Italy’s health minister under scrutiny over his scientific studies on cancer

Orazio Schillaci, the health minister in the cabinet of the far-right Giorgia Meloni since October, finds himself at the center of a scientific scandal. The Italian left-wing newspaper Il manifesto conducted an investigation that yielded indications of possible fraud in some of his published work, and the prestigious scientific journal Science picked up on the investigation, publishing an article of its own about “possible misconduct” by the minister. The opposition is already calling on Meloni to take action.

Il manifesto analyzed the scientific articles signed by Schillaci between 2018 and 2022, when he was rector of the second-biggest university of Rome, the Università di Tor Vergata, as well as serving as a minister. His extraordinarily prolific rate of scientific publication set off alarm bells: in the last four years he has signed 110 studies, and 30 so far in 2023. This year, his political activity has left him enough time to sign nearly four studies a month.

Thanks to AI-powered software called ImageTwin, which Il manifesto said can “compare a particular image with a database of tens of millions of images used in the scientific literature in a matter of seconds,” it has been possible to identify duplicates in several papers where the minister was responsible for supervising the scientific content or the “corresponding” author, that is to say, the person to contact for further inquiries about the research. Many of the studies dealt with the diagnosis and cure of cancer.

Same image, different tumor

The most relevant case involves an image labeled “prostate tumor cells” in a publication in the Journal of Clinical Medicine in 2021. The same image had already been used in another article from 2019 in the International Journal of Molecular Sciences, and had been described as “breast tumor cells.” In another case, the same image had been used twice in the same 2019 article in the Journal of Clinical Medicine: in one case, to illustrate prostate tumor cells in patients with metastasis; and in another case, after having enlarged the image, as cells from patients who had not had metastases. Furthermore, in another study, published in Applied Sciences in 2021, the team led by Schillaci used the same image to show cells to which a drug had been administered and, after recropping, also as an example of cells without treatment.

I wouldn’t expect for a researcher of that level to make that type of mistake so frequently

Science integrity expert Elizabeth Bik

The minister responded to Il manifesto that he did not know that his articles contained errors. “I am not an expert in electron microscopy, I trusted the person who provided those images. We will check if there are indeed errors.” One of the minister’s scientific collaborators and co-author of the published articles, Manuel Scimeca, has confirmed to the Italian newspaper that the duplications are not appropriate and require a correction. He spoke about “an error when the images were uploaded.”

But the Dutch scientific integrity expert Elisabeth Bik, who has analyzed the material mentioned by Il manifesto, believes that this case “is far from normal.” “I wouldn’t expect for a researcher of that level to make that type of mistake so frequently,” she said. The manipulation of images is the most frequent instance of scientific malpractice, which can sometimes be considered “scientific fraud” and lead to the withdrawal of the published paper.

Carelessness?

According to this microbiologist, who has been working for more than 10 years hunting for signs of errors and fraud in images of scientific articles, “at best, it is multiple carelessness.” “That is if we rule out intentionality. Also, these are the visible errors. But then, what will be the level of sloppiness in data that is much more difficult to verify, such as that contained in a table?”

“A mistake is always understandable. And each magazine can correct them individually, but the magazines do not see the general pattern: it is not a question of having it happen once, but a number of times. And this also raises the question: why is your name in that article if you have not done the research or taken charge of verifying the data?” says the fraud expert.

Biologist Enrico Bucci, a research professor at Temple University in Philadelphia (USA) is the founder of the company Resis, which is dedicated to detecting plagiarism and behavior that affects scientific integrity. According to Bucci, one of the magazines where these problematic images were found is what’s known as a predatory journal, that is, as Bucci himself explains, “a fake scientific journal.” These are “journals created with the aim of sending a flurry of requests to researchers to send in articles that are published without adequate scientific review and in exchange for payment. They have no scientific credibility, although they are presented under the guise of serious journals.”

The magazine Cancer Research and Reports is one of these, according to Bucci. “I wonder how it is possible that a rector who already has hundreds of publications to his name can decide to publish an article for which he is the lead author in a journal like that.” According to this specialist, who has published research on the subject, “between 10% and 12% of scientific articles in the field of biomedicine contain some problematic image.” Bucci is blunt about the minister’s scientific merit: “I very much doubt that if you are doing another job like university rector or minister, you can be a good researcher.”

Schillaci’s successor at the head of Tor Vergata University, Nathan Levialdi Ghiron, says that all research at his university is done “with seriousness and rigor,” although the minister has so far shown no intention of accepting his responsibility.

Schillaci is the second member of the Italian executive that is giving Meloni headaches: Daniela Santanché, the tourism minister, is under investigation for alleged tax fraud. Schillaci’s position could be in danger just when a new spike in Covid cases could signal a complicated autumn.

The Italian Left lawmaker Nicola Frantoianni has already requested Schillaci’s appearance in parliament, while his party colleague Angelo Bonelli has asked Meloni for explanations in the same forum. The microbiologist and Democratic Party legislator Andrea Crisanti has described the case as “very serious.”

In recent years, scientific fraud has increasingly come under public scrutiny. An investigation by EL PAÍS brought to light a system originating in Saudi Arabia that pays scientists to cheat to improve the rankings of the best universities in the world. Last summer, the president of Stanford University, Marc Tessier-Lavigne, had to resign after an independent review found flaws in studies that he had supervised.

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