Syndrome is a group of disorders that mainly affects the development of the eye. Common eye symptoms include cornea and iris defects.
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The claim in the research paper, that after the patient underwent cataract surgery with repair of iridodialysis (a localised separation or tearing away of the iris from its attachment to the ciliary body) in the right eye in 2018 he regained 6/9 vision in that eye (considered good), is also questionable.
Patient record shows that before the surgery, immediately after the surgery and couple of weeks thereafter, the vision in the right eye was recorded as very poor, which was also the condition in 2013.
Surprisingly, as per records, Dr Simar Rajan Singh and Dr Sonam Yangzes, two of the authors of the publication, were quite familiar with the previous history and treatment of the patient. They had seen the case 6-7 years ago in the glaucoma clinic when the glaucoma consultant Dr Sushmita was of the opinion that the childhood trauma to the patient in the right eye was just incidental (to the condition of the right eye) and that all this was part of the developmental process. She had diagnosed the patient as suffering from Axenfeld Anomaly and he was being treated for glaucoma in both eyes since then.
Responding to emailed observations and attached documents sent to him by LifeInChandigarh.com, IJO Editor Dr Santosh G Honavar did not find anything amiss in the research paper within the limited scope of the category “Ophthalmic Images” of the journal in which it was published.
He informed that the requirement of the category is that “the images must stand alone without the need for a detailed description of more than 100 words. The purpose of this specific publication was to use the supplied image to show a unique teaching point,” he maintained, while leaving a window open by adding further, “and not to bring out the details of the surgery or the long term outcome.”
Claiming to have accessed the relevant medical records from the hospital and gone through the details, he maintained that “The medical records available with us clearly show that the OPD diagnosis is as stated in the publication, and the surgery as stated in the publication was performed on July 6, 2018. As per the follow-up medical records available to me, vision on July 12, 2018 was measured as 6/9p with pinhole and is documented as such. The same has been stated in the publication, which was written up at that time.”
Incidentally, in an earlier development, after a reader is learnt to have pointed out how the image carried in this publication could be the same as the one appearing in another publication by uncommon authors carried in the same edition of the journal, the editor conveniently omitted the image from the other publication and published it as an erratum stating that it is incorrectly published at IJO.
Dr Santosh G Honavar had an explanation for this too. “Genuine errors can rarely and inadvertently happen in any publication process,” he said and went on to explain that “If the error is noticed by the editorial team post-publication, or is pointed out by a reader, the Journal communicates with the corresponding author of the concerned manuscript and seeks a response. If the explanation by the corresponding author is acceptable, then the Journal publishes an erratum, clearly pointing out the inadvertent error and the relevant correction. This does not amount to retraction, and is considered a corrigendum.
“…… IJO has followed the same standard policy in case of the manuscript in question,” he added.
PGIMER Director Dr Jagat Ram, while responding to an email in this connection sent by LifeInChandigarh.com, had this to say, “Thank you for your mail. A detailed response regarding the matter at hand has been submitted by Editor, IJO after due investigation on 24th January 2021 via email, a copy of which was sent to me as well. The same is being attached along with for your immediate reference. I have nothing more to add to the same.”
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