Otolaryngologist Shares Experience with Image Manipulation in Research and How to Prevent It

It was 2005, and I was working at the South Korean government office in lieu of military service. The whole nation was shocked when the country learned that the researcher Hwang Woo-Suk, PhD, who claimed he had cloned human embryos using cells taken from different people to produce embryonic stem cell lines from each cloned embryo, had simply made it all up. And it was also the first time I heard about scientific misconduct with image manipulation in his Science paper.

Fast forward 16 years later, and I had become involved in the Committee of Responsible Conduct of Research at my institution, the University of Alabama at Birmingham. Since then, my eyes have been opened to the world of scientific fraud through image manipulation.

I was going through training and devouring multiple articles, especially ones from Elisabeth Bik, PhD, a former staff scientist at Stanford University in California. She rose to prominence for discerning image duplications across numerous scientific papers. (You can read all about her in Nature’s “Meet This Super-Spotter of Duplicated Images in Science Papers.”) I became one of her most ardent fans and continue to follow her work. Some check the daily Wordle puzzle—I check Dr. Bik’s Twitter posts. In fact, solving her Twitter quiz about spotting fraud is one of my favorite pastimes.

Identifying the Problem

As a board-certified otolaryngologist in two countries (South Korea and the United States) and a physician–scientist, I’ve reviewed multiple articles from various otolaryngology journals for more than 10 years. I now feel like a detective: looking at each figure numerous times with my eyes wide open to spot any possible fraud. I’m not using a fancy software program to detect duplicated images—I mainly change the contrast or rotate the figures to find any signs of manipulation.

To my astonishment, here’s what I’ve found: In the past six months, I’ve detected duplicated images in multiple submitted articles, equating to more than 40% of the articles (four out of 10) I reviewed. More than 90% of these manipulations were found in the immunohistochemistry staining figures.

When I noticed the image duplication in an article for the first time, I initially attributed it to haphazard work. I kept seeing the duplications, however, one after the other, as I went through other submitted articles. In one instance, there were more than five manipulations in one figure. It was a shock. I recognize that human error can play a role—especially when uploading multiple figures. But I had to pause and ask myself: Is it considered a mistake when you see a figure with more than five manipulations?