JAMA Journal Retracts Well-Publicized Paper Linking Doctor Burnout to Patient Safety

Retraction Watch Staff

May 26, 2020

A JAMA journal has retracted a 2018 paper linking physician burnout to poor patient care, after a misconduct inquiry found evidence of shoddy work but not data fabrication.

The article, "Association between physician burnout and patient safety, professionalism, and patient satisfaction: a systematic review and meta-analysis," was published in JAMA Internal Medicine by a group based at the National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, in England. The journal also published a commentary on the article and three letters to the editor, which have been flagged to indicate the new retraction.

The paper — which concluded that burned-out doctors might be jeopardizing the well-being of their patients — received a significant amount of coverage in the media, with stories trumpeting the take-home message that:

physicians with burnout are twice as likely to be involved in patient safety incidents, twice as likely to deliver suboptimal care to patients owing to low professionalism, and 3 times more likely to receive low satisfaction ratings from patients

It has also been cited 138 times, according to Clarivate Analytics' Web of Science, making it a "Hot Paper" and a "Highly Cited Paper."

But it also drew some criticism, some of which prompted a response from the authors that the editors published in April 2019 in which they acknowledged potential shortcomings of their analysis but stood by their conclusions.

According to the notice:

The University of Manchester Panel of Investigation has investigated concerns about the conduct of research following the reporting of errors in the Original Investigation, "Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction: A Systematic Review and Meta-analysis," 1–5 that was published online first on September 4, 2018, and in the October 2018 issue of JAMA Internal Medicine. We received a report from the University of Manchester indicating the following: "the Panel of Investigation found no evidence of intentional fabrication. However, due to flaws in the systematic review process, it is likely that there are additional errors in the publication. The Panel therefore cannot confirm that the results of the meta-analysis are wholly valid and recommend the paper be retracted." Thus, this article 1 has been retracted.

JAMA and its family of journals have been making wider use of the "retract and replace" approach for papers that do not have evidence of misconduct, but did not do so here.

We contacted first author Maria Panagioti, of the University of Manchester, who said she would comment for this post but did not get back to us again before press time. An email to the institution's research integrity office went unreturned.

This article originally appeared on Retraction Watch.

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