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Not one reviewer raised a red flag in the bastions of intellect

Coloured women have an increased risk of low cognitive functioning because of low education levels and unhealthy lifestyle behaviours. This is the erroneous conclusion of a recent Stellenbosch University (SU) research project.

Erroneous, because of how the researchers defined their study. Erroneous, because no red flags were raised about the moral, ethical and factual validity of the study by any one of a number of role players who are meant to do so, to the point that I am dumbstruck, says Dr Tozama Qwebani-Ogunleye.

The research project, called: "Age and education-related effects on cognitive functioning in coloured South African women" assessed the cognitive function and its association with age and education. The study is flawed for a number of reasons.

It is a ridiculously tiny sample. Only 60 women took part in the study, a small sample group by any standard, but especially in light of the claims the study purported. The title, abstract and introduction infer that the results are applicable to all "coloured South African women". To add insult to injury, the women, who were between 18 and 64 years of age, were all from the same area.

Furthermore, the authors use the apartheid racial designation 'coloured' incorrectly and suggest that these communities are a homogeneous class. I cannot fathom how this study passed through all of the checkpoints a scientific study has to go through without as much as a single flag being raised in the bastions of SU. To me, this raises questions about the levels of bias and stereotypes still entrenched in the scientific community.

The study was funded by the National Research Foundation (NRF). To qualify for the funding, a study proposal is assigned to two or three reviewers for scrutiny. Their evaluation is then presented to a panel, which further scrutinises the proposal before making recommendations to the NRF board, which makes the final call on whether or not funding is approved.

To err is human, which is why further checks are in place. Each university has a research committee. This committee, which generally comprises experienced and emerging researchers, verifies the scientific integrity of every proposal prior to submission for research purposes at the university.

Once the proposal has passed through this check, it then has to go through another committee: the Ethics Committee. A panel assesses the proposal based on the moral and ethical fibre of the intended research. This is an especially vigorous vetting process when human participants are involved. If a university does not have an ethics committee, scientists can submit their proposal to the Ethics Committee of another university in order to receive an ethics certificate, allowing the research to continue.

When the time finally arrives to submit the research paper for publication, the editor of the academic journal will first send the manuscript to two or three reviewers for comment. Based on their comments and recommendations, and the opinion of the editor, the paper will be published or rejected.

So again, I must ask the question: How did this study make it through all of these checks? Did no one sitting on one of those boards or committees find the study flawed?

As a citizen of the scientific community, I signed a petition demanding the withdrawal of the study. At the same time, other members of the scientific community defended the study, pointing to the fact that similar studies had been conducted in South Africa.

Does it make it right that this is not the first study of its sort?

Just because the NRF approved funding for the research to continue, does that mean the research is morally and ethically correct?

The human race is fraught with prejudice and bias, are we not?

Even someone with a moral backbone has the potential of straying from their conscience, do they not?

Who then guards the guards?

It is clear that science, knowledge, research methods, practices and the like are not free from bias. We are falling short of the ideal, but it need not be so. Let us learn from this study and the mistakes made so as to not repeat them and cause more harm.

The Department of Health (DOH) and the South African National Human Research Ethics Council (NHREC) formulated eight principles to help regulate scientific research: NHREC, Chapter 2 2015.

I will mention four in this blog: relevance, value, scientific integrity and fair selection.

* Relevance and value

Research should be relevant to the needs of the people of SA. It should contribute to knowledge generation and to how the findings might translate into products, interventions or services likely to improve the standards and well-being of South Africans.

* Scientific integrity

The scientific community should be trusted. The only way we will achieve this is if we act with an indefatigable integrity, not some of the time but all of the time, always making plain the truth even if it is uncomfortable or inconvenient or directly opposed to our intents or wishes.

* Fair selection

Selection must be based on sound scientific and ethical principles for: recruitment, selection, exclusion and inclusion.

Applying the four principles above to the study in question might shed some light on the situation.

What would have been a fair selection? To evaluate all "coloured" people in South Africa? Are men excluded from the reported malaise? Is this really a symptom exhibited by coloured women or is it not rather a symptom exhibited by people subjected to certain living conditions? The fact that 100% of the sample group come from the same area certainly suggests that there is merit to this hypothesis.

Where were the men and women of integrity during the research and reviewing process? Perhaps it is unfair to be too harsh on the researchers if it turns out to be that they are young and inexperienced. But what about their mentors and all those people who sat on the review boards and committees; why did they remain silent?

Of what value has the research been? How can the findings be translated into anything of value that will benefit South Africans? Notwithstanding the skewed dataset as a result of the flawed research methodology, I don't think much can come of the study except that a group of people have now been hurt. If the scientific community can learn from this, then positives can be derived.

Maybe, just maybe, all that was needed to prevent this situation was a tweak here and there; rephrase the title, increase the sample size and expand the selection to include people from across the country.

SU has realised that it has made a mistake, has acknowledged the fact publicly and has apologised. This shows that the university does have some moral backbone, and this is definitely a step in the right direction. Further to this, the study has been retracted. As per SU's policy on publishing ethics and integrity, and the COPE guidelines on retractions, the article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as "Retracted".

As a scientific community, how do we begin to remove the bias still pervading the human race?

I propose that a thirst for truth, an awareness of what is happening in the scientific world and an active participation by its citizenry, as we have seen by the reaction of the community to this study, might just be the medicine humanity needs.

After all, anything that divides us weakens us.

By Dr Tozama [email protected]