Concussion Expert's Papers Retracted

— Did misquotations alter concussion science and care?

MedicalToday
A photo of sports doctors treating a soccer player for a concussion on the field.

The British Journal of Sports Medicine (BJSM), a BMJ publication, is retracting nine more non-research articles authored by former editor-in chief and concussion researcher Paul McCrory, MBBS, PhD, of the Florey Institute of Neuroscience and Mental Health in Melbourne, Australia.

Expressions of concern will be placed on another 74 articles published in BMJ journals on which McCrory is the only author, noted Helen Macdonald, MBBS, MSc, of BMJ Publishing, and Jonathan Drezner, MD, of the University of Washington in Seattle, and co-authors in the .

The decision follows an internal investigation by BMJ's research integrity team and Drezner, who is the current editor-in-chief of the BJSM. It was about publication misconduct made by researcher Nick Brown, PhD.

McCrory edited the BJSM from 2001 to 2008, during which time he published at least 164 articles in BMJ journals.

Earlier this year, an in the BJSM, prompted by concerns that it shared similarities with one that another author had written for Physics World.

Plagiarism may not be the most serious breach that might concern BJSM readers, observed Stephen Casper, PhD, of Clarkson University in Potsdam, New York, and Adam Finkel, ScD, of the University of Michigan in Ann Arbor, in an

Misquotation may be worse, they noted. In a , "McCrory fundamentally changed a quote from sports medicine pioneer Thorndike [Augustus Thorndike, MD], in an egregious warping of Thorndike's published words," Casper and Finkel wrote.

"In a 1952 article, Thorndike had written unequivocally that '(p)atients with cerebral concussion that has recurred more than three times or with more than momentary loss of consciousness at any one time should not be exposed to further body-contact trauma,'" they noted.

"However, in his editorial, McCrory purported to 'quote' Thorndike's 1952 article as having advised that after 'three concussions, which involved loss of consciousness for any period of time, the athlete should be removed from contact sports for the remainder of the season,'" changing and weakening Thorndike's recommendation in two different ways, Casper and Finkel pointed out.

In his career, McCrory led several iterations of consensus statements on concussion in sports, which were published in BJSM.

"While those statements were said to be informed by systematic reviews (some of which McCrory was part of or led) and include many co-authors who also contributed to the consensus guidelines, readers may question how McCrory's misquotation or the possible mindset it reveals on his part, especially when considered together with McCrory's plagiarism and the possibility of other misrepresentations, may have altered the interpretation of concussion science and thus shaped the content of consensus statements on concussion," Casper and Finkel wrote.

Questions about McCrory's actions go beyond published work, noted Chris Nowinski, PhD, of the Concussion Legacy Foundation in Boston.

"We are only beginning to understand the implications of Paul McCrory's serial scientific misconduct," Nowinski told .

"In my mind, the serial plagiarism and duplicate publications are dwarfed by the fact that he has repeatedly misrepresented the work of others in public scientific forums, both regarding historical concussion care guidelines in a medical journal and chronic traumatic encephalopathy [CTE] research in a public lecture," Nowinski observed.

"That is what we know he was willing to misrepresent publicly. Who knows what he said in private meetings, but I suspect it has played a role in global sports' past and current hostile resistance to conservative concussion care and acceptance that CTE is caused by contact sports," he added.

The nine retractions all concern opinion pieces, commentaries, and editorials on which McCrory is the only author. They include five cases of plagiarism and three of redundant publication. The other retracted article is the one in which McCrory quoted Thorndike.

After a review of the 2016 concussion consensus statement, the BMJ research integrity team concluded it had "no concerns about plagiarism," and considered that "the question of the extent of McCrory's contribution to, and influence on, the five versions of the consensus statement is a matter within the purview of the scientific committee appointed by the Concussion in Sport Group (CISG)."

After plagiarism allegations first surfaced, McCrory resigned his leadership position in the CISG and stepped down from his role as a member of the Scientific Committee of the International Consensus Conference on Concussion in Sport, Macdonald and co-authors noted.

"The scientific record relies on trust, and BMJ's trust in McCrory's work -- specifically the articles that he has published as a single author -- is broken," they wrote.

"We will investigate any new allegations that we receive about McCrory's work in BMJ journals," they added. "We ask other publishers and his institution to do the same."

Correction: A previous version of this article stated that expressions of concern would be placed on 38 other articles published in BMJ journals on which McCrory was the only author. On October 14, the BMJ updated this number to 74 single-authored articles.

  • Judy George covers neurology and neuroscience news for , writing about brain aging, Alzheimer’s, dementia, MS, rare diseases, epilepsy, autism, headache, stroke, Parkinson’s, ALS, concussion, CTE, sleep, pain, and more.

Disclosures

Macdonald and co-authors are employees of BMJ. Drezner is editor-in-chief of the British Journal of Sports Medicine.

Casper is retained by plaintiffs as a medical historian expert witness in concussion litigation pending in the U.S. and the U.K. Finkel reported no disclosures.

Primary Source

British Journal of Sports Medicine

Macdonald H, et al "Update on the investigation of the publication record of former BJSM editor-in-chief Paul McCrory" Br J Sports Med 2022; DOI: 10.1136/bjsports-2022-106408.

Secondary Source

British Journal of Sports Medicine

Casper ST, Finkel AM "Did a misquotation warp the concussion narrative?" Br J Sports Med 2022; DOI: 10.1136/bjsports-2022-105689.