While going about my business last month, I stumbled upon the scientific fraud case of Stephen Breuning. In the early 1980s, Breuning was a rising star in the field of psychopharmacology for his research on the use of behavioral drugs on individuals with intellectual disabilities. By the end of the decade, Breuning would be a convicted felon and his research career would be over.
Stephen Breuning was born in 1952 in Texas. He earned his PhD in psychology in 1977 from the Illinois Institute of Technology, writing a dissertation on classical conditioning in goldfish (Breuning, 1977). As many graduate students do, he had a variety of short-term positions, including time as an adjunct instructor, behavior analyst, teaching assistant, and student teacher in a high school. After graduation, he went to work for the Oakdale Regional Center for Developmental Disabilities in Lapeer, Michigan, as a psychologist. In September 1978, he moved to the Coldwater Regional Center for Developmental Disabilities in Coldwater, Michigan, where he was a psychologist. Both institutions are now closed but were, at the time, state-run inpatient facilities for individuals with intellectual disabilities. Breuning left Coldwater in January 1981 to take an academic appointment at the Western Psychiatric Institute & Clinic at the University of Pittsburgh School of Medicine.
Research Career and Conviction
After publishing a number of articles on goldfish (likely related to his dissertation research) and education psycology, Breuning fell into research on patients with intellectual disabilities. Between 1980 and 1983, Breuning published approximately one-third of the research on psychopharmacology treatment of individuals with intellectual disabilities (Willcox, 1992), and his work was taken very seriously.
Breuning’s research was an illusion, though. In 1983, a colleague working on the same grant as him, Dr. Robert Sprague, encountered some odd characteristics in the data that Breuning was producing. Victoria “Vicky” Davis, Breuning’s research assistant (who was living with him at the time and would later become his wife) told Sprague that their interrater reliability was 100% for judgments of patients’ abnormal movements from tardive dyskinesia, a medication side effect (Sprague, 1993). When Sprague scrutinized a written report, he realized that seven studies Breuning had reported could not have occurred as quickly as Breuning had claimed (Sprague, 1993).
Sprague asked Breuning for the raw data for a study that they would present at a conference soon. Breuning produced only a fraction of the documentation, and some of the forms were data from a time after Breuning supposedly left Coldwater, where the study supposedly took place (Sprague, 1993). Sprague reported his suspicions to the National Institute of Mental Health (NIMH) in December 1983. After a very lengthy investigation process, an investigatory panel created by NIMH stated in 1987,
It is the unanimous conclusion of the Panel that Stephen E. Breuning knowingly, willfully, and repeatedly engaged in misleading and deceptive practices in reporting grants MH-32206 and MH-37449; that he did not carry out the described research; and that only a few of the experimental subjects described in publications and progress reports were ever studied; and that the complex designs and rigorous methodologies reported were not employed. Dr. Breuning also misrepresented, implicitly or explicitly, the locations at which research was supposedly conducted. The Panel did not find credible Dr. Breuning’s shifting explanations as to where the various studies were carried out and his ultimate contention that many were conducted years before in the Chicago area. The Panel unanimously concludes, on the basis of all the facts, that Dr. Stephen E. Breuning has engaged in serious scientific misconduct.NIMH investigatory panel (pp. 35-36, paragraph break removed)
In the early stages of the investigation (on April 30, 1984), Breuning resigned from his academic position at the University of Pittsburgh. The case was referred to federal prosecutors, and in 1988, Breuning was indicted on two counts of making false statements to the United States (for submitting reports to NIMH that contained incorrect information about studies) and one count of obstruction of an agency proceeding (for lying during the NIMH investigation). In a plea bargain, Breuning pleaded guilty to the two counts of making false statements, and the final count was dropped. Based on the prosecutor’s recommendation, Breuning was sentenced to 60 days in a halfway house, five years probation, and an order to repay $11,352 in restitution. He was also banned from conducting research for 10 years (Willcox, 1992). He has never published an article since his guilty plea, and he seems to have worked in clinical practice in Michigan, where his license as a psychologist is still active.
The Breuning case was big news in the 1980s. The story appeared in the scientific press and in major newspapers and was one factor contributing to congressional hearings on the integrity of science conducted with taxpayer funds. But it has faded since then. I had never heard of the case, and many of Breuning’s articles from the era are still being cited favorably in the 21st century (Korpela, 2010).
The NIMH panel investigated 15 articles, 5 book chapters, and a number of abstracts and unpublished manuscripts that Breuning was sole author or a coauthor on. Of the 20 published articles and chapters, the panel found that only 2 accurately reported research that happened, 4 were partially accurate, 1 was inconclusive, and 13 reported studies that either did not happen or were not conducted in the manner described. Of these, three articles were retracted between 1986 and 1989 (though one of those is ambiguous). According to the Retraction Watch database of retracted articles, no one has taken action on the other publications since then, which means that those discredited articles and chapters remain in the scholarly record.
The investigative panel’s report was disseminated to the media at the time and interested parties — including journal editors. But today it is not available in full on any government web site. It took some excellent librarians over two weeks to track it down for me, and I am making it available to the public on my web site.
Why were most of Breuning’s discredited articles never retracted? Perhaps it was because the recommendation from the NIMH investigatory panel did not explicitly demand it. Their recommendation on the articles was:
. . . editors of relevant journals be notified of the findings of this Panel so that appropriate measures can be taken to advise readers, researchers, and others of these findings [of Breuning’s fraud], and that journal editors be made aware of the capability of the National Library of Medicine to provide notice of retraction through MEDLINE and Index Medicus . . .NIMH investigatory panel (p. 47)
Freedman (1988, p. 635) stated that this was “. . . in effect, a request to elicit a retraction” of Breuning’s discredited articles. However, the wording definitely is ambiguous.
These suspicious articles are still being cited favorably. A 2010 study showed that citations to Breuning’s work were generally negative in the 1990s. However,
. . . an upsurge of positive citations started in 2000 in journals with higher impact factors than those citing the case as a fraud.Korpela (2010, p. 845)
Korpela (2010, p. 845) also interpreted these results to indicate that “. . . the collective memory of the scientific community is malfunctioning.” This shows the importance of retraction. Without the permanent correction of the scientific record, future generations of scientists and students will unwittingly rely on incorrect research and be led astray, long after a fraudster has left the scene.
Status of Investigated Articles
Here is a summary of the 15 articles that the NIMH panel investigated. They are listed in alphabetical order by the first author’s surname. Citation counts are from Google Scholar and collected on January 23, 2022.
- Breuning, S. E. (1982). An applied dose-response curve of thioridazine with the mentally retarded: Aggressive, self-stimulatory, intellectual, and workshop behaviors–A preliminary report. Psychopharmacology Bulletin, 18(1), 57-59. PubMed record
Cited 30 times. According to the NIMH panel, “The Panel could find no evidence that such a systematic study was ever carried out. The study, as a whole, appears to be implausible because it could not have been conducted at any known site available to Dr. Breuning over the prolonged 80-week timeframe of the reported observations. The panel concludes that . . . the described study was not conducted” (p. 202). This article has not been retracted.
Breuning & Davidson (1981)
- Breuning, S. E., & Davidson, N. A. (1981). Effects of psychotropic drugs on intelligence test performance of institutionalized mentally retarded adults. American Journal of Mental Deficiency, 85(6), 575–579. PubMed record
Cited 48 times. The NIMH panel could not have occurred at either of the inpatient facilities that Breuning worked at. He later claimed that it had happened in Illinois when he was a graduate student (in the mid- to late 1970s), but could not recall exactly where. “The Panel was unable to identify a plausible site where this study might have been performed. . . . the Panel concludes that the described study was not carried out” (NIMH investigatory panel, p. 194). This article has not been retracted.
Breuning, Davis, Matson, & Ferguson (1982)
- Breuning, S. E., Davis, V. J., Matson, J. L., & Ferguson, D. G. (1982). Effects of thioridazine and withdrawal dyskinesias on workshop performance of mentally retarded young adults. The American Journal of Psychiatry, 139(11), 1447–1454. https://doi.org/10.1176/ajp.139.11.1447
Cited 27 times. This article was retracted in 1989. This was part of the Breuning (1982) study (NIMH investigatory panel, p. 204). The NIMH panel stated, “. . . the Panel could find no evidence that a study with this type of medication design had been carried out . . .” (p. 204), and “The Panel concludes that the described study was not carried out” (p. 205).
Breuning, Davis, & Poling (1982)
- Breuning, S. E., Davis, V. J., & Poling, A. D. (1982). Pharmacotherapy with the mentally retarded: Implications for clinical psychologists. Clinical Psychology Review, 2(1), 79-114. https://doi.org/10.1016/0272-7358(82)90006-X
Cited 23 times. This is a review paper, not a report of an original study. The investigators stated, “Many of the findings reported here are from studies which the Panel has concluded were carried out as described. The paper must thus be regarded as scientifically unsound and misleading” (NIMH investigatory panel, p. 218). This article has not been retracted.
Breuning, Ferguson, & Cullari (1980)
- Breuning, S. E., Ferguson, D. G., & Cullari, S. (1980). Analysis of single-double blind procedures, maintenance of placebo effects, and drug-induced dyskinesia with mentally retarded persons. Applied Research in Mental Retardation, 1(3-4), 175-192. https://doi.org/10.1016/0270-3092(80)90003-X
Cited 28 times. “No plausible site for the execution of this study has been identified,” according to the NIMH investigatory panel (p. 176). Additionally, “The Panel concluded that the study described was not carried out” (p. 177).
Breuning, Ferguson, & Cullari (1981)
- Breuning, S. E., Ferguson, D. G., & Cullari, S. (1981). Analysis of single-double blind procedures, maintenance of placebo effects, and drug-induced dyskinesia with mentally retarded persons — A brief report. Psychopharmacology Bulletin, 17(1), 122-123. PubMed record
Cited 2 times. This is a brief report version of Breuning, Ferguson, & Cullari (1980), according to the NIMH panel (p. 178), which means that the 1981 article also reports a study that never occurred. This article has not been retracted.
Breuning, Ferguson, Davidson, & Poling (1983)
Breuning, S. E., Ferguson, D. G., Davidson, N. A., & Poling, A. D. (1983). Effects of thioridazine on the intellectual performance of mentally retarded drug responders and nonresponders. Archives of General Psychiatry, 40(3), 309-313. https://doi.org/10.1001/archpsyc.1983.01790030079010
Cited 40 times. The Retraction Watch database counts this article as retracted in 1988, and in PubMed it shows up as retracted. However, neither the web page for the article, nor the PDF version indicates this. The announcement from the editor concerning this article confusingly states, “Journals cannot retract — that is the obligation of authors who must personally vouch for the accuracy and opinion their report contains. We can repudiate our association with a study. . . . the published findings should no longer be associated as a document able to meet our standards for publication. We, in brief, will notify the Index Medicus of the change in status of the published report” (Freedman, 1988, p. 686). The same document publishes letters from Breuning’s coauthors. Two of them (Ferguson and Davidson) stated that they could vouch for the article’s veracity, while Poling explicitly stated that he does not believe the study was conducted.
As for the NIMH advisory panel, they stated, “Given the size of the sample (142 in the prestudy drug trial), the complexity of the design, and the described behavioral recording at 30-minute intervals 24 hours per day, this study could not have been done in the Chicago area schools. All evidence from Oakdale and Coldwater indicates it could not have been carried out at either site. The Panel concludes that the described study was not carried out” (p. 196).
Breuning, O’Neill, & Ferguson (1980)
- Breuning, S. E., O’Neill, M. J., & Ferguson, D. G. (1980). Comparison of psychotropic drug, response cost, and psychotropic drug plus response cost procedures for controlling institutionalized mentally retarded persons. Applied Research in Mental Retardation, 1(3-4), 253-268. https://doi.org/10.1016/0270-3092(80)90008-9
Cited 34 times. This article produced one of the NIMH panel’s most unambiguous judgements: “. . . it is inconceivable that a study of this complex design and duration could have been carried out . . . without the knowledge of supervisors or coworkers . . . the Panel . . . found no evidence that a study as described here was carried out at Coldwater. . . . the study described was not carried out” (pp. 191-192). This article has not been retracted.
Davis, Poling, Wysocki, & Breuning (1982a)
- Davis, V. J., Poling, A. D., Wysocki, T., & Breuning, S. E. (1982). Effects of phenytoin withdrawal on matching to sample and workshop performance of mentally retarded persons. The Journal of Nervous and Mental Disease, 169(11), 718-725. PubMed record
Cited 28 times. The conclusions of the NIMH investigatory panel are nuanced: “The Panel concluded that although test and workshop performance evaluations were carried out, there are serious irregularities in the published report” (p. 200). These irregularities surround whether drugs were manipulated and whether placebos were used, which there is conflicting evidence of at the Coldwater site.
Davis, Poling, Wysocki, & Breuning (1982b)
- Davis, V. J., Poling, A. D., Wysocki, T., & Breuning, S. E. (1982). Effects of phenytoin withdrawal on matching to sample and workshop performance of mentally retarded persons. — A brief report. Psychopharmacology Bulletin, 18(1), 51-54. PubMed record
Cited 0 times. This is a brief report of the Davis, Poling, Wysocki, & Breuning (1982) article in The Journal of Nervous and Mental Disease. Therefore, the same nuanced conclusions from the NIMH investigatory panel apply to this article.
Ferguson, Cullari, Davidson, & Breuning (1982)
- Ferguson, D. G., Cullari, S., Davidson, N. A., & Breuning, S. E. (1982). Effects of data-based interdisciplinary medication reviews on the prevalence and pattern of neuroleptic drug use with institutionalized mentally retarded persons. Education and Training of the Mentally Retarded, 17(2), 103-108. https://www.jstor.org/stable/23877168
Cited 17 times. Another article that drew an ambiguous response from the NIMH investigatory panel: “Although it is possible that this study was carried out as reported, it was not possible to verify that data existed for that portion contributed by Dr. Breuning. Therefore, the Panel was not able to draw any conclusion regarding the validity of this study” (p. 190).
Gualtieri, Bruening, Schroeder, & Quade (1982)
- Gualtieri, C. T., Breuning, S. E., Schroeder, S. R., & Quade, D. (1982). Tardive dyskinesia in mentally retarded children, adolescents, and young adults: North Carolina and Michigan studies. Psychopharmacology Bulletin, 18(1), 62-65. PubMed record
Cited 38 times. Retracted in 1987. There were no problems with the North Carolina data. However, the Michigan data in this article came from Breuning. In regards to Breuning’s data, the NIMH panel is very clear: “. . . The Panel concluded that there were serious irregularities in this study. . . . any data that might have been collected were deliberately misrepresented and that the described study was not carried out” (pp. 181, 182).
It was the follow-up to this study that originally made Sprague suspicious of Breuning’s research.
Poling & Breuning (1983)
- Poling, A., & Breuning, S. E. (1983). Effects of methylphenidate on the fixed-ratio performance of mentally retarded children. Pharmacology Biochemistry and Behavior, 18(4), 541-544. https://doi.org/10.1016/0091-3057(83)90278-2
Cited 7 times. Despite the study supposedly occurring at the University of Pittsburgh, no fixed-ratio data were collected there, according to the NIMH investigatory panel (pp. 229, 231). The final conclusion states, “The Panel checked widely and carefully and found no corroboration at all of his [Breuning’s] account. The Panel, therefore, concludes the data were not collected” (p. 239). Additionally, Poling “. . . could no longer personally vouch that the study was conducted as reported nor that the data were accurate” (p. 230). This article has not been retracted.
Sprague et al. (1984)
- Sprague, R. L., Kalachnik, J. E., Breuning, S. E., Davis, V. J., Ullmann, R. K., Cullari, S., Davidson, N. A., Ferguson, D. G., & Hoffner, B. A. (1984). The dyskinesia identification system — Coldwater (DIS-Co): A tardive dyskinesia rating scale for the developmentally disabled. Psychopharmacology Bulletin, 20(2), 328-338. PubMed record
Cited 41 times. This one checks out. “The panel identified no issues regarding the reported study . . .” (NIMH investigatory panel, p. 187).
Wysocki, Fuqua, Davis, & Breuning (1981)
- Wysocki, T., Fuqua, W., Davis, V. J., & Breuning, S. E. (1981). Effects of thioridazine (Mellari) on titrating delayed matching-to-sample performance of mentally retarded adults. American Journal of Mental Deficiency, 85(5), 539-547. PubMed record
Cited 42 times. This is another article that checks out. It was based on Wysocki’s 1980 dissertation at Western Michigan University. The NIMH investigatory panel gives its unequivocal seal of approval on the article: “The Panel confirmed that this study was carried out and found no information to suggest that it was conducted improperly” (p. 198).
The panel’s ability to verify this study’s existence is important. It proves that a study conducted at Coldwater could be verified several years later, even after the principal investigator had moved on to another position in a different state. Thus, Breuning’s explanations (e.g., discarding data too quickly, forgetting people who helped carry out a study) for why his studies that occurred at roughly the same time — and sometimes in the same location — could not be verified are increasingly unlikely.
Status of Investigated Book Chapters
Barrett & Breuning (1984)
- Barrett, R. P., & Breuning, S. E. (1984). Assessment of intelligence. In J. L. Matson & S. E. Breuning (Eds.), Assessing the mentally retarded (pp. 87-114). Grune & Stratton.
Cited 0 times. The NIMH panel was mixed in its view of this chapter, stating, “With the exception of one section, this appears to be a straightforward review of available instruments. The section on medication effects, however, depends on studies which the Panel has found to be not carried out as described. Even though labeled tentative, these findings are seriously misleading” (p. 218).
Breuning & Poling (1982)
- Breuning, S. E., & Poling, A. D. (1982). Pharmacotherapy. In J. L. Matson & R. P. Barrett (Eds.), Psychopathology in the mentally retarded (pp. 195-251). Grune & Stratton.
Cited 25 times. This chapter apparently consists of a pilot study and a literature review. The NIMH investigatory panel found severe fault with both. “These pilot data show uniformity of outcome and agreement across measures that seem, at best, implausible. The study could not have been carried out at Pittsburgh, and the complex double-blind drug-placebo crossover design and daily ratings make it impossible that the study could have been conduced in Chicago areas schools. The Panel concluded that the study described was not carried out” (p. 209). “This review article relies heavily on the work by Dr. Breuning that the Panel concluded was not carried out as described. It, therefore, must be regarded as scientifically unsound and misleading” (p. 216).
Davis, Cullari, & Breuning (1982)
- Davis, V. J., Cullari, S., & Breuning, S. E. (1982). Drug use in community foster-group homes. In S. E. Breuning & A. D. Poling (Eds.), Drugs and mental retardation (pp. 359-376). Charles C. Thomas.
Cited 31 times. This is a massive survey with a 93.2% response rate(!), totaling information about 3,496 patients in foster or group homes in 4 states. As the NIMH panel states, “As described, this project would have required a large investment of time on the part of a number of people in the community” (p. 214). But Breuning could only name one person who assisted, and that person denied any involvement with the survey (pp. 214-215). He would have required use of a central computer center at a university (because this study predates widely available personal computers and data analysis programs) to enter the data. But logs did not indicate that he had used the computers for sufficient time to enter data from so many surveys (p. 215). “The Panel could find no confirmation that this large study was carried out” (p. 215; see also p. 216).
Ferguson & Breuning (1982)
- Ferguson, D. G., & Breuning, S. E. (1982). Antipsychotic and antianxiety drugs. In S. E. Breuning & A. D. Poling (Eds.), Drugs and mental retardation (pp. 168-214). Charles C. Thomas.
Cited 18 times. Another mixed assessment: “The section of this article on anti-anxiety drugs appears well-done. The section on antipsychotic drugs relies heavily on studies by Dr. Breuning that the Panel concluded were not carried out as described. This part of the article must be regarded as scientifically unsound and misleading” (NIMH panel, p. 216).
Sisson & Breuning (1984)
- Sisson, L. A., & Breuning, S. E. (1984). Medication effects. In J. L. Matson & S. E. Breuning (Eds.), Assessing the mentally retarded (pp. 143-180). Grune & Stratton.
Cited 3 times. Another unequivocal negative judgment from the NIMH investigatory panel. This one states, “This chapter extends the influence of studies the Panel has found to have not been carried out as described. It must be considered unsound scientifically and seriously misleading” (p. 219).
One interesting tidbit from the panel’s analysis of this chapter is that Sisson “. . . had asked Dr. Breuning to remove her name from any papers submitted for publication” (NIMH panel, p. 219).
Analysis and Next Steps
The 10 articles that the NIMH panel stated were fraudulent or seriously deficient have been cited a total of 277 times (27.7 citations per article). The three articles with ambiguous, nuanced, or inconclusive conclusions have been cited 45 times (15.0 citations per article). The two articles that NIMH had verified received 83 citations (41.5 citations per article).
The 3 discredited book chapters have been cited 59 times (19.7 citations per chapter), while the 2 with mixed fraudulent and credible sections have been cited 18 times (9 citations per chapter).
Of the 10 articles that the NIMH panel stated were fraudulent or seriously deficient, only three have been retracted — and one of those is incomplete because the article page and PDF do not label the article as retracted. The other seven have not been retracted. These appear in the American Journal of Mental Deficiency, Applied Research in Mental Retardation (2 articles), Clinical Psychology Review, Pharmacology Biochemistry and Behavior, and Psychopharmacology Bulletin. What is strange is that one of the retracted articles appeared in Psychopharmacology Bulletin, and it’s not clear why the editor at the time would have taken action against that article, but not the other two Breuning articles published in that journal.
Unsurprisingly, none of the book chapters have been retracted. Book chapters do not enter databases in the way that articles do (especially in pre-internet days), and it may be difficult to remove a chapter from a book that already had its print run.
Despite the thoroughness of the investigation, the NIMH panel never speculated about Breuning’s motive. On the one hand, there is the obvious motive of advancing an academic career, gaining prestige, having access to research funds, surviving in a “publish or perish” environment, etc.
But I also believe there may be another motive. Many of these discredited articles and chapters have the message that patients with intellectual disabilities were overmedicated, either taking drugs that they did not need to or at higher dosages than necessary. I wonder how much of Breuning’s fraud was motivated by a sincere belief that he was helping vulnerable people who were being given too many drugs. That doesn’t excuse his fraud, but it would make this more complex than a simple tale of greed and dishonesty. After all, many questionable research practices are motivated by an effort to make messy data produced a desired result (John et al., 2012). Why would fraud be any different?
The next step in this is to contact the current editors of the journals American Journal of Mental Deficiency (today called the American Journal on Intellectual and Developmental Disabilities), Applied Research in Mental Retardation (now called Research in Developmental Disabilities), Clinical Psychology Review, Pharmacology Biochemistry and Behavior, and Psychopharmacology Bulletin and ask them to retract Breuning’s articles. Hopefully, the existence and availability of the NIMH investigatory panel’s final report will make the editors’ decision easy. While all these articles are at least 39 years old, it is not too late to do the right thing and retract them. Better late than never.
For the book chapters, there is much less to do. One of the publishers (Grune & Stratton) does not seem to exist any more. Charles C. Thomas, the other publisher of Breuning’s book chapters, does not have the book Drugs and Mental Retardation in its catalog. The books have probably been out of print for decades. It’s not really clear what, if anything, can be done about those.
Finally, there are other articles to investigate. According to Google Scholar, Breuning published 31 articles between 1975 and 1985. The NIMH panel limited itself to research products (i.e., articles, chapters, manuscripts, and abstracts) that were linked to federal grants from NIMH. This amounts to approximately half of Breuning’s published articles. It seems incredibly unlikely that Breuning published reputable, high-quality research and then suddenly decided to commit fraud when he started working on projects funded by NIMH. Do Breuning’s pre-1980 articles have similar characteristics as the ones identified by the NIMH panel as fraudulent? what about his other work? I have started to investigate some of these articles and will report my conclusions as soon as I can.
I appreciate the hard work from Jennifer Harbster (head of the science reference section at the Library of Congress) and Alisha Robinson (senior library assistant for interlibrary loan at Utah Valley University) for tracking down the NIMH investigatory panel’s final report and helping me digitize it. I never would have discovered most the details in this post without their help.
Breuning, S. E. (1977). Successive contrast effects in appetitive activity classical conditioning with goldfish (Carassius auratus) [Unpublished doctoral dissertation]. Illinois Institute of Technology.
John, L. K., Loewenstein, G., & Prelec, D. (2012). Measuring the prevalence of questionable research practices with incentives for truth telling. Psychological Science, 23(5), 524-532. https://doi.org/10.1177/0956797611430953
Korpela, K. M. (2010). How long does it take for the scientific literature to purge itself of fraudulent material?: The Breuning case revisited. Current Medical Research and Opinion, 26(4), 843-847. https://doi.org/10.1185/03007991003603804
Sprague, R. L. (1993). Whistleblowing: A very unpleasant avocation. Ethics & Behavior, 3(1), 103-133. https://doi.org/10.1207/s15327019eb0301_4
Willcox, B. L. (1992). Fraud in scientific research: The prosecutor’s approach. Accountability in Research, 2(2), 139-151. https://doi.org/10.1080/08989629208573810