Abstract
Croes Council
Chairman
Jean de la Rosette, MD
Amsterdam (The Netherlands)
Adrian Joyce, MS
Leeds (UK)
Stavros Gravas, MD
Larissa (Greece)
Margaret Pearle, MD
Dallas, TX (USA)
Dean Assimos, MD
Wake Forest, NC (USA)
Ying-Hao Sun, MD
Shanghai (China)
Tadashi Matsuda, MD
Osaka (Japan)
Treasurer
John Denstedt, MD
London (Canada)
Executive Director
Sonja van Rees Vellinga
Amsterdam (The Netherlands)
Mission
Through worldwide collaboration, CROES seeks to assess, using evidence based scientific methodology, the various aspects of clinical endourology.
Vision
By applying rigorous scientific evaluation to the field of clinical endourology, CROES will enable all urologic surgeons to bring to their patients the most effective and efficient care possible.
Projects
• Global PCNL study
• Global URS study
• Global GreenLight Laser study
• Global Renal Mass study
• Global NBI study
Contact
For more information please contact Sonja van Rees Vellinga (
IT'S GOOD TO KNOW THAT THERE IS CROES
Bad news
• The German education minister, Dr. Schavan, loses her academic title and resigns in February 2013 on charges of academic plagiarism. Blog-driven research since early 2012 has shown that her doctoral thesis written 30 years ago contains numerous partly reformulated citations, the sources she has not referred to.
• According to an article published in the December 2012 Newsletter by the Office of Research Integrity of the U.S. Department of Health and Human Services, the retraction rate of scientific articles is continuously rising. 1 Data of the latest U.S. National Library of Medicine report on the frequency of retracted scientific publications shows an increase by 38% from 2011 to 2012. 2 A recently published review of all retracted articles listed by PubMed since 1973 revealed that more than two-thirds are attributable to misconduct. 3
• Application of certain therapeutic techniques is not necessarily driven by scientific evidence illustrated by the conclusions drawn in two recently published articles on ureteroscopy and shockwave lithotripsy: “Nonclinical factors are associated with the use of ureteroscopy or shock wave lithotripsy for initial stone management, which may reflect provider and/or patient preferences or experience.” 4 and “There is wide variation in procedure choice for children with kidney stones at freestanding children's hospitals in the United States. Treatment choice depends significantly on the hospital at which a patient undergoes treatment.” 5
• As a reader and reviewer of different journals, I frequently get the impression that some articles are too good to be true.
Good news
• The topic of Mrs. Schavan's doctoral thesis was not urologic.
• The overall frequency of retracted scientific articles is relatively low: In 2012, the U.S. National Library of Medicine reports 760,903 citations indexed for MEDLINE and 375 retracted articles, 7 which is equivalent to a 0.049% retraction rate.
• The list of the 53 journals with between 70 and 3 retractions contains no urologic journal. 3
• The most recent retracted urologic article I am aware of concerns circumcision and thus no endourologic topic. 6
I still wonder, however, why some colleagues sometimes defend and perform obsolete procedures. My impression as a reader and reviewer of the better than good publications is probably attributable to advanced age and experience, which frequently are accompanied by a higher rate of skepticism. I know that others share the same impression, even though a rational proof for a gut feeling is difficult to give.
The fact that there are only two surgical journals in that list of 53 journals with retractions probably does not mean that surgery/urology is without problems.
But there is the Clinical Research Office of the Endourological Society
(CROES): • In the CROES global studies, the raw data come from different institutions in different countries; the data are initially handled by the data managers of the CROES office.
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• Then the task of the CROES Audit Committee is monitoring, validation, and quality control of the data “to safeguard that the conclusions coming from the studies are impeccable and accurate.”
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• The data are evaluated by the Steering Committee of the relevant study and with the assistance of the CROES publication office,
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articles are prepared according to the guidelines for CROES publications
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and reread by the Steering Committee members and by additional authors from different institutions and different countries. • Reproducibility of a certain technique or procedure is documented by the identical = reproducible outcomes in a large number of cases at different times within the hands of different surgeons in different countries. Like this, not only reproducibility but also credibility is gained. Thus, the character of CROES publications finally reflects crowd wisdom.
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This setup should actually guarantee a negligible influence of any of those frequently quoted reasons for article retraction such as data falsification or fabrication, plagiarism, or duplicate publication. As a consequence of the whole mechanism of article generation, the CROES publications approach a quality that should rank them high in the hierarchy of evidence-based medicine information.
In addition, crowd wisdom has some prerequisites, and a problem remains. One of the main characters of a wise cloud is the independence of the individual opinion. Urologists attend the same meetings, read the same journals, and share similar opinions. The real NEWs will be hidden in the bulk of data we accept as granted because they fit into our view of the world. We should have careful eyes and ears for results that contradict our common understanding and anticipations concerning well-known topics. The truth or the new may show up as something we do neither expect nor accept at first glance.
Like this, the quotation Dr. Clayman used in his comment on the CROES Percutaneous Nephrolithotomy study, 13 “None of us is as smart as ALL of us,” by Eric Schmidt, hopefully can sometimes be turned into “One of us is smarter than ALL of us.”