One need not allege scientific fraud to be concerned over documented -- even confessed -- evidence that NIH-funded researchers have cooked the books on major research that supports the policy direction favored by the government. An investigative report in today's New York Times Magazine , "An Unwelcome Discovery" by Jeneen Interlandi, reports the scientific fraud perpetrated by Dr. Eric Poehlman of the University of Vermont in his studies on hormone replacement therapy after menopause, supported by the National Institutes of Health with results confirming that agency's policy choices. Dr. Poehlman is now in jail.

Given that the media regularly give government-funded researchers a free pass on conflict of interest and virtually indict researchers for receipt of drug company or food company funding, the case is instructive. I'd note that the Salt Institute has no horse in this race; we report on peer-reviewed science, but we do not fund the research.

Interlandi explains why the Poehlman story matters:

The scientific process is meant to be self-correcting. Peer review of scientific journals and the ability of scientists to replicate one another's results are supposed to weed out erroneous conclusions and preserve the integrity of the scientific record over time. But the Poehlman case shows how a committed cheater can elude detection for years by playing on the trust - and the self-interest - of his or her junior colleagues.

. . . .

The length of time that Poehlman perpetrated his fraud - 10 years - and its scope make his case unique, even among the most egregious examples of scientific misconduct. Some scientists believe that his ability to beat the system for so long had as much to do with the research topics he chose as with his aggressive tactics. His work was prominent, but none of his studies broke new scientific ground. (This may also be why no other scientists working in the field have retracted papers as a result of Poehlman's fraud.) By testing undisputed assumptions on popular topics, Poehlman attracted enough attention to maintain his status but not enough to invite suspicion. Moreover, replicating his longitudinal data would be expensive and difficult to do.

"Eric excelled at telling us what we wanted to hear," Matthews, Poehlman's former colleague, told me. "He published results that confirmed our predisposed hypotheses." Steven Heymsfield, an obesity researcher at Merck Pharmaceuticals in New Jersey, echoed Matthews's sentiments and added that Poehlman's success owed more to his business sense and charisma than to his aptitude as a scientist.

"In effect, he was a successful entrepreneur and not a brilliant thinker with revolutionary ideas," Heymsfield wrote me via e-mail. "But deans love people who bring in money and recognition to universities, so there is Eric."

At his sentencing hearing, Poehlman took responsibility for his actions, but between the lines, he seemed to be placing some blame on the system that requires principal investigators to raise money for their research through government grants.

"I had placed myself, in all honesty, in a situation, in an academic position which the amount of grants that you held basically determined one's self-worth," he told the court in June. "Everything flowed from that." With a lab full of people dependent on him for salaries, Poehlman said he convinced himself that altering some data was acceptable, even laudable. "With that grant I could pay people's salaries, which I was always very, very concerned about."

He continued: "I take full responsibility for the type of position that I had that was so grant-dependent. But it created a maladaptive behavior pattern. I was on a treadmill, and I couldn't get off."

Interlandi quotes NIH spokesperson Sally Jean Rockey on the lessons to be learned. Rockey

said that lost grant money was not the only, or even the most significant, cost incurred. "Science is incremental," she said, explaining that most scientific advances build on what came before. "When there's a break in the chain, all the links that follow that break can be compromised." Moreover, she said, fraud as extensive as Poehlman's would inevitably lead to further erosion of the public's trust in science. Poehlman's sentence, she said, should send a clear message to the scientific community and the public at large that fraud would not be tolerated.

The story is a tragedy at several levels, of course. Besides landing him in prison and utterly wasting $2.9 million in NIH taxpayer investment, the Poehlman fraud misdirected medical advice given to thousands of post-menopausal women. Further research has shown dramatic health risks for Hormone Replacement Therapy -- another expensive case where a plausible theory was undone by controlled health outcomes studies.

Again, recounting this tragic story is not an underhanded way of alleging scientific fraud on the part of the NIH and its cadre of university researchers. It does illustrate quite clearly, however, that effective safeguards to ensure research integrity are lacking. It should cause all of us to be concerned about the potential for analytic bias by researchers whose funding (and career health) are determined by a government agency with an unswerving policy proclivity.

In the case of the health impacts of dietary salt, NIH-funded researchers have generally lined up behind their funding agency's policy conclusions. NIH has protected the researchers it's funded against having to make their data available for independent professional review required under the federal Data Quality Act. Again, without alleging fraud, could it be that the policy bias of the federal funders has allowed another intervention, like Hormone Replacement Therapy, to be promoted to the public without the scientific rigor of a controlled trial?

Indeed, there has been no controlled trial of the health outcomes of dietary salt despite the vocal advocacy of salt reduction based on extrapolations of blood pressure data as if that was the only metabolic impact of cutting dietary salt. Could this story be parallel to the Poehlman one? Interlandi points that Poehlman "had derived predicted values for measurements using a complicated statistical model. His intention, he said, was to look at hypothetical outcomes that he would later compare to the actual results."

Let's be charitable: if public health policy is to be based on "predicted values" of health benefit derived from a "complicated statistical model" as has been the case built for reducing dietary salt, perhaps it's time for HHS to heed our call for a controlled clinical trial of the cardiovascular outcomes (mortality and the incidence of heart attacks and strokes) of the pet NIH theory that cutting salt will save lives. Let's see the evidence.