KEY TAKEAWAYS

• Retracted journal articles can still be cited years later, disseminating misinformation and potentially affecting patient care.
• Readers may find it difficult to identify articles that reference retracted work.

Although publications reporting flawed or fraudulent research can be retracted, many such papers linger in the literature thanks to post-retraction citations. In a Science article, Jeffrey Brainard describes how some retracted works are still being cited years later, with potential adverse consequences for patient care.

Avenell et al examined the impact of 27 clinical trial reports retracted between 2015–2019 on the publications that cited them: 70 systematic reviews and 18 clinical guidelines published between 2003–2020 included at least 1 of the retracted works in the analysis, and many did not warn readers that they cited discredited research. In 44% of cases, the authors assessed that removal of the retracted trial(s) would likely weaken the final conclusions substantially.

Systematic reviews and clinical guidelines are often used to guide medical treatments, and Mr Brainard warns that inclusion of retracted work can mislead clinicians and put patients at risk of harm.

Avenell’s team emailed the authors of the affected publications (with or without alerting the journal) to ask whether they believed any action needed to be taken in light of the retractions. Just over half of the authors replied, with 80% stating that they were unsure how to proceed or did not intend to amend their papers. The cited reasons included:

• publication was too old
• lack of time to re-analyse the data
• removal of one retracted study would not affect the overall findings.

One year after the emails were sent, 1 of the papers had been retracted and warnings had been posted for a further 8; however, only 4 of these announcements were directly linked to the citing paper.

“Even if a retracted citation doesn’t change the bottom line, journals and authors have an obligation to say so publicly.”

The article ends on a positive note, highlighting the actions already taken to minimise the impact of retracted publications:

• Bibliographic databases such as EndNote and Zotero flag papers included in the Retraction Watch database.
• The International Committee of Medical Journal Editors recommends that journal editors routinely check submitted manuscripts for post-retraction citations.
• Cochrane now adds a warning to systematic reviews citing retracted papers and asks authors of flagged reviews to revise their work.

We look forward to seeing how other journals and publishers might address this issue.

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