Letter to the Editor: Expression of Concern. CORR Insights®: Preoperative Pain Sensitization Is Associated with Postoperative Pillar Pain After Open Carpal Tunnel Release

To the Editor,

Academics should pay attention to an expression of concern that was recently issued in Clinical Orthopaedics and Related Research® [5], not so much because of the topic itself, but because there are several underlying lessons associated with it that merit our focus.

First, I note a couple of misconceptions regarding academic publishing. For one, there is no such thing as a “safe” paper. Academics who consider their published work to be in a final form should know that science and knowledge are in a constant state of flux. Thus, information that might be valid today may be invalidated later on. In the case of Dr. Vranceanu, through no fault of her own, an expression of concern was issued because of the inability of Roh et al. [2] to present proper ethical approval for their now-retracted studies. Although science may appear to be self-correcting, the correction of a scientific paper and science itself is often a proactive and reactive process that can occur years after publication [1].

Second, the safety and half-life of published articles will differ among journals, sometimes independent of the quality of editorial and peer-review scrutiny, because concerns, criticisms, or other discoveries about a published paper may arise through postpublication peer review or postpublication dialogue, including on social media and blogs [4].

A paper may become retracted via many routes and for many reasons. Prior to its retraction, however, the paper may have been cited as a valid form of scientific evidence, but postretraction, those citations become invalidated. Despite their invalidation, some retracted papers continue to be cited [3]. Citing retracted literature can impact the integrity (ethical, methodological, ideological) of the paper itself, or society, if the information is related to health. If the original information that relied on a retracted paper is no longer valid, if core arguments are no longer true, or if fundamental aspects are disproved, then a tough choice has to be made: (1) to leave the paper as is; (2) to issue an expression of concern and to allow others to weigh in on the case; or (3) to skip the second step (expression of concern) and issue an erratum for minor errors or a retraction for major or more serious problems.

It is impossible for academics to know, when they select a paper to cite in their own manuscripts, whether the cited paper might someday be retracted. As mentioned earlier, the fact that Dr. Vranceanu’s CORR Insights® commentary received an expression of concern was no fault of hers; she committed no error. Still, researchers need to know that this can occur; papers that scientists cite or comment on in good faith may subsequently be retracted, and this may result in people whose work was both well intentioned and well performed earning an expression of concern.