Perceptions of Research Integrity Among Medical Researchers in Shanghai Teaching Hospitals: A Cross‐Sectional Survey

ABSTRACT

Research integrity has become a pressing concern in China, which accounts for a large share of global retractions. Yet little is known about how research integrity is understood and enacted within teaching hospitals. In this cross‐sectional study, we surveyed 106 medical researchers across four Shanghai hospitals to assess their awareness, attitudes, and practices regarding scientific misconduct, as well as the role of integrity education. Most respondents reported familiarity with definitions of fabrication, falsification, and plagiarism and expressed strong disapproval of these behaviors. Nonetheless, 11%–22% indicated some degree of tolerance toward selective reporting or unjustified authorship, and firsthand reports of witnessed misconduct were uncommon. Participation in formal courses or lectures on research integrity was associated with higher knowledge scores and stronger agreement with ethical principles. These findings reveal a tension between high awareness and partial tolerance, highlighting the importance of exploring how institutional cultures and incentive systems may influence ethical behavior in future research and policy efforts.

1. Introduction

Research integrity, which refers to the adherence to ethical principles and professional standards in the design, execution, and reporting of research, is fundamental to the credibility and advancement of science [1, 2, 3]. The U.S. Office of Science and Technology Policy (OSTP) defines “research misconduct” specifically as fabrication, falsification, or plagiarism in proposing, performing, or reviewing research, or in reporting research results [4]. Upholding research integrity ensures the reliability of findings, protects the rights of research participants, and preserves public trust in academic and clinical research. This is especially critical in the medical field, where research outcomes directly influence patient care and public health policies [5].

Globally, breaches of research integrity—such as data fabrication, falsification, plagiarism, and unethical authorship—have sparked widespread concern [6, 7]. High‐profile cases of misconduct not only damage the reputations of individual researchers but also undermine the credibility of entire institutions and research fields. The scale of the issue is further highlighted by incidents involving senior scientists, including university presidents, who have faced serious allegations of misconduct [8]. Wendy Rogers and colleagues have demanded the masFs retraction of over 400 transplantation‐related papers due to ethical violations. Meanwhile, during the COVID‐19 pandemic, the reliance on “rapid peer review” contributed to what has been termed a "retraction tsunami" [9, 10].

Prior research has identified pressures to publish, insufficient familiarity with ethical guidelines, and ambiguous institutional policies as key factors that compromise research integrity [11, 12, 13]. These issues are especially acute in resource‐limited settings or institutions with underdeveloped oversight mechanisms.

In China, the rapid development of scientific research, particularly in the field of medicine, has been accompanied by a growing number of cases of research misconduct, including duplicate publications and unethical clinical trials [14]. According to a report by Nature, over 0.2% of published papers were retracted in 2022 [15]. China is now ranked among the countries with the highest rates or proportions of paper retractions [6, 16, 17]. Teaching hospitals play a critical role in this context, as they amalgamate clinical practice, education, and research. Medical professionals working in these institutions often face conflicting obligations: providing high‐quality patient care, fulfilling educational goals, and meeting institutional expectations for research output. This multifaceted workload, combined with high stakes of career advancement being closely tied to research accomplishments, can create an environment where ethical breaches are more likely to occur [18, 19].

This study investigates the perceptions, attitudes, and self‐reported behaviors concerning research integrity among medical staff at four teaching hospitals in Shanghai. Through a cross‐sectional survey employing a structured questionnaire, we assessed participants’ understanding of core misconduct concepts, their attitudes toward questionable practices, and their willingness to report misconduct they had observed. We further explored whether prior participation in formal research integrity training was associated with more robust ethical orientations. By focusing on practicing clinicians and academic faculty within these hospital settings, the study offers context‐sensitive evidence that adds to the expanding empirical literature on research integrity. The findings are intended to support the design of targeted training initiatives and policy measures in clinical academic environments.

2. Methods

2.1. Study Design

This study employed a cross‐sectional, questionnaire‐based survey design to assess researchers’ perceptions, attitudes, and experiences regarding scientific integrity and misconduct. Data were collected from researchers affiliated with four teaching hospitals in Shanghai, China, between July 2024 and February 2025. The survey used anonymous self‐report questionnaires to facilitate candid responses.

We selected teaching hospitals because they integrate clinical practice, education, and research, and therefore represent high‐pressure institutional environments where research integrity issues may be particularly salient. This focus may not be generalizable to other types of institutions, such as rural or private clinics.

2.2. Participants

Eligible participants were full‐time hospital staff—including physicians, pharmacists, technicians, and research personnel—who had conducted scientific research and published at least one original research article in their field. Participation was voluntary, and informed consent was assumed upon completion of the anonymous questionnaire. Only questionnaires that were fully completed were included in the analysis; incomplete responses were excluded.

2.3. Questionnaire

In designing the survey, we drew upon Macrina's (2014) and other pertinent scholarly works addressing responsible research practices [12, 14, 16]. The survey was structured into five parts:

• 1.Demographic characteristics (8 items);
• 2.Attitudes toward scientific misconduct (14 items);
• 3.Knowledge of scientific integrity and misconduct (9 items);
• 4.Experience with scientific misconduct (4 items);
• 5.Perceived factors contributing to scientific misconduct (9 items).

Response formats included three‐choice items (“Agree,” “Disagree,” “Neutral”), five‐point Likert‐type scales (used for assessing knowledge and frequency), and yes/no questions (for capturing experiences). The full list of survey questions (Q1–Q12 on attitudes and Q1–Q10 on knowledge) is available in the Supporting Material (Supplementary Table S1 & S2).

2.4. Data Analysis

All statistical analyses were conducted with R Studio (version 2025.05.0+496). All statistical analyses were performed in R Studio (version 2025.05.0+496). We summarized participant demographics and questionnaire responses using descriptive statistics. For categorical variables, we reported counts and percentages; for Likert‐type items, we presented means and standard deviations. Based on average scores, we also created heatmaps to visualize knowledge and attitude patterns—though these graphics did not include inferential significance testing. Using logistic regression, we assessed the relationship between scientific integrity knowledge and participants' willingness to report misconduct, reporting odds ratios (ORs) with 95% confidence intervals (CIs). We considered a two‐tailed p‐value < .05 statistically significant.

3. Results

As detailed in Table 1, all 106 respondents completed the survey. The sample was predominantly female (58.5%), with most individuals (91.5%) aged between 25 and 45 years. A large majority held a master's or doctoral degree (96.2%), and the primary professional roles were physicians (36.8%) and surgeons (34.0%). More than half (53.8%) held a middle‐level professional title (e.g., Attending Physician or Assistant Researcher), and about one‐third (36.8%) had fewer than 5 years of work experience. The majority (63.2%) had published between 1 and 5 research articles. Nearly all participants (96.2%) had received education on scientific integrity, mainly through lectures (87.3%) and meetings (69.6%).

Table 1.

Demographic characteristics.

Item	N = 106	Percentage
Gender
Male	44	41.51%
Female	62	58.49%
Age Groups
25‐35	54	50.94%
36‐45	43	40.57%
46‐55	7	6.60%
> =56	2	1.89%
Education background
Bachelor's and below	4	3.77%
Master	44	41.51%
M.D. or Phd	58	54.72%
Type of Job
Physician	39	36.79%
Surgeon	36	33.96%
Medical technician	31	29.25%
Professional title
Primary	28	26.42%
Middle	57	53.77%
Vice‐senior	14	13.21%
Senior	7	6.60%
Length of service
< =5 yrs	39	36.79%
6‐10 yrs	24	22.64%
11‐15 yrs	28	26.42%
> =16 yrs	15	14.15%
Number of published research articles
1~5	67	63.21%
6~10	16	15.09%
11‐15	12	11.32%
> =16	11	10.38%
Received scientific integrity education
Yes	102	96.23%
No	4	3.77%
Forms of participation in scientific integrity education
Courses	62	60.78%
Lectures	89	87.25%
Meetings	71	69.61%
Media	44	43.14%
Others	13	12.75%

According to Table 2, participants generally expressed strong ethical opposition to scientific misconduct. All respondents (100%) considered it inappropriate to fabricate experimental data, manipulate results for presentation purposes, or plagiarize text or data. A high proportion also rejected questionable research practices, such as repeatedly applying statistical methods to attain significance (84.9%) or taking credit for others’ ideas (99.1%). Although most participants disagreed with selective reporting (83.0%) and data fabrication (73.6%)—even when confident in their findings—a notable minority expressed some tolerance for these behaviors (11.3% and 21.7%, respectively). In terms of scientific responsibility, 89.6% of respondents felt ethically obliged to intervene upon witnessing misconduct. Most indicated they would report a colleague (90.6%) or supervisor (87.7%) for misconduct. However, only 78.3% agreed that all co‐authors should receive equal punishment if fabricated data were identified in a publication, reflecting some uncertainty regarding collective accountability in collaborative research.

Table 2.

Participants’ attitudes toward scientific misconduct.

Questions	Agree	Disagree	Neutral
	N (%)	N (%)	N (%)
It is never appropriate to report experimental data that have been created without actually having conducted the experiment.	106 (100%)	0 (0)	0 (0)
It is never appropriate to alter experimental data to make an experiment look better than it actually was.	106 (100%)	0 (0)	0 (0)
It is never appropriate to try a variety of different methods of analysis until one is found that yields a result that is statistically significant.	90 (84.90%)	14 (13.21%)	2 (1.89%)
It is never appropriate to take credit for the words or writing of someone else.	106 (100%)	0 (0)	0 (0)
It is never appropriate to take credit for the data generated by someone else.	106 (100%)	0 (0)	0 (0)
It is never appropriate to take credit for the ideas generated by someone else.	105 (99.05%)	1 (0.94%)	0 (0)
If you were confident of your findings, it is acceptable to selectively omit contradictory results to expedite publication.	12 (11.32%)	88 (83.02%)	6 (5.66%)
If you were confident of your findings, it is acceptable to falsify or fabricate data to expedite publication.	23 (21.70%)	78 (73.58%)	5 (4.72%)
It is more important that data reporting be completely truthful in a publication than in a grant application.	95 (89.62%)	8 (7.55%)	3 (2.83%)
If you witness someone committing research misconduct, you have an ethical obligation to act.	95 (89.62%)	3 (2.83%)	8 (7.55%)
If you had witnessed a co‐worker or peer committing research misconduct, you would be willing to report that misconduct to a responsible official.	96 (90.56%)	3 (2.83%)	7 (6.60%)
If you had witnessed a supervisor or principal investigator committing research misconduct, you would be willing to report that misconduct to a responsible official.	93 (87.74%)	5 (4.72%)	8 (7.55%)
If fabricated data are discovered in a published paper, all co‐authors must equally share in the blame.	93 (87.74%)	9 (8.49%)	4 (3.77%)
If fabricated data are discovered in a published paper, all co‐authors must receive the same punishment.	83 (78.30%)	16 (15.09%)	7 (6.60%)

As illustrated in Figure 1, participants demonstrated substantial awareness of key concepts related to scientific integrity. For most items, over 80% reported at least a moderate understanding (“know” or “completely know”). The best‐known concepts included duplicate publication (87.7%), multiple submission (85.8%), authorship criteria (82.1%), and the principle of advising a peer reviewer (78.3%). Core definitions such as plagiarism, falsification, and fabrication were also well understood, with approximately 80% or more of participants reporting they “know” or “completely know” these terms. Nonetheless, awareness of official scientific integrity policy documents issued by regulatory bodies was rather limited, with merely 70.8% reporting moderate to comprehensive understanding. This points to a potential gap in awareness of institutional or national guidelines, despite a solid conceptual grasp of misconduct definitions.

Figure 1.

Participants’ knowledge of scientific integrity and misconduct.

Furthermore, reports of observed misconduct in participants’ departments over the past year were rare (Table 3). Few participants indicated awareness of data fabrication or falsification, and only one participant acknowledged knowledge of plagiarism in publications; no cases of data plagiarism were recorded. These low reporting rates may be interpreted in two distinct ways. First, they could indicate a genuinely low incidence of misconduct within these departments. Second, they may reflect limited awareness or a reluctance to report observed misconduct, potentially influenced by departmental culture or inadequate emphasis on research integrity issues.

Table 3.

Participants’ experience with scientific misconduct.

Item	Yes	No
	N (%)	N (%)
Have you heard about anyone in your department during the last 12 months that has fabricated data	1 (0.94%)	105 (99.05%)
Have you heard about anyone in your department during the last 12 months that has falsified data	1 (0.94%)	105 (99.05%)
Have you heard about anyone in your department during the last 12 months that has plagiarized data	0 (0)	106 (100%)
Have you heard about anyone in your department during the last 12 months that has plagiarized publications	1 (0.94%)	105 (99.05%)

Participants identified several pressures within the research environment as perceived contributors to scientific misconduct (Figure 2). Notably, 87.8% believed that promotion pressure contributed at least partially to such behavior, whereas 90.6% identified pressure to publish as a contributing factor. External funding demands (86.8%) and the desire for recognition (88.7%) were also widely acknowledged as relevant factors. On the other hand, protective factors such as training in scientific integrity (92.5%) and awareness of misconduct regulations (95.3%) were recognized by the majority as helping to reduce misconduct. The perceived deterrent effect of surveillance and punishment (97.2%) and the possibility of being investigated (95.3%) were also affirmed, underscoring the importance of institutional oversight in promoting research integrity.

Figure 2.

Researchers’ Views on Work Pressure, Supervision, and Research Integrity.

Figure 3 shows that respondents who received scientific integrity education through formal channels—such as dedicated courses or lectures—demonstrated strong agreement with ethical statements regarding research misconduct. Agreement rates exceeded 95% for most items (Q1–Q6 and Q8–Q10). which encompassed fundamental principles such as the prohibition of data fabrication, falsification, and plagiarism (Q1–Q6), as well as the ethical duty to address or report misconduct observed among peers or supervisors (Q8–Q10). In contrast, lower levels of agreement were observed among those who relied on informal sources of education, particularly within the “Others” category. Notably, this group showed substantially lower agreement on Q7 (61.5%), Q11 (69.2%), and Q12 (53.8%), indicating a weaker recognition of the importance of full data transparency and shared accountability among co‐authors. These findings underscore potential gaps in ethical awareness when scientific integrity is learned through informal means.

Figure 3.

Heatmap of Participation in Scientific Integrity Education and Attitudes Toward Q1: It is never appropriate to report experimental data that have been created without actually having conducted the experiment. Q2: It is never appropriate to alter experimental data to make an experiment look better than it actually was. Q3: It is never appropriate to try a variety of different methods of analysis until one is found that yields a result that is statistically significant. Q4: It is never appropriate to take credit for the words or writing of someone else. Q5: It is never appropriate to take credit for the data generated by someone else. Q6: It is never appropriate to take credit for the ideas generated by someone else. Q7: It is more important that data reporting be completely truthful in a publication than in a grant application. Q8: If you witness someone committing research misconduct, you have an ethical obligation to act. Q9: If you had witnessed a co‐worker or peer committing research misconduct, you would be willing to report that misconduct to a responsible official. Q10: If you had witnessed a supervisor or principal investigator committing research misconduct, you would be willing to report that misconduct to a responsible official. Q11: If fabricated data are discovered in a published paper, all co‐authors must equally share in the blame. Q12: If fabricated data are discovered in a published paper, all co‐authors must receive the same punishment.

In Figure 4, a similar pattern emerged across educational formats in relation to self‐reported knowledge (Q1–Q9). These items evaluated participants’ awareness of key scientific integrity concepts, including the availability of institutional documentation (Q1), definitions of integrity and core forms of misconduct—such as fabrication, falsification, and plagiarism (Q2–Q5)—as well as authorship criteria (Q6), and publishing ethics covering multiple submissions, duplicate publications, and peer‐review responsibilities (Q7–Q10).

Figure 4.

Heatmap of Participation in Scientific Integrity Education and Knowledge of Scientific Integrity and Misconduct. Q1: Policy documents on scientific integrity. Q2: Definition of integrity. Q3: Definition of fabrication. Q4: Definition of falsification. Q5: Definition of plagiarism. Q6: Authorship criteria. Q7: Concept of multiple submission. Q8: Concept of duplicate publication. Q9: Principle of advising a peer reviewer.

Participants who engaged in courses or lectures had higher average knowledge scores (reaching up to 4.4 on a 5‐point scale), particularly concerning the definitions of duplicate publication (4.37±0.95) and authorship criteria (4.33±0.95). These results imply that structured educational formats are more effective than informal channels in promoting an accurate understanding of scientific research integrity.

Logistic regression analysis examining the correlation between knowledge of scientific integrity and reluctance to report scientific misconduct indicated that all knowledge variables were negatively correlated with reporting unwillingness, implying a protective trend (Figure 5). In particular, greater awareness of duplicate publishing is substantially associated with a reduced likelihood of being unwilling or uncertain about reporting misbehavior (OR = 0.64, 95% CI: 0.42–0.99, p‐value=.04). Other factors—such as awareness of plagiarism, data fabrication, and falsification—showed similar inverse trends, though they did not reach statistical significance.

Figure 5.

Forest Plot of the Association Between Scientific Integrity Knowledge and Reluctance to Report Misconduct.

4. Discussion

This study offers localized insights into the perceptions, comprehension, and application of scientific integrity among researchers at four teaching hospitals in Shanghai. Although the sample is restricted in both geographic and institutional scope, the findings shed light on how policy objectives related to research integrity are translated into everyday attitudes and behaviors within clinical academic environments.

Firstly, participants expressed strong ethical opposition to well‐known forms of research misconduct such as fabrication, falsification, plagiarism, and other questionable research practices. This aligns with previous studies conducted in both Western and Asian settings, which suggest that core principles of scientific integrity are widely acknowledged across diverse cultural and institutional contexts [18, 20, 21, 22]. However, a small yet notable proportion of respondents expressed partial tolerance toward behaviors like selective reporting and unjustified authorship, pointing to persistent grey areas in the understanding of academic misconduct. This apparent permissiveness stands in stark contrast to the very low self‐reported incidence of such misconduct shown in Table 3 (with only one reported case of plagiarism). This discrepancy suggests potential underreporting and/or sampling bias. Such tolerance should not be overlooked: even limited acceptance of practices like selective reporting or data fabrication can compromise scientific credibility, erode public trust, and potentially endanger patient safety [23, 24].

One contextual factor to consider is the structural environment in Chinese teaching hospitals. Promotion systems that link career advancement to publication counts, along with performance bonuses tied to research output, may create strong incentives for questionable practices [25]. Moreover, hierarchical norms shaped by Confucian traditions can make junior staff reluctant to question their superiors, thereby diminishing the likelihood of misconduct being reported [26]. These cultural and institutional pressures help explain why some respondents hesitated to fully reject grey‐area behaviors despite their awareness of ethical standards.

While the present study did not empirically measure these institutional and cultural factors, their relevance is supported by prior qualitative research on academic environments in China. Hierarchical norms rooted in Confucian traditions may discourage junior researchers from confronting senior colleagues, even when misconduct is recognized [26]. Future research should therefore examine how institutional incentives, cultural hierarchies, and national policies interact to shape ethical behavior in clinical research environments.

A key contribution of our study lies in identifying an association between structured integrity training (such as lectures and formal courses) and higher self‐perceived understanding and ethical awareness. As reflected in our heatmaps, participants who engaged in structured educational activities reported stronger ethical attitudes and greater familiarity with research integrity concepts compared to those relying on informal channels such as media exposure or self‐study. This finding aligns with previous studies emphasizing the importance of active, institutionally supported integrity education in fostering responsible research practices [27, 28]. However, given the cross‐sectional nature of our study, these associations must be interpreted with caution. The observed association may reflect perceived rather than actual understanding, and it remains unclear whether integrity training enhances ethical reasoning or whether individuals with stronger ethical awareness are more inclined to participate in formal education.

Our logistic regression analysis indicated that higher self‐reported understanding of scientific integrity, assessed across nine knowledge items, was associated with lower reluctance to report misconduct. Although only one of these associations reached statistical significance, which may be attributable to the relatively small sample size, the consistently negative trends suggest that better‐informed researchers tend to be more willing to address ethical violations. These findings, however, should be interpreted with caution, as the study assessed subjective knowledge rather than objective understanding.

Participants’ self‐perceived familiarity with terms such as plagiarism, fabrication, or falsification may reflect true comprehension. As highlighted in previous cross‐cultural research, perceptions of misconduct such as plagiarism are not always viewed as strictly black‐and‐white violations [29, 30]. Since the questionnaire did not include verification items to assess the accuracy or depth of participants’ knowledge, the high levels of reported awareness may reflect confidence more than actual competence. The coexistence of strong self‐reported knowledge with partial tolerance for questionable practices highlights a critical tension: mere awareness of ethical definitions may not sufficiently guide ethical decision‐making in real‐world contexts.

Our findings are consistent with studies conducted in other developing‐country contexts—such as Brazil, India, Myanmar, and Ghana—which also reported high awareness of plagiarism and fabrication alongside partial tolerance for selective reporting or honorary authorship [31, 32, 33, 34]. These parallels may reflect the influence of systemic pressures common to rapidly developing research environments, as suggested in prior comparative studies. Such pressures— including intense publication demands and hierarchical evaluation systems—have been linked to similar ethical challenges across diverse national settings.

Beyond these international parallels, China has also intensified its own efforts to strengthen research integrity. In 2023, the government carried out its first nationwide review of retractions and research misconduct, resulting in nearly 14,000 retraction notices—approximately three‐quarters of which involved Chinese co‐authors [17, 35]. This unprecedented initiative signaled not only stronger enforcement against individual misconduct but also an acknowledgment that existing incentive systems—long emphasizing publication quantity—require fundamental reform. The audit thus represented a turning point in China's research governance, highlighting the need to shift from output‐driven evaluation toward mechanisms that reward integrity, transparency, and reproducibility. In China, academic promotion, funding allocation, and even departmental prestige are often closely linked to the number of publications in high‐impact journals, creating a “publish or perish” environment. Such metrics‐based evaluation not only amplifies competition but may also blur ethical boundaries when researchers face pressure to produce rapid, positive results. In this context, the 2023 retraction audit can be understood as both a corrective intervention and a signal of the government's intent to reform these entrenched incentive mechanisms rather than merely punish individual offenders.

Yet our findings indicate that, within hospital environments, tolerance for practices such as selective reporting and unjustified authorship still persists. This gap between national policymaking policy initiatives and local practice highlights the need for implementation strategies that not only enforce top‐down regulation but also address institutional incentives, organizational cultures, and everyday research contexts [36].

To narrow this gap, Shanghai hospitals could adopt several practical measures. First, establishing anonymized reporting channels and appointing research integrity officers could provide safer pathways for whistleblowing and independent investigation. Second, revising performance evaluation systems—reducing the weight of publication quantity—would help realign incentives with ethical practice. These localized reforms could complement national oversight mechanisms by embedding integrity within everyday research governance.

This research possesses multiple limitations. First, the sample size was relatively small (n=106) and restricted to four teaching hospitals in Shanghai, which may limit the generalizability of the findings to other settings or types of institutions, including rural hospitals, private sectors, or non‐teaching facilities. Second, the reliance on self‐reported data introduces the potential for social desirability bias and prevents objective verification of participants' actual knowledge or behaviors. Third, the cross‐sectional design does not allow for the assessment of temporal trends or causal relationships regarding the influence of policies, training, or institutional culture on research integrity practices. Fourth, the questionnaire predominantly evaluated awareness and attitudes through closed‐ended items, omitting qualitative or open‐ended approaches that could have provided richer insights into contextual factors or nuanced ethical reasoning. Finally, although the study highlights a misalignment between national policy reforms and local practices, it did not directly examine specific hospital‐level regulations, promotion systems, or incentive structures that might perpetuate tolerance of misconduct. Future research should employ larger and more diverse samples, integrate mixed methods to triangulate self‐reports with objective measures, and systematically explore institutional and policy‐related determinants of research integrity.

5. Conclusion

This study contributes to empirical research on research integrity in Chinese medical institutions by documenting both participants’ self‐reported awareness of misconduct definitions and their notable tolerance for certain questionable practices. These findings underscore the urgent need to translate such awareness into actionable strategies that counteract the normalization of selective reporting and authorship misuse. For policymakers, the results suggest that large‐scale reforms and auditing mechanisms should be paired with institution‐level measures that realign incentives and foster ethical research conduct. For hospital administrators, structured integrity training and clear, transparent authorship and reporting policies are crucial. Future research should extend to more diverse institutional settings and adopt mixed‐method designs to better understand the cultural and organizational factors that influence tolerance of misconduct.

Author Contributions

Zhenbo Zhang and Wei Chen contributed to the study conception and design. Zikai Zhang, Lei Huang and Yufei Huang collected the data and performed the data analysis. All authors contributed to the interpretation of the data and the completion of figures and tables. All authors contributed to the drafting of the article and final approval of the submitted version.

Ethics Statement

All procedures performed in studies were in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved the ethic committee of the Tongji Hospital, School of Medicine, Tongji University (No:SBKT‐2024‐293). All patients gave their written informed consent.

Conflicts of Interest

The authors declare no conflicts of interest.

Supporting information

Supplementary Table S1.

Supplementary Table S2.

Zhang Z., Huang L., Huang Y., Zhang Z., and Chen W., “Perceptions of Research Integrity among Medical Researchers in Shanghai Teaching Hospitals: A Cross‐sectional Survey,” Developing World Bioethics 26 (2026): 194‐203. 10.1111/dewb.70022.

Data Availability Statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.