By Brenda Goodman, Jacqueline Howard, Betsy Klein, CNN
(CNN) — The first report from the Trump administration’s Make America Healthy Again Commission, released last week, appears to be rife with errors, including some studies that don’t exist.
Touted by US Health and Human Services Secretary Robert F. Kennedy Jr. as a milestone, the report lays out the government’s priorities for addressing chronic health problems in children, which it ascribes to poor diet, lack of exercise, stress, overprescribing of drugs and exposure to environmental chemicals.
The sweeping 78-page document was produced in a little more than three months after it was ordered by President Donald Trump. It contained 522 references to studies, government reports and news articles. But some of these references were wrong or don’t appear to exist. In other cases, studies in the report were misrepresented, according to the researchers who conducted them.
The citation errors were first reported by NOTUS, a nonprofit, nonpartisan news site created by former Politico Publisher Robert Allbritton.
An updated version of the report was posted online Thursday with some changes to the text and the works cited.
“Minor citation and formatting errors have been corrected, but the substance of the MAHA report remains the same — a historic and transformative assessment by the federal government to understand the chronic disease epidemic afflicting our nation’s children,” HHS press secretary Emily Hilliard said in a statement.
Dr. Robert Findling, chair of the Department of Psychiatry at Virginia Commonwealth University, said he didn’t write a study that was credited to him in the first version of the report, according to university spokesperson Michael Porter.
The study was used to suggest that pharmaceutical ads rely on vague symptom lists that overlap with normal teenage behaviors and could be driving overprescription of drugs to teens.
“Dr. Findling did not author the article you cite and would not be able to address the report or its findings,” Porter wrote in response to a question from CNN.
There’s also no study by that name listed in the issue of the journal that was cited, The Journal of Child and Adolescent Psychopharmacology, and no evidence of such a paper in PubMed, the database of medical studies maintained by the National Library of Medicine.
The reference citing Findling was removed from the updated report.
Two studies initially attributed to the journal Pediatrics also don’t exist, according to Lisa Robinson, media relations manager for the American Academy of Pediatrics, which publishes the journal.
There was no record of a study with the title “Overprescribing of Oral Corticosteroids for Children With Asthma.” The journal had published a study called “Oral Corticosteroid Prescribing for Children With Asthma in a Medicaid Managed Care Program” in 2017. It had the same first author as the study listed in the MAHA report but different co-authors.
In other cases, studies were attributed to the wrong journal or the wrong authors and sometimes even the wrong year.
White House press secretary Karoline Leavitt called the problems “formatting issues.”
“I understand there were some formatting issues with the MAHA report that are being addressed, and the report will be updated, but it does not negate the substance of the report, which, as you know, is one of the most transformative health reports that has ever been released by the federal government,” Leavitt said in a briefing Thursday.
Dr. Ivan Oransky, a journalism professor at New York University who runs Retraction Watch, a website that tracks fraud and errors in medical publishing, said the nature of the discrepancies seems to indicate that they were generated by artificial intelligence.
“I’m speculating here. I don’t know this. The only people who would know that are the ones who actually created the paper,” Oransky said, adding that an article by him and his coauthor on Retraction Watch, Adam Marcus, had been cited in a research paper submitted to the Australian government last year. However, the article didn’t exist.
Leavitt deferred questions about the use of AI in the report to HHS, which did not respond to CNN’s questions about how the report was created.
The larger issue, as Oransky sees it, is that nobody caught these errors before the report was released.
“Either nobody checked this or nobody was looking very carefully at this before it was published,” he said.
Typically, official government reports go through layers of review, including critical reviews that questions their conclusions, before they are released. This report doesn’t seem to have followed that same kind of vetting process.
The citations in the report were “most likely an AI error” and not a formatting error, said Dr. Art Caplan, a professor of bioethics and founding head of the Division of Medical Ethics at NYU’s Grossman School of Medicine.
“AI is not sophisticated enough to be trustworthy and accurate in surveying science, and that would appear to be what’s going on here, which is unacceptable. It’s the kind of thing that gets a senior researcher into deep trouble, potentially losing their funding. It’s the kind of thing that leads to a student getting an F. It’s inexcusable,” he said. “And this is coming from people promising gold-standard science but delivering tin.”
The errors came to light barely a week after Trump issued an executive order declaring that science has a reproducibility crisis – meaning scientists can’t follow the methods of other scientists and come to the same conclusions – and promising to restore trust in the federal government’s research.
The order pledges a return to “Gold Standard Science,” promising “that Federal decisions are informed by the most credible, reliable, and impartial scientific evidence available.”
Kennedy said on “The Ultimate Human” podcast this week that the National Institutes of Health would devote about a fifth of its budget to “replication” and would stop publishing research in prominent peer-reviewed journals such as JAMA, the New England Journal of Medicine and the Lancet.
“We are going to stop NIH scientists from publishing there,” Kennedy said. “We’re going to create our own journals in-house in each of the institutes.
“They will become the preeminent journals.”
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