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10/27/06
DEar
Dr. Roberts, on behalf of Dr. Minoja and Dr. Okuchi, I am sending you
the repaly to your letters. I apologize for the delay, due to academic
and hospital duties.
I remain at your disposal for anything you may require.
Sincerely
Enrico Facco
Dear
Dr. Roberts,
We
apologize for replying so late to your persistent requests, but summer
holidays first and, then, academic and hospital duties and congresses
have prevented us to answer to your questions.
We
hold the Cochrane Injuries Group and his co-ordinating editor in the
highest attention and regard. On the other hand, the authors of the
paper also deserve a full respect: Dr. Okuchi is a Japanese board certificate
neurosurgeon, Dr. Minoja is the head of NICU dept. in the University
hospital of Varese and Prof. Facco is professor of Anesthesiology and
Intensive care at the University of Padua. All of us have over 20 year
clinical experience in the management of head injury and in the use
of mannitol, as well as all other aspect of management: we cannot help
with rejecting any possible insinuation about our honesty, professionalism
and skill. Dr. Cruz has been a leading authority in the field of head
injury in the eighties and nineties and was the most honest, rigorous
researcher and bright clinician we met. Any charge of falsity is indeed
incompatible with his personality, professionalism and biography. For
all of us even the slightest intention of doing something false would
be simply unconceivable.
We cannot exclude that, in our previous correspondence, something might
have been misunderstood, despite we only told you the truth and this
is our only aim. Therefore, now we have joined to give all our information
and opinion, then you will decide what is right to do.
As
you have already be informed by us, we had only a minor role in the
papes by J. Cruz you mentioned, despite we think that it was not a gift-authorship.
In fact, as you know, we did not participate in data collection, but
all of us had a good clinical experience with the use of high dose mannitol
before starting the study, and all of us, including Dr. Cruz, discussed
together and shared our clinical experience: we participated in conceiving
the study, namely, in defining the aims and study design. Dr. Cruz collected
the data, a relatively small sample when the last paper is concerned
(44 cases), because the protocol called for very early mannitol administration
in the emergency room, that is, before the admission to the NICU (authors
working NICU did not work in the emergency room and could not collect
the data). Probably, this is the simple reason for your uncertainty
about the centres involved in data collection: the study has been conducted
in Brazil only, instead of 3 Countries, due to our impossibility of
treating the patients in the emergency room.
Of
course, none of us claimed to remain in the study as an author, due
to our incapability of collecting the cases, but Julio kindly recognized
our contribution, which was only "philosophical" but, anyway,
relevant, since it sprang from our experience and discussion. We do
not think that it can be considered as a mere gift-authorship, but,
so far, we have done absolutely nothing to claim or get something undue.
On the other hand, you should grant that data collection is only one
of the manifold aspects of a study, and the choice of including or withdrawing
co-authors according to their involvement is up to the main author only.
Further
aspects to be taken into account are the following:
1.
The paper has been published in an international, peer reviewed journal,
where the full author's responsibility is an essential part of the process
of submission: it seems to us that this should be enough. Any doubt
about that, would involve the journal and its editor in the charge of
misconduct.
2.
None of us has ever doubted about the existence of the patients and
correctness of results: we do know that he has done data collection
rigorously, because we know him very well and we do know that he would
never have been able to do something false. Such a charge is simply
unconceivable for a rigorous, keen, honest scientist, as he has been
throughout his professional life. In our previous correspondence we
told you that we were not responsible for data collection because we
did not collect them directly, but we have no doubt about them.
3.
The main problem is that Dr. Cruz is dead, and, thus, you cannot ask
him directly: this is the only reason for your doubts. He already took
full responsibility and, would he be still alive, he would strongly
confirm it to you again, with no doubts. On our opinion, it looks questionable
doing it again: in fact, no dead scientist can confirm the responsibility
he took during his life. As a consequence, for the sake of coherence,
one should retract all the published papers, once the authors are dead.
4.
The results of the study are not only true, but also are confirmed by
our clinical experience and there is no reason for considering them
as false and even harmful.
5.
We have no right at all of retracting the paper from the journal: it
might be decided by J. Cruz only. But, please, consider again that everything,
including responsibility has been done when required. A bright scientist
as J. Cruz was, deserves the highest esteem during his life and after
his death, and all of us are to keep a good memory of him, instead of
trying to kill him for the second time, with no reasons.
In
conclusion, we have nothing to claim for ourselves, but we are to reject
any charge. We do believe that your concerns are not grounded, despite
some possible misinformation in your process of reviewing. We feel able
to witness the absolute honesty and correctness of Dr. Cruz, who has
always detested any bias, falsity, prejudices and politics in the world
of science, as well as whatever looked to be not true or "politically
correct". We cannot retract the paper (we have not the right to
do it) and we believe that it would be conceptually wrong: if you believe
that the paper is true, you can include it in your review process; otherwise,
you can simply skip it, if some doubt persists, despite the paper, the
patients are true, the results are good, reliable and useful to the
patients, with no harm: in deeply comatose, decerebrated patients the
only harm would be denying them the proper dose of mannitol.
We
hope that our comments can meet your requirements and remain at your
disposal for anything right you may require.
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