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J Bone Joint Surg Am. 2015 Jan 7;97(1):e2. doi: 10.2106/JBJS.N.00245.

How do you know it is true? Integrity in research and publications: AOA critical issues.

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Department of Orthopaedics and Rehabilitation, College of Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 01008 JPP, Iowa City, IA 52242.
Children's Hospital Los Angeles, Department of Orthopaedics, Keck School of Medicine at University of Southern California, 1520 San Pablo Street, Suite 2000, Los Angeles, CA 90033.
Department of Orthopaedic Surgery, Washington University School of Medicine, 660 South Euclid, CB 8233, St. Louis, MO 63110. E-mail address:


High-quality medical care is the result of clinical decisions based upon scientific principles garnered from basic, translational, and clinical research. Information regarding the natural history of diseases and their responses to various treatments is introduced into the medical literature through the approximately one million PubMed journal articles published each year. Pharmaceutical and device companies, universities, departments, and researchers all stand to gain from research publication. Basic and translational research is highly competitive. Success in obtaining research funding and career advancement requires scientific publication in the medical literature. Clinical research findings can lead to changes in the pattern of orthopaedic practice and have implications for the utilization of pharmaceuticals and orthopaedic devices. Research findings can be biased by ownership of patents and materials, funding sources, and consulting arrangements. The current high-stakes research environment has been characterized by an increase in plagiarism, falsification or manipulation of data, selected presentation of results, research bias, and inappropriate statistical analyses. It is the responsibility of the orthopaedic community to work collaboratively with industry, universities, departments, and medical researchers and educators to ensure the integrity of the content of the orthopaedic literature and to enable the incorporation of best practices in the care of orthopaedic patients.

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