Background and Goal of Study: In the last decade, publicized fraud scandals involving anesthesia have led to mass retractions. Our objectives were to classify clinical specialties by the number of retracted articles and to identify causes of retractions associated with anesthesia publications.

Materials and Methods: MEDLINE/Pubmed was searched on January 5, 2016, using the medical subject heading "retracted publication" without restriction of language or period. Clinical studies, as in, studies involving humans, were included while preclinical studies and basic science studies were excluded. For each included study, clinical specialties were classified according to the European classification of medical specialties and causes of retractions were assessed through retraction notices. Two reviewers assessed eligibility and extracted data both independently and in duplicate using piloted electronic extraction forms.

Results and Discussion: We identified and appraised 1555 clinical studies. Anesthesia held 282 retracted publications (18.1%), obstetrics and gynecology 108 (6.9%), oncology 92 (5.9%), cardiology 78 (5%). Causes of retraction were fabrication or falsification of data in 281 articles (18.1%), plagiarism in 232 articles (14.9%), honest errors in 230 articles (14.8%), duplicate publications in 176 articles (11.3%). Compared to retracted clinical studies of other medical specialties, among anesthesia articles, fabrication or falsification of data [50.7% (113/223) v 17.7% (141/798), P < 10-15]; as well as violation of ethical standard were more frequent [30.9% (69/223) v 5.1% (41/798), P < 10-15]; honest error was less common [4.9% (11/223) v 24.3% (194/798), P < 10-11]; studies were more frequently randomized controlled trials (RCT) [58.5% (165/282) v 9.7% (108/1115), P < 10-15].

Conclusion: Not only was anesthesia the specialty holding the highest number of retractions but, retractions occurred more often due to fabrication or falsification of data and involved more RCTs. Investigating the reasons why anesthesia is exposed might help restore confidence and reduce waste in this field's research.

07 / Which medical specialties hold the most retractions? A systematic review