Author + information
- Wei-Hua Yin, MD,
- Bin Lu, MD∗ (, )
- Felix G. Meinel, MD and
- U. Joseph Schoepf, MD
- ↵∗Fuwai Hospital, 167 Bei-Li-Shi Street, Xi-Cheng District, Beijing, 100037, China
We thank Drs. Achenbach, Chandrashekhar, and Narula for initiating a refreshing debate on the ethics of publishing.
In our role as reviewers and editors of scientific contributions, it is not unusual to encounter submissions that reportedly have received sanctification by a local institutional review board, but were conducted in a fashion that places them in an ethical gray zone or renders them plainly unethical. Common examples include a purportedly “retrospective” nature of data analysis where patient management was obviously prospectively altered or the research use of ionizing radiation without approval by national agencies in countries where such a requirement exists. In our opinion, there is not really a question whether such practices should be scrutinized and, if necessary, penalized by the Editorial Boards of our established journals. This should apply without regard to the provenience and possibly divergent local ethical cultures and institutional review mechanisms. The submission of scientific work to one of our more established journals implies the understanding that the underlying research must be performed in a fashion that is commensurate with the prevailing consensus on ethical conduct in the societal context of the journals’ home base.
We would strongly agree that the dual exposure of patients to imaging tests that involve ionizing radiation and contrast media, as done in our recent work (1), should always heighten the attention of reviewers and editors of established medical journals as to the ethical conduct of research. Until very recently such an approach would indeed have raised ethical questions because with less evolved technology a single research study would have exposed participating individuals to substantially more radiation and contrast material than they received by the 2 scans combined, which they underwent in our investigation using the most advanced technical equipment. We thank the editors for their concurrence that our work conducted in this fashion provides valuable insights into radiation protection strategies that will benefit a vast population of patients going forward.
We are grateful to Dr. Pontana and colleagues for bringing to the readers’ attention our previous research on this topic, which established elegant technical means for simulating low photon environments (2–4) and which has since seen adaptation by others. We found these techniques valid to a point and certainly hypothesis generating. However, as pointed out by various reviewers of our eventual submissions, these techniques are just that—simulations—and cannot fully substitute for the actual performance of study acquisitions with varied parameters in a real-life setting. We hope that with our more recent work we were able to “break the mold” and demonstrate to the medical community how we can harness recent technical accomplishments to conduct ethically sound and methodologically strong comparative research by dual testing of research subjects in order to investigate the effect of a limited set of variables (1).
Please note: Dr. Schoepf is a consultant for and/or receives research support from Bayerhttp://dx.doi.org/10.13039/100004326, Bracco, GE Healthcare, Medrad, and Siemens. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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