A doctor responsible for more than 50 papers on reproductive health issues—including chronic hypertension in pregnancy, drug treatment during preterm labor, and heart disease—has likely faked the data behind the studies, according to a group of scientists in the field. Even worse, some of that work has made it into trend studies in major American scientific journals that influenced clinical care.
Drs. Ben Willem Mol (of Monash University in Australia), Dr. Lyle Gurrin (of University of Melbourne), Francis Gitahe Muriithi (of University of Birmingham UK), and Jim Thornton allege that 51 papers authored by Dr. Mohamed Rezk of Menoufia University, in Egypt, don’t hold up to scrutiny and likely constitute data fabrication. The group published its allegations in a paper submitted for preprint in Archives of Gynecology and Obstetrics. “We’re talking about families who lose their mother, who lose their baby because of this problem,” Mol, the lead author, told Jezebel via Zoom.
Rezk is already known in academic fraud research circles. His name is connected to eight papers listed in Retraction Watch’s database, half of which were retracted. Retraction Watch is an independent blog that tracks scientific fraud, fabrication and, of course, retraction. If all Rezk’s 51 accused papers were retracted, he’d make into the site’s top 10 worst offenders. The doctor did not respond to Jezebel’s email requests for comment.
This group of scientists say they’ve found evidence of falsification of data across Rezk’s work. The problems alleged by the group are best illustrated by two studies Rzek authored or co-authored. Each paper is about a randomized clinical trial (the gold standard for testing drug efficacy) that studies mild to moderate chronic hypertension in pregnancy, a condition affecting upwards of 20% of pregnant women.
Both studies recruited pregnant patients from August 2017 to August 2018. Each looked at three possible medical interventions for chronic hypertension (high blood pressure). The first study was released in 2019 with 520 participants, and the second, released a year later, with 514 participants.
One red flag, according to Thornton, an emeritus professor of obstetrics & gynecology at the University of Nottingham, was that the vast majority of raw data presented in tables in the study were even numbers. “That shouldn’t happen in biology. It should be more or less an equal number [of odds and evens],” Thornton told Jezebel by phone.
Thornton calculated the probability it would happen like Rezk reported. “One in hundreds of millions,” he said. “It was less probable than all the stars in the universe.”
That study made it into a meta-analysis, or trend study, in the influential American Journal of Obstetrics and Gynecology. The second red flag were the sizable numbers of pregnant women Rzek was able to enlist for his studies, which would have required a robust recruitment effort costing millions. While not impossible, it seemed improbable. Australian epidemiologist Gideon Meyerowitz-Katz, who studies scientific fraud, described his own trial currently underway, concerning diabetes. He’s working with a “skeleton team,” he explains, with one nurse helping recruit patients. “It is very impressive that they managed to recruit hundreds of people for all of these trials, usually within the space of six to nine months,” he told Jezebel. “It is a remarkable coincidence.”
Meanwhile, Mol has been notifying publishers of Rzek’s questionable studies, but his warnings have largely fallen on deaf ears. Mol, along with Dr. George R. Saade of University of Texas Medical Branch Galveston, wrote a letter to the editor that was published in the journal Pregnancy Hypertension concerning Rzek’s 2020 hypertension study. Rzek published a response in the same issue, defending his recruitment process and study design. And that was the end of that.
Mol feels a duty to speak out about issues of fabrication, especially in obstetrics, because of the high stakes. “You need collaborative and trustworthy research all over the world,” Mol said.