World reference doctor in the treatment of concussions in sport is accused of plagiarism

For more than two decades, Paul McCrory has been the physician who has most influenced the concussion assessment protocols used by sports leagues and organizations around the world.

As leader of the Concussion in Sport Group (CISG), McCrory helped select group members and write the quadrennial consensus statement on the latest research on concussions — a veritable bible for leagues, fitness coaches, sports doctors and academics, once defined by an NFL spokesperson as “the foundation of all sports-related research”.

But McCrory’s status as a guardian of concussion treatments and research is being challenged now that he faces multiple charges of plagiarizing other scientists, in some cases in articles for a scientific journal of which he was the editor. The doctor denied that he had intentionally reproduced others’ texts without credit, and called an article, which was taken out of circulation after the discovery of plagiarism, “an isolated and unfortunate incident”.

The scandal that the renowned doctor is facing has raised questions about the relationship between him and the sports leagues and about the influence he may have had on the interpretation of research on brain and brain trauma. McCrory has long expressed doubts about the legitimacy of CTE (chronic traumatic encephalopathy).

“It’s concerning because he had a leadership position in writing the consensus statement, a very important document, and we should have access to his reasoning process,” said Kathleen Bachynski, a professor of public health at Muhlenberg College, who has published work on head and brain injuries in sport. “McCrory’s research agenda and his published statements and work as an expert witness come from a point of view to downplay the importance of ETC.”

McCrory’s importance grew as sports leagues began to seek a consensus opinion on concussions.

The doctor’s rise to power in concussion research circles is notable because he works in Australia, far from the research centers studying brain and head trauma in the United States and Europe.

A neurologist at the Florey Institute for Neuroscience and Mental Health, McCrory worked for 15 years as a doctor at Collingwood Football Club, an Australian football club in Melbourne, starting in about 1990.

He has been a consultant to the Australian Football League and F1 and boxing, rugby, football and sporting bodies including the IOC (International Olympic Committee), FIFA and the International Ice Hockey Federation since the beginning of this year. century.

McCrory expanded his influence by writing hundreds of articles published in scientific journals, often based on research by other doctors, and as editor of the British Journal of Sports Medicine between 2001 and 2008, which allowed him to write editorials and help decide which articles would be published.

McCrory’s stature grew around the world because of his position with the Concussion in Sport Group. He rarely speaks to the press, which he accused of distorting the dangers of concussions in a way that “creates a sense of fear”, criticized Boston University researchers who have done most of the existing work on ETC, and called the effects of concussions as “transient”.

Peter Jess, who represents former Australian Football League players who are fighting for benefits, have been battling McCrory and the league for years. Jess said McCrory casts doubt on ETC by implying that players’ neurological problems may be related to alcohol or drug abuse, or to genetic factors.

Jess compared McCrory’s approach to “the playbook followed by the big tobacco companies,” and questioned whether connections between the doctor and the big sports organizations might have influenced his judgment.

McCrory was a founding member of the concussion group, which released its first consensus statement at a 2001 meeting organized by the International Ice Hockey Federation, the IOC and FIFA. As the sports world became more and more aware of the results of research on the long-term effects of concussions, starting in the middle of the last decade, sports leagues began to seek recommendations from the group, which defined itself as a collegiate body. of scientific leaders that offered consensus on the latest research.

“In the meantime, the sport seemed content to allow this to continue, because it was ‘independent experts and leaders in concussion research’ offering them industry guidance on how to manage concussions,” said Willie Stewart, a neuropathologist at Queen Elizabeth University Hospital. , in Glasgow, which operates Europe’s largest sports-related brain bank.

The first consensus statement released by the concussion group, in 2001, had 10 authors. By 2016, when the fifth and most recent was released, the list of authors had grown to 36, and included Richard Ellenbogen, then one of the chairman of the NFL’s Head, Neck, and Spine Injury Committee, and Allen Sills, who became became the league’s vice president of medicine in 2017.

But as the group’s impact grew, more of its members came to be supported by the sports leagues the group was supposed to advise. These relationships have led critics to question whether the organization would really be able to offer a rigorous and unbiased interpretation of existing research on head and brain trauma.

“There’s no basis for saying that’s a consensus when it’s a consensus among people who have been paid a lot of money to come to a certain opinion,” said David Michaels, former assistant secretary of labor in the federal government’s Occupational Health and Safety Administration. and author of “The Triumph of Doubt: Dark Money and the Science of Deception”. “That may not mean that they are intentionally hiding the truth. But we all know that financial interest can blind them to reality.”

The first accusation of plagiarism against McCrory relates to an editorial he wrote in 2005 for the British Journal of Sports Medicine, of which he was editor at the time. However, Steve Haake, a professor of sports engineering in Sheffield, England, noticed that about half of the article had been copied from a text published by Haake five years earlier in the journal Physics World.

The publication decided not to pursue the case further. Last year, Haake raised the issue with the British Journal of Sports Medicine, which eight months later, on February 28, withdrew McCrory’s editorial as “an illegal and indefensible copyright infringement.”

Haake was not satisfied with this answer.

“I wish there were some punishment for such blatant plagiarism, as happens when a student commits this kind of infraction,” Haake wrote on the website Retraction Watch. “If anyone can steal our words at any time and get away with it, what’s the point?”

McCrory did not respond to a request for comment, but told Retraction Watch that the plagiarism example was “an isolated case”. By then, Nick Brown, a physician who runs a popular blog documenting flaws in published research, had identified two other works published by McCrory in the British Journal of Sports Medicine that appeared to have been plagiarized. McCrory said that in one of them, a draft article had been uploaded to the internet prematurely and that he had asked the publication to take it down. In the other, the text composition did not include the necessary quotation marks.

“In both cases, the errors were not deliberate or intentional, but they still require correction, as what has been published is plagiarism,” McCrory told Retraction Watch. “Once again, I apologize for my mistake.”

Since then, Brown has published even more examples of McCrory reproducing entire excerpts from works by other authors, without attribution. Chris Nowinski, founder of the Concussion Legacy Foundation, mentioned other examples of McCrory’s distortion of data from researchers at Boston University on the severity of CTE.

“I’ve never seen anyone make the mistakes McCrory made in referencing our studies, which includes unmedically trained media members, bloggers or even lay people on their social media accounts,” Nowinski wrote.

A spokeswoman for the company that publishes the British Journal of Sports Medicine said the publication “is studying the allegations and will investigate and act accordingly”.

With the number of allegations of plagiarism mounting, McCrory resigned this month from his post on the concussion group. Medical regulatory authorities in Australia acknowledged that he had been “prevented from performing neurodiagnostic procedures” in May 2018, without giving reasons for that decision. Jess said McCrory screened 10 of his clients after that ban.

McCrory’s employer, the Florey Institute, said in a statement that the articles in question had been published in 2005, before he began working there, but that the institute “treats all issues concerning scientific integrity with the utmost seriousness.” A spokeswoman declined to say whether McCrory would be penalized.

Spokespeople for FIFA and World Rugby said the organizations were reviewing their relationship with the concussion group. The Australian Football League no longer has formal ties to McCrory, but continues to work with three of his allies who also signed the latest consensus statement. The league did not respond to a request for comment.

For now, the concussion group says it will continue its “work, centered on the scientific content of the consensus conference” to be held later this year in Amsterdam, said Jiri Dvorak, former FIFA vice president of medicine and one of the members. group founders.

The allegations of plagiarism are the most serious ones to undermine McCrory’s credibility regarding the long-term effects of repeated blows to the head and ETC, and some say this could force sports organizations to reconsider the guidelines he and other doctors have set.

“The consensus statement provides a cover of respectability for a conspiracy of well-connected figures,” said Stephen Casper, who has written on the history of head and brain injuries in sport, testified on behalf of former NHL hockey players in a lawsuit over concussions and is an expert witness involved in lawsuits against the NCAA, the American Confederation of College Sports, the Rugby League and the Rugby Union. “All authors are tainted by McCrory.”

Revamping the concussion group will be difficult, however, because from the beginning it has been supported by organizations that view athletes’ brain and head injuries as a threat to their very existence. The group is not an independent organization with open elections or expert rotation, and even with McCrory gone, many of his allies remain who have advised, worked for or received research funding from FIFA, the IOC, the NFL, the NHL and other organizations.

Still, some members see an opportunity for the group to become more transparent about potential conflicts of interest, publicly answer questions about its findings, and incorporate views from neuropathologists, public health experts, and epidemiologists that better reflect the scientific aspects of ETC.

“With Paul excluded from the group, there is an opportunity,” said Robert Cantu, a member of the group and clinical professor of neurology and neurosurgery at the Boston University School of Medicine.

Bachynski signed an editorial in the Journal of Law, Medicine & Ethics in 2021 calling for the concussion group to become more transparent. She argued that cutting the ties that link the group to the sports organizations that fund it is also critical.

As an example, she said, “we in public health have a really tough rule that we’re not going to accept health care guidance” for tobacco-related issues “from a Philip Morris-funded health organization.”