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Joachim Boldt was a prominent German anaesthetist with an international research reputation. He was regarded as a leading specialist in intravenous fluid management and was an advocate for the use of colloids, particularly hydroxyethyl starch solutions, to boost blood volume during surgery.
However, a lengthy investigation has led to 88 out of the 102 studies that Boldt has published since 1999 being withdrawn from the medical literature. He has been found guilty of research misconduct, including failure to acquire ethical approval and fabrication of study data, and sacked from his position as professor at Klinikum Ludwigshafen, a large teaching hospital in Ludwigshafen, Germany, where he carried out his research. The retraction of such a large body of work has had far reaching effects on clinical practice, research oversight, and editorial policies.
Deception unmasked
The story starts in December 2009 when the journal Anesthesia and Analgesia published a study comparing the effect of two bypass pump priming solutions, albumin and hydroxyethyl starch colloidal solution, on markers of postoperative inflammation and organ function. 1 On 18 December, two weeks after publication, a reader sent an email to the journal's editor in chief, Steven Shafer, saying he was puzzled by the research. The email said: "The results are all very consistent, all very much statistically significant with very small standard deviation." He described the results as "extraordinary given the small number of included patients." And "the reported effect on coagulation tests and bleeding is particularly 'magic.'"
Shafer, who is also professor of anaesthesiology at Columbia University, told the BMJ: "Boldt was incredibly prolific. He submitted around one manuscript a month to us and other anaesthesia journals. He tended to publish small studies that you would think were underpowered but often had an interesting finding. All his papers were multiauthored by people with a reputation in anaesthesia. He appeared to have a very effective team."
A second email arrived a day later, also questioning the authenticity of the research. Shafer sent an email to Boldt asking him to discuss the issue. "At this point I just thought there would be a simple explanation, a simple error," said Shafer.
The paper had been through the journal's normal peer review process before publication. Shafer went through the research again, but...