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zt JAMA宣布撤回一篇肝癌治疗方面的论文
作者:USMedEdu
发表时间:2009-05-13
更新时间:2009-05-13
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发信人: docrockville (docrockville), 信区: MedicalCareer
标 题: JAMA宣布撤回一篇肝癌治疗方面的论文
发信站: BBS 未名空间站 (Wed May 13 19:05:24 2009)

Retraction: Cheng B-Q, et al. Chemoembolization combined with radiofrequency
ablation for patients with hepatocellular carcinoma larger than 3 cm: a
randomized controlled trial. JAMA. 2008;299(14):1669-1677.

Catherine D. DeAngelis, MD, MPH; Phil B. Fontanarosa, MD, MBA

JAMA. 2009;301(18):1931. Published online April 20, 2009 (doi:10.1001/jama.
2009.640).

In the April 9, 2008, issue of JAMA, an article entitled "Chemoembolization
Combined With Radiofrequency Ablation for Patients With Hepatocellular
Carcinoma Larger Than 3 cm: A Randomized Controlled Trial" was published by
Dr Cheng and colleagues.1 We subsequently received information that raised
concerns about the integrity of the data and the veracity of the report. We
conducted an extensive internal investigation into these concerns, contacted
the primary author of the study, and also notified Shandong University, the
authors' institution, expressing our concerns about the conduct of the
trial and the integrity of the data. Based on the responses we received from
the authors, we continued to have concerns about the validity and integrity
of the study, and therefore requested a formal investigation by the authors
' institution.

On March 23, 2009, we received a report from Yun Zhang, MD, PhD, Vice
President, Shandong University, and Dean, Shandong University School of
Medicine. Dean Yun Zhang indicated that "it took a long time to make a
complete investigation" because the university "organized a group of experts
in the field of hepatology to investigate the article" by Cheng et al and
these experts "thoroughly investigated the protocol, ethics, medical records
, methods, statistics, results, and conclusions relevant to this article."
In addition, this investigative group carefully studied the comments of the
JAMA editors and reviewers and previous versions of the manuscript reporting
the results of this study.

The report by the dean indicates the following:

"Based on these investigations, we have drawn the following conclusions:

1. The protocol and ethics of this study were not submitted to the
Academic Committee of Shandong University Qilu Hospital for approval. Dr
Cheng wrote and submitted this manuscript during his postdoctoral training
in Sweden without informing our institution.

2. This study was not a well designed, randomized and controlled clinical
trial despite the fact that chemoembolization and radiofrequency ablation
for patients with hepatocellular carcinoma have been performed in Shandong
University Qilu Hospital for many years. Therefore, conclusions drawn from
this study are not valid.

3. Because of these unscientific behaviors, we suggest that the article
by Dr Cheng should be withdrawn from JAMA.

We apologize for any negative impacts on JAMA caused by publication of this
paper. We have submitted a report on this serious issue to the Academic
Committee of Shandong University and will keep you informed of further
decisions on Cheng's mistakes from our university."

Accordingly, based on this report, we hereby retract this article from JAMA
and from the medical literature. We appreciate that readers of JAMA brought
their concerns about this article to our attention and their patience in
allowing us to investigate, and we are grateful to the dean at Shandong
University School of Medicine for the thorough and detailed investigation
and professional response to our concerns. The cooperation and professional
actions of all involved in this inquiry allowed for a complete investigation
. This is an example of how maintaining scientific integrity for published
articles requires a team effort by readers, journal editors, and the system
of academic oversight.


AUTHOR INFORMATION

Published Online: April 20, 2009 (doi:10.1001/jama.2009.640).

Financial Disclosures: None reported.

Editorials represent the opinions of the authors and JAMA and not those of
the American Medical Association.

Author Affiliations: Dr DeAngelis ([email protected]) is
Editor in Chief and Dr Fontanarosa is Executive Deputy Editor, JAMA.


REFERENCE

1. Cheng B-Q, Jia C-Q, Tao C-T; et al. Chemoembolization combined with
radiofrequency ablation for patients with hepatocellular carcinoma larger
than 3 cm: a randomized controlled trial. JAMA. 2008;299(14):1669-1677. FULL
TEXT | PUBMED

--

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共有2条评论
1   [DrNewbie 于 2010-11-04 00:46:10 提到] [FROM: 98.]
力刀评注:

这是个很有趣的案例,在住院医生面试时时有发生和遇到或类似的场景。这种情况
的应对常常是面试者有意无意地从你反应回答、面部和BODY语言来考察你的反应能
力和个性特点及成熟的素质。表现得好和应答从容合适到位可以让面试者大为开心
或对你留下深刻良好印象,你就得了高分;而相反,应答错误或不当,轻的引起对
方不快或疑虑,严重的,可以说立即被面试者在心里判了死刑--你出局了!

这个CMG提出了个很好得问题,在我所印的下列讨论里,ChiUSMD和Dojo的发言非常
出色,值得大家认真思考和进一步充分讨论,学习提高自己的面试及对这样问题得
脑筋急转弯能力,以及自己的为人处事成熟能力培养。

值得指出的是:那个在麦地喋喋不休到处卖弄她的所谓“英语”并爱好给人改错的
蠢人的发言更充分地反映出其愚蠢和无知,她的所谓良好英语在她的愚蠢脑袋支配
下成了砸她自己脚的石头。此人在麦地已经贩卖了无数的垃圾和错误得东西。我实
在无法忍受这种蠢人无休无止地误导CMG,所以不惜大开杀戒痛砍此ID,得罪了麦地
版规和版主。

说来是坏事,但这也成就了俱乐部的诞生,这里不会再有这种苍蝇和垃圾的泛滥横
行而不受制止。

我希望这里的各位能从这个案例学到更多,大家积极讨论相互收益提高。

力刀 于加拿大
美国医学教育博客(USMedEdu):
http://www.mitbbs.com/pc/index.php?id=USMedEdu (面对全球网站)
http://www.mitbbs.cn/pc/index.php?id=USMedEdu (大陆镜像网站)
MITBBS美加临床医学考版俱乐部(Pre_Resident_Club):
http://www.mitbbs.com/club_bbsdoc/Pre_Resident_Club.html
力刀_新浪博客:
http://blog.sina.com.cn/u/1247007007
文学城_温柔一刀_力刀博客:
http://blog.wenxuecity.com/myindex.php?blogID=2828
北美中国医生网站
http://physician.cmgforum.net/dok/viewforum.php?f=16&start=0

*****************************************************************************

发信人: kaye ([email protected][email protected]~埋底海豚~热爱游泳), 信区: MedicalCareer
标 题: [合集] 面试碰到的尴尬事
发信站: BBS 未名空间站 (Tue Nov 2 02:42:11 2010, 美东)


☆─────────────────────────────────────☆

ZXCVBNMWUJI (无极) 于 (Sun Oct 31 22:38:21 2010, 美东) 提到:

面试碰到的尴尬事:

我的第一个面试的一个面试官是一个看上去很和蔼的老先生,进去后他一上来就笑眯眯
的问,你是怎么认识Dr.XXX的?Dr.XXX是我到美国后的第一个老板。我说,您认识他?
他微笑地点头,说Dr.XXX跟他一起在XXX做的resident。我于是精神为之一振,把我当初
出国如何联系Dr.XXX到他那儿做POSTDOC给绘声绘色了一遍,末了还加了一句类似“He
is the nicest person I've ever met.”之类的评论。面试官耐心听我说完,然后仍
然笑眯眯地说:“Well, I was not getting along with him very well at that
time.”然后就是blah blah blah blah.我当场差点晕倒。

☆─────────────────────────────────────☆

DrNewbie (NN) 于 (Sun Oct 31 23:33:50 2010, 美东) 提到:

You could have said back, Ohh, he must have changed quite a bit.
Or he only gets along well with suck-ups. I jam him up real good.

【 在 ZXCVBNMWUJI (无极) 的大作中提到: 】

☆─────────────────────────────────────☆

fionaww (加州无鱼) 于 (Mon Nov 1 00:00:52 2010, 美东) 提到:

第一句还好,第二句就不行啦。万一人家说,感情你是suck-up阿,不然人家怎么看上
你,把你从国内招来呢?不更晕倒了?


【 在 DrNewbie (NN) 的大作中提到: 】
: You could have said, Ohh, he must have changed quite a bit.
: Or he only gets along well with suck-ups.

☆─────────────────────────────────────☆

DrNewbie (NN) 于 (Mon Nov 1 00:03:49 2010, 美东) 提到:

hehehehe.

Third one: Am I such a charming person that I get along so well with him? Or Am I personable that we get along so well.

Fourth one: You should be happy with my people skills now right? Since I can get along with this snob.

If you love my answers and you get my sick humor, please join my club:

Pre_resident_english_corner.

☆─────────────────────────────────────☆

DrNewbie (NN) 于 (Mon Nov 1 01:25:54 2010, 美东) 提到:

The rest are for professionals only. No imitation by amateurs.
The 1st is witty. The 2nd is humor.


☆─────────────────────────────────────☆

dojo (麦地里的豆角) 于 (Mon Nov 1 20:34:37 2010, 美东) 提到:

楼上大哥,你是来搞笑的还是来做广告的?你的这些自以为幽默的答案不是too judgemental ("he must"...lol) 就是自我吹捧。

这个情况下,面试官故意不在开始的时候就说合不来,而是在等楼主说了一大堆以后才
说,其实就是想看楼主遇到尴尬时的反应。象楼上大哥这种回答,把球踢回去,反让面
试官尴尬,我以为不好。我的建议是回答"oh, sorry to hear about that" 就行了,
最多再加一句"I don't know why he treats you and me differently",把这话题带
过就得了。Dr.XXX或者任何一个普通人都不可能跟所有人都合得来,这本是正常现象,
何须画蛇添足

☆─────────────────────────────────────☆

ChiUSMD (治病救热) 于 (Mon Nov 1 20:56:20 2010, 美东) 提到:

I agree. I assume you are a cute girl, and probably got a high remark from
him, otherwise he won't say this political incorrect thing. Go back ask your
boss whatever he said is true or not, then Send him a nice followup email
and make up something 拍一下马屁.

if your boss can send him a short email, 100% you are in or prematched.
My personal experience you will be ranked very high by that program. 美国人的尊师是骨子里的

☆─────────────────────────────────────☆

sfkitty (meow) 于 (Mon Nov 1 21:12:16 2010, 美东) 提到:

这真的是个需要脑筋急转弯的问题,我觉得理想的答案是结合NN和豆角的智慧。“sorry to hear that" ,加上适当的表情(让面试官觉得你的确 feel sorry about it, 而不是随口说说),再加上 “well, I guess he must have changed a lot“, 然后以一个beautiful smile to wrap it up。



☆─────────────────────────────────────☆

dojo (麦地里的豆角) 于 (Mon Nov 1 21:28:20 2010, 美东) 提到:

对的,表情要搭上。但这个must就免了,我对NN第一个答案不满意的就是这个must,显
得好象你多知道Dr.XXX的过去似的。你用"I guess"就对了。

说到底,我觉得这个回马枪问题固然尴尬,但老实应对,或者就是尴尬在那儿傻笑没有
答案,也比表现出自大和judgmental要好,这些性格可是要命的。尤其在正式面试问答
的时候,玩幽默是玩火。

☆─────────────────────────────────────☆

kaye ([email protected][email protected]~埋底海豚~热爱游泳) 于 (Mon Nov 1 23:09:01 2010, 美东) 提到:


dojo(豆角)和chiusmd的分析都很有道理,谢谢!
个人认为是这个问题的正解吧。

☆─────────────────────────────────────☆

ChiUSMD (治病救热) 于 (Mon Nov 1 23:45:44 2010, 美东) 提到:

The old people always have some 童心,he tried to say "got you", just be his
way and do something satisfy his joke. Now matter how smart you are, just
pretend "he got you".

"oops" then smile, or slightly 夸张一下,any other words might turn the
table completely opposite.
American would anwer: "you are good" or "you got me".

在中国,就自罚杯酒。
中美情况差不多,就是不能充大拿。
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共有1条评论
1 [DrNewbie 于 2010-11-04 00:40:19 提到][删除][修改] [FROM: 98.119.]
1 [DrNewbie 于 2010-11-03 23:04:34 提到][删除][修改] [FROM: 98.119.]
Reply to the attached comment.

"Must" is perfect here. "May" is NOT.

Would anyone use suck-ups, jam-up in a formal interview as in Joke #2? Would this be a clue that it is a joke? Would anyone use snob in Joke #4?

The 'Sorry' line could be interpreted in the wrong way. It is Not like you say sorry when some1 is sick.

Read my reply please before you comment. MadDoc initially made the club private. Only under the protests from the righteous people who think he has gone too far, he made it public a few days later.

Because I use 'real world' examples for English writing practice, private club is best suited for this purpose. A couple of thugs on medi routinely harass me for correcting their English. Btw, your English is superb. Thats why I thought you would want to help us. But you refused. I am truly sorry for this.

Some people get dark humors. Some dont. It is just a matter of personal tastes. Yes, many did think it was funny.

Clearly, you have got the bad influence from MadDoc. You had very lousy attitude with your LOLs towards my posts. You are smart enough to have got into a medical school. But your lack of manners will hurt your personal and professional life. Doc is a prime example. Hope you dont follow his path.
-------------------------------------------------------------------
2 [dojo 于 2010-11-03 22:31:32 提到][删除] [FROM: 71.163.]
Okay, now you say #2-4 are for laughs only, why didn't you say that in your originial post? You could see that fionaww challenged your #2 answer, but you did not tell her you were kidding. Instead you gave two more answers "for laughs", but did any one actually laugh in that thread, before I responded? Your humor is really sick.

I made it clear that your #1 answer is fine except that you shall not say "must". "Maybe he has changed a lot" is an okay answer, but how could you use "must"?

Your comment on my "sorry to hear that" shows that you don't even understand what "sorry" means here. It is a very common, sympathetic response to any kind of misfortune. If you ever tried to describe something unfortunate in your life to an American, you should have heard this sentence before. The sympathetic American saying this would never ever think that he is sorry because you are an ass. Your thinking is ridiculous.

Finally, your conspiracy theory "To exclude me ... you tried to drag everyone into ur private club" really makes me sick, even though I was never a fan of Lao Dao. Lao Dao's club is PUBLIC, everyone in the world can read it, and I joined it on my own without Lao Dao's any email. YOUR club is PRIVATE, and YOU sent me email twice to try to drag me into ur club.

2 [dojo 于 2010-11-03 22:31:32 提到][删除] [FROM: 71.163.]
Okay, now you say #2-4 are for laughs only, why didn't you say that in your originial post? You could see that fionaww challenged your #2 answer, but you did not tell her you were kidding. Instead you gave two more answers "for laughs", but did any one actually laugh in that thread, before I responded? Your humor is really sick.

I made it clear that your #1 answer is fine except that you shall not say "must". "Maybe he has changed a lot" is an okay answer, but how could you use "must"?

Your comment on my "sorry to hear that" shows that you don't even understand what "sorry" means here. It is a very common, sympathetic response to any kind of misfortune. If you ever tried to describe something unfortunate in your life to an American, you should have heard this sentence before. The sympathetic American saying this would never ever think that he is sorry because you are an ass. Your thinking is ridiculous.

Finally, your conspiracy theory "To exclude me ... you tried to drag everyone into ur private club" really makes me sick, even though I was never a fan of Lao Dao. Lao Dao's club is PUBLIC, everyone in the world can read it, and I joined it on my own without Lao Dao's any email. YOUR club is PRIVATE, and YOU sent me email twice to try to drag me into ur club.
 
2   [dokknife 于 2009-05-14 08:53:49 提到] [FROM: 10.]
发信人: docrockville (docrockville), 信区: MedicalCareer
标 题: Re: JAMA宣布撤回一篇肝癌治疗方面的论文
发信站: BBS 未名空间站 (Wed May 13 21:25:15 2009)

http://www.cmt.com.cn/article/080522/a080522b0201.htm


当化疗栓塞遇上射频消融

我国山东大学齐鲁医院程宝泉等进行的随机对照临床研究表明,对于无法手术切除
的较大的原发性肝癌(HCC),经导管肝动脉化疗栓塞(TACE)联合射频消融(RFA)是安全有
效的治疗选择,该联合疗法可改善患者长期生存率。该研究论著近日已发表于JAMA[2008
, 299(14): 1669]。

貌似普通的研究

□ 本报记者 代妮

得知JAMA杂志刊登了我国学者程宝泉等的论著后,记者日前联系了程宝泉医师,就
该研究中一些感兴趣的话题进行了电话采访。



记者:目前国际上肝癌治疗现状如何?

程宝泉:对于早期发现的小于5 cm的单发、无转移大肝癌,首选手术切除,包括局部
切除和肝移植。早期手术有治愈可能,但符合上述标准的患者较少。对于无法手术治疗
的肝癌患者,目前国际上公认的治疗方法为TACE,该疗法对于单发、多发肝癌以及大肝癌
均有效。RFA是近10年来兴起的治疗方法,对于小于3 cm的肝癌疗效较好,但对大于3 cm
者单独应用效果不佳。其他疗法如微波治疗、经皮乙醇注射、氟尿嘧啶注射或碘(131I)
放射微粒置入及免疫疗法效果均不佳。我们的研究目的是探讨 TACE和RFA两种方法联合
应用对大肝癌(>3 cm)的疗效。

记者:除了病灶大小外,该研究的入选患者还要符合哪些条件?

程宝泉:我们在研究中选择患者时主要考虑以下条件:肿瘤大小>3 cm并且≤7.5 cm
,无转移,肝功能较好(Child-Pugh国际肝功能分级为A级或B级),肾功能较好,无腹水,出
凝血试验正常,肿瘤位置不靠近胆囊和肠管。



记者:研究中如何分析TACE联合RFA的疗效?

程宝泉:我们主要对比了TACE联合RFA、TACE单独应用和RFA单独应用的患者生存率
。在进行总体分析后,我们还针对肿瘤大小和肿瘤结节数进行了亚组分析,因为目前国际
公认RFA对单发、较小的肝癌疗效较好,TACE则对多发、较大的肝癌也有效,为进一步明
确这两种方法单用及联合应用的疗效,必须进行上述亚组分析。

记者:如果要进一步深入研究,您会考虑从哪些方面切入?

程宝泉:我们正在准备继续扩大样本量以进一步验证本研究结果,同时也计划与国
内其他医院合作进行大样本多中心临床研究。另外,我国肝癌的主要致病因素是乙型肝
炎病毒感染,而西方国家和日本则是丙型肝炎病毒感染、酒精滥用或其他病因,因此我们
也考虑进行国际合作,以明确TACE联合RFA治疗对丙型肝炎病毒和酒精引起的肝癌疗效如
何。



后记:程医师在接受采访时给人的印象是比较低调,回答问题时也格外言简意赅,并
一再表示不希望对该研究进行大事张扬的宣传。这反而引起了记者的兴趣,为什么这样
低调的学者完成的研究能在世界顶级杂志上刊登?这可能需要从该研究本身的细节中寻
找答案,对于国内其他临床研究者,该研究可能具有值得借鉴之处
--

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发信人: laojifuli (laojifuli), 信区: MedicalCareer
标 题: Re: JAMA宣布撤回一篇肝癌治疗方面的论文
发信站: BBS 未名空间站 (Wed May 13 22:13:29 2009)

>>程医师在接受采访时给人的印象是比较低调,回答问题时也格外言简意赅,并
一再表示不希望对该研究进行大事张扬的宣传。

做贼心虚啊。不过据说程已经凭这篇文章破格进了正高了,不知道此事最后怎么收场。
山大在著名杂志上发的医学论文,有问题不止这一篇。
--

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