A note from Sage on retractions in Health Services Research and Managerial Epidemiology

Today, we retracted three articles in the Sage journal Health Services Research and Managerial Epidemiology:

  • “A Longitudinal Cohort Study of Emergency Room Utilization Following Mifepristone Chemical and Surgical Abortions, 1999–2015” (2021)

  • “A Post Hoc Exploratory Analysis: Induced Abortion Complications Mistaken for Miscarriage in the Emergency Room are a Risk Factor for Hospitalization” (2022)

  • “Doctors Who Perform Abortions: Their Characteristics and Patterns of Holding and Using Hospital Privileges” (2019)

Following Committee on Publication Ethics (COPE) guidelines, we made this decision with the journal’s editor because of undeclared conflicts of interest and after expert reviewers found that the studies demonstrate a lack of scientific rigor that invalidates or renders unreliable the authors’ conclusions. More specifically, the following factors informed the decision to retract: 

Conflicts of interest (COI)

Upon submission, the lead author declared no conflicts of interest and all authors declared the same within each article; however, all but one of the article’s authors had an affiliation with one or more of Charlotte Lozier Institute, Elliot Institute, and American Association of Pro-Life Obstetricians and Gynecologists – all pro-life advocacy organizations that explicitly support judicial action to restrict access to mifepristone. Had the authors followed guidance from the journal (per the International Committee of Medical Journal Editors), they would have declared these affiliations as conflicts of interest.

Problem with pre-publication peer review

All three articles were originally reviewed by a researcher who was also affiliated with the Charlotte Lozier Institute at the time of the review. In accordance with COPE guidelines, we found that the peer review process for the articles was unreliable.

Unreliable findings

We asked experts in epidemiology and public health to conduct an independent post-publication peer review.  With regard to the 2021 and 2022 articles, which rely on the same dataset, two subject matter experts found that the authors’ conclusions were invalidated in whole or in part based on the following:

  • fundamental problems with the study design and methodology,

  • unjustified or incorrect factual assumptions,

  • material errors in the authors’ analysis of the data, and

  • misleading presentations of the data.

A statistician who reviewed the 2021 article identified similar problems.

In the 2019 article, which relies on a different dataset, both subject experts identified unsupported assumptions and misleading presentations of the findings that, in their opinions, demonstrate a lack of scientific rigor and render the authors’ conclusion unreliable.

Moving forward

Sage was founded on the belief that rigorous scholarship can improve the world. As an independent publisher, we prioritize academic integrity free from the pressures of shareholders, and, while upholding editorial independence, work with our journal editors to achieve high standards of scientific rigor and integrity. When we become aware that those standards have not been met, we take seriously our responsibility to investigate and correct the academic record when necessary – all in accordance with COPE guidelines.

Our Research Integrity Team is dedicated to ensuring our processes are continuously reviewed and improved in support of publishing articles based on sound science that is rigorously reviewed by scholars who are experts in their fields.

Sean Scarisbrick