‘Correcting the record on “Publication integrity and industry influences on the editorial process: a case study" Res Integr Peer Rev. 2026;11:49.’ Reply

In response to Dr. Rathmell’s Correspondence [1], we firmly stand behind our original essay [2] which was objective, factual, referenced, and independently verifiable.

We do appreciate Dr. Rathmell’s acknowledgement that 1) publication of the article by Hussain et al. [3] and accompanying editorials took too long, 2) explicit disclosure of the American Society of Anesthesiologist's organizational relationships with Pacira would have improved transparency, and 3) his complete recusal and procedural separation would have avoided an editorial conflict. Nevertheless, the fact is that Dr. Rathmell accepted and published a peer reviewed research article and then simultaneously published two extraordinarily conflicted editorials that contradicted or undermined the article.

It still remains unclear why an editor would invite two negative editorials from conflicted authors, and compromise journal integrity through this approach. Why would an editor believe – given the immense number of publications on liposomal bupivacaine (approximately 940 prior to the Hussain et al. article) – that any one review article, which simply summarized prior research, would be controversial? And why would an editor believe that this review article would engender litigation, given the rulings of the Federal trial court and Federal Appeals court that research is protected speech [4]? These key issues were not addressed in Dr. Rathmell’s letter. And still left undisclosed are the external pressures, circumstances, and unconscious processes of logic that led to the editorials.

As we stated, and as Dr. Rathmell noted, and as recommended by the International Committee of Medical Journal Editors [5], the venue for responsible debate, critique, and disagreement is Correspondence. Critical letters are welcome, and the authors of articles discussed in such Correspondence should have an opportunity to respond. Publishing critiques of an article as two editorials bypassed this accepted process. That accepted process was followed by Anesthesiology several months later (correspondence regarding a minor statistical point in the article by Hussain et al. and their reply) [6, 7]. Why was this not done initially, engaging open scholarly dialogue in the traditional manner and time frame, particularly about issues apparently of greater concern to the Journal and its readers?

Dr. Rathmell’s description of the content and handling of our communications with Anesthesiology is incorrect. We initially submitted a multipage, thoroughly referenced, fact-based essay. Per his instructions, this was revised and resubmitted by us after multiple rounds of review. In response, on each occasion, Dr. Rathmell sent us a lengthy denial. Eventually he sent us a highly abridged, uninformative, single paragraph that he had composed, and said he would publish it if we signed our names to it. We believed it misrepresented the situation and would have constituted ghostwriting. Thus, we declined to sign it. Our submission was then rejected.

The decisions and actions of Anesthesiology and the Editor-in-Chief with respect to this issue were unwise and at the very least created the impression of conflicts at multiple levels. Hopefully this is never to be repeated.

Authors’ contributions

All authors contributed to the writing of the manuscript, and read and approved the final version.

Funding

No funding was received to assist with the preparation of this manuscript.

Data availability

No datasets were generated or analysed during the current study.

Declarations

Competing Interests

Evan Kharasch serves on a Data and Safety Monitoring Committee for Vertex Pharma.