Perioperative mischief: the price of academic misconduct

Abstract

Recent allegations of fraud committed by one of the most prolific researchers in perioperative medicine, Don Poldermans, have left many clinicians in a state of disbelief. With over 500 peer-reviewed publications, Poldermans heavily influenced the clinical practice of perioperative beta-blockers and statins in noncardiac surgery, shaping guidelines and national policies on the use of these treatments. The effects of fraud in perioperative medicine are particularly caustic owing to a profound domino effect. Many investigators devoted their academic careers to following the footsteps of investigators such as Poldermans. Similarly, funding agencies supported this line of enquiry, incurring significant cost and expense. Most importantly, hundreds of patients were exposed to treatments that may have been harmful in an effort to advance this research agenda. How should perioperative clinicians utilize beta blockade now that a considerable portion of the literature is enshrouded in uncertainty? In this brief review, we reiterate and emphasize basic principles about the indications and administration of perioperative beta blockade. Because research misconduct in perioperative medicine can be so damaging, we present strategies to prevent such events in the future. Without such reform, fraud in research may very well continue. The price for such misconduct is simply too great to pay.