Doc Goes Missing From Shift; Patient-Centered Long COVID Research; Science Sleuth

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Emergency Medicine Chair Unconscious During Supervision

The head of the emergency medicine department at Thomas Jefferson University Hospital in Philadelphia was disciplined after skipping out on his supervision duties to undergo a diagnostic gastrointestinal procedure under anesthesia, according to the Philadelphia Inquirer.

Theodore Christopher, MD, was scheduled to supervise a first-year resident in the clinical decision unit (CDU) from morning until afternoon, but left for his procedure without alerting the on-call emergency medicine doctor or any other backup physician. According to the Inquirer, a nurse practitioner was present in the unit, but was not authorized to supervise residents.

A hospital spokesperson characterized Christopher’s medical condition as “acute,” and told the Inquirer that Christopher had checked on the “well-being” of his patients before leaving. Christopher ultimately apologized to his fellow physicians, and was placed on leave from November to early December.

Christopher and his department had faced previous scrutiny, including lawsuits over gender discrimination by female doctors who worked there.

A Research Framework That Listens to Patients

Two researchers from Yale are taking a non-traditional approach to studying long COVID and similar illnesses, according to the New Yorker: patient-centered research. In the LISTEN (Listen to Immune, Symptom and Treatment Experiences Now) trial, cardiologist Harlan Krumholz, MD, and immunologist Akiko Iwasaki, PhD, are conducting research with continuous patient input.

Krumholz and Iwasaki wrote patient participation into their trial design, and they host regular “town halls” where patients can ask questions and give feedback. Though based at Yale, the research is decentralized, meaning patients from all over the world can enroll using an app, and use online journals to write about their experience. The team expects first results from Pax-C, a phase II randomized controlled trial, in June.

The researchers believe the framework is an improvement on traditional clinical research design, which can demand time and effort from participants without much in return — but it’s not without drawbacks. Their research uses convenience sampling, and is less diverse than the NIH’s RECOVER study, despite its wide criticism by patient advocates.

Patients, who are experiencing symptoms in real time, also want results that can impact their lives sooner than such research can meaningfully deliver.

“There’s always that disconnect between what patients expect and what we can deliver in a timely manner,” Iwasaki told the New Yorker. “I would rather be criticized for being late than put out something that’s half-baked, whereas I think patients, because of their suffering — they’re really expecting something to happen much quicker.”

According to the New Yorker, the same sense of urgency that propelled the AIDS movement forward, largely thanks to conflict and collaboration between government researchers and patient activists, may also apply in the search for answers on long COVID.

Meet the Sleuth Behind the “Dana-Farberications”

From a little town in Wales called Pontypridd, Sholto David, PhD, uncovered dozens of problems with papers published by top Dana Farber researchers, STAT reported.

Shortly after David published an irreverent blog post flagging images he said were likely manipulated in dozens of papers, Dana-Farber announced it would retract six papers and correct 31 more. According to STAT, the cancer research center had already begun an investigation prior to the post, which may explain its quick response to the allegations.

David himself has welcomed the attention cautiously, STAT wrote, taking interviews but wary of a focus on him rather than the research. He’s also aware of a new level of responsibility that could come with being a well-known figure in the online research sleuthing world, which conducts much of its business from the site PubPeer. Some science sleuths and others have criticized his tone, along with mocking language and images in his post about Dana Farber. But according to David, being polite, as he had tried in the past, never yielded any results.

David, an unemployed biologist, will often stay up until 2 a.m. reading papers because he enjoys the process, according to STAT. “I’m not a successful researcher, am I? Let’s be realistic,” David told STAT. “But I’m seeing all these people who’ve got these high-flying careers and they’re just bloody photoshopping all the blots. Wouldn’t you be mad about that? I didn’t go far in academia, and probably because I’m not a very inventive, creative, or prolific scientist in a lot of ways. But I’m just fascinated by it.”