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UK Panel for Research Integrity: more than a smokescreen
UK Panel for Research Integrity: more than a smokescreen Your Oct 25 Editorial1 on the work of the UK Panel for Research Integrity, which I chair, is full of errors. You state that the Panel is “funded and hosted by Universities UK—the representative body for the universities’ executive heads”. In fact, the Panel receives most of its funding from sources other than Universities UK. They include the Medical Research Council, the Medicines and Healthcare Regulatory Agency, the Biotechnology and Biological Sciences Research Council, the Academy of Medical Sciences, and the Department of Health. Additionally, the Panel is governed by an independent board, rather than by instructions from any of its funding bodies. The procedure for the investigation of misconduct in research2 has been designed to ensure that investigations of alleged misconduct are thorough and objective, and done with confidentiality, fairness, and sensitivity to both complainants and respondents. As such, whistleblowers should feel confident that their concerns will get a fair hearing. The procedure is not, contrary to what you state, quick to point out that disciplinary actions will be taken against complainants who make allegations that are found to be mistaken. It clearly states that “[t]hose who have made allegations in good faith should not be penalised and might require support.”2 The procedure is legally robust but not legally driven. The roles of the named person and the screening panel ensure a proportionate and appropriate initial response to allegations, before a full and formal investigation. At every stage the document makes clear that involved parties must declare any potential conflicts of interest; similarly, it states that the named person must withdraw from the investigation of allegations which are in any way linked to him or her. The screening of www.thelancet.com Vol 372 November 29, 2008
an allegation is most certainly not a licence to act as a smokescreen. You are right that the Panel has “an advisory role with no statutory powers”. This, unsurprisingly, is because Parliament has chosen not to act in this area. The Panel has stepped in to fill the breach, providing support to employers, research organisations, and researchers where there was none. Its remit extends beyond universities to cover research wherever it is done. The guidance it offers is, I feel, a welcome step towards tackling a largely ignored, but crucially important, area of activity. A statutory regime of regulation could ultimately be regarded as desirable. Meanwhile, the Panel will continue to raise the profile of good practice in research and expose misconduct. I am Chair of the UK Panel for Research Integrity in Health and Biomedical Sciences.
Ian Kennedy [email protected] UK Panel for Research Integrity in Health and Biomedical Sciences, UK Research Integrity Office, 4th Floor, Woburn House, 20 Tavistock Square, London WC1H 9HQ, UK 1 2
The Lancet. The UK Panel of Research Integrity: a missed opportunity. Lancet 2008; 372: 1438. UK Research Integrity Office. Procedure for the investigation of misconduct in research. London: UK Research Integrity Office, 2008. http://www. ukrio.org/resources/UKRIO%20Procedure%20fo r%20the%20Investigation%20of%20Misconduc t%20in%20Research.pdf (accessed Nov 13, 2008).
Primary immunodeficiency: a call for multidisciplinary care The Seminar by Miguel Park and colleagues (Aug 9, p 489)1 gives an excellent update on emerging knowledge of the heterogeneous antibody deficiency syndrome common variable immunodeficiency. What the paper fails to do, however, is help identify key management issues and illuminate care plans. In three short sentences antibiotic treatment is recommended then dismissed without specific guidance. This shortfall is common2 and
reflects the diverse specialist needs of individuals with common variable immunodeficiency. Indeed, respiratory complications, chiefly bronchiectasis, are major sources of morbidity, substantially affect quality of life, and are the major contributors to a mortality rate that can approach 35% over 6·5 years.3,4 Maintenance long-term antibiotic therapy is often recommended yet largely fails the test of meta-analysis.5 This point is made not to diminish the benefit of antibiotic use but to call for their proactive, directed, and specific use. Flexible antibiotic use might include strategies designed for: (1) eradication of novel pathogenic bacterial isolates, (2) maintenance suppressive therapy, (3) immunomodulation with agents such as azithromycin, and (4) selection of antibiotic combinations and delivery strategies for mild and severe exacerbation. Antibiotic therapy, however, is only a single component of care in chronic sinopulmonary sepsis. Here, optimum outcomes are founded on a combined approach crucially requiring physiotherapy assessment, institution of airway clearance and an exercise programme, trial of mucolytic therapy, addressing of nutritional needs, and control of complicating factors such as sinusitis and gastro-oesophageal reflux disease. The needs of patients with primary immunodeficiency syndromes are diverse and demand highly specialised management programmes best delivered by multidisciplinary care.
The printed journal includes an image merely for illustration
Ian Kennedy
I declare that I have no conflict of interest.
R G Stirling [email protected] Department of Medicine, Monash University, Melbourne, VIC 3004, Australia 1
2
3
Park MA, Li JT, Hagan JB, Maddox DE, Abraham RS. Common variable immunodeficiency: a new look at an old disease. Lancet 2008; 372: 489–502. Bethune CA, Spickett GP. Common variable immunodeficiency: an update on therapeutic approaches. BioDrugs 2000; 13: 243–53. Aghamohammadi A, Pouladi N, Parvaneh N, et al. Mortality and morbidity in common variable immunodeficiency. J Trop Pediatr 2007; 53: 32–38.
Submissions should be made via our electronic submission system at http://ees.elsevier.com/ thelancet/
1877
Rex Features
Correspondence
an allegation is most certainly not a licence to act as a smokescreen. You are right that the Panel has “an advisory role with no statutory powers”. This, unsurprisingly, is because Parliament has chosen not to act in this area. The Panel has stepped in to fill the breach, providing support to employers, research organisations, and researchers where there was none. Its remit extends beyond universities to cover research wherever it is done. The guidance it offers is, I feel, a welcome step towards tackling a largely ignored, but crucially important, area of activity. A statutory regime of regulation could ultimately be regarded as desirable. Meanwhile, the Panel will continue to raise the profile of good practice in research and expose misconduct. I am Chair of the UK Panel for Research Integrity in Health and Biomedical Sciences.
Ian Kennedy [email protected] UK Panel for Research Integrity in Health and Biomedical Sciences, UK Research Integrity Office, 4th Floor, Woburn House, 20 Tavistock Square, London WC1H 9HQ, UK 1 2
The Lancet. The UK Panel of Research Integrity: a missed opportunity. Lancet 2008; 372: 1438. UK Research Integrity Office. Procedure for the investigation of misconduct in research. London: UK Research Integrity Office, 2008. http://www. ukrio.org/resources/UKRIO%20Procedure%20fo r%20the%20Investigation%20of%20Misconduc t%20in%20Research.pdf (accessed Nov 13, 2008).
Primary immunodeficiency: a call for multidisciplinary care The Seminar by Miguel Park and colleagues (Aug 9, p 489)1 gives an excellent update on emerging knowledge of the heterogeneous antibody deficiency syndrome common variable immunodeficiency. What the paper fails to do, however, is help identify key management issues and illuminate care plans. In three short sentences antibiotic treatment is recommended then dismissed without specific guidance. This shortfall is common2 and
reflects the diverse specialist needs of individuals with common variable immunodeficiency. Indeed, respiratory complications, chiefly bronchiectasis, are major sources of morbidity, substantially affect quality of life, and are the major contributors to a mortality rate that can approach 35% over 6·5 years.3,4 Maintenance long-term antibiotic therapy is often recommended yet largely fails the test of meta-analysis.5 This point is made not to diminish the benefit of antibiotic use but to call for their proactive, directed, and specific use. Flexible antibiotic use might include strategies designed for: (1) eradication of novel pathogenic bacterial isolates, (2) maintenance suppressive therapy, (3) immunomodulation with agents such as azithromycin, and (4) selection of antibiotic combinations and delivery strategies for mild and severe exacerbation. Antibiotic therapy, however, is only a single component of care in chronic sinopulmonary sepsis. Here, optimum outcomes are founded on a combined approach crucially requiring physiotherapy assessment, institution of airway clearance and an exercise programme, trial of mucolytic therapy, addressing of nutritional needs, and control of complicating factors such as sinusitis and gastro-oesophageal reflux disease. The needs of patients with primary immunodeficiency syndromes are diverse and demand highly specialised management programmes best delivered by multidisciplinary care.
The printed journal includes an image merely for illustration
Ian Kennedy
I declare that I have no conflict of interest.
R G Stirling [email protected] Department of Medicine, Monash University, Melbourne, VIC 3004, Australia 1
2
3
Park MA, Li JT, Hagan JB, Maddox DE, Abraham RS. Common variable immunodeficiency: a new look at an old disease. Lancet 2008; 372: 489–502. Bethune CA, Spickett GP. Common variable immunodeficiency: an update on therapeutic approaches. BioDrugs 2000; 13: 243–53. Aghamohammadi A, Pouladi N, Parvaneh N, et al. Mortality and morbidity in common variable immunodeficiency. J Trop Pediatr 2007; 53: 32–38.
Submissions should be made via our electronic submission system at http://ees.elsevier.com/ thelancet/
1877
Rex Features
Correspondence