Ole Petter Ottersen, president Karolinska Institutet 2017-2023

Recently a person with the name Lars Andersson published an article on HPV vaccination in the Indian Journal of Medical Ethics. The title page (now revised by the editor) stated that the author was affiliated with Karolinska Institutet. When the article was brought to our attention we quickly concluded that no such affiliation exists. This person is not employed by KI, nor associated with KI in any other capacity.

At first glance this is primarily a story about deception – about a person that abuses the name and status of a leading university to get his article into a peer-reviewed journal. And yes, Lars Andersson turns out to be a pseudonym. We do not know the identity of this person that falsely claims to be a researcher at KI.

So is this just a story about a willful deception on the part of a single, yet unidentified person?

Deeply troubling

I would say that this incident is deeply troubling because it goes far beyond mere deception, which in itself is serious enough. This incident reveals critical flaws in the current practice of medical publishing. In this particular case, the deceit was discovered swiftly, arguably because the article dealt with a sensitive and controversial issue. In other cases, false affiliations might escape detection. In fact, it turns out that Lars Andersson has published at least three more articles under a false KI identity, in addition to the current one in Indian Journal of Medical Ethics. If the author’s identity is unknown to the reader as well as to the journal’s editor, who should be held accountable for the article’s contents and conclusions? And how about reproducibility? Any author must be prepared to assist if results are to be reproduced by others. Authors that operate under false identities cannot be held to account.

A publishing system that allows papers to be published under false identities and affiliations might easily foment distrust of the medical publishing process and of research in general. Validating the identity and affiliation of the author(s) and safeguarding quality in published reports are issues of utmost importance. Journals have a responsibility in this regard. In this particular case, leading researchers with intimate knowledge of the vaccination field have identified serious flaws in the published report and its conclusion, thus questioning the quality of the review process.

Conclusions

The current incident leads me to conclude as follows:

1. Authors must not publish under false identities and affiliations. There should be national and international guidelines that clearly identify false identity and false affiliation as scientific fraud.
2. Journals must safeguard the quality of the review process. Authors must be allowed to challenge accepted wisdom and dogma – obviously this is of utmost importance for scientific progress and for trust in research – but soundness in scientific approach must be a conditio sine qua non.
3. Journals should be attentive to the need to identify authors and confirm their affiliation. Systems are available that deliver a digital identifier that any individual researcher can use to distinguish her/him from any other researcher.
4. Universities also have a responsibility and must act swiftly when it is brought to their attention that their logo has been misused.

The present case has unveiled an ethical grey zone in medical research. Those who operate in this grey zone – and who are allowed to do so with impunity – undermine trust and confidence in medical research. It is time for collective action.