Comment Research misconduct and the INTERGROWTH-21st study On Oct 20, 2016, a statement appeared on the WHO website, announcing that “An independent review commissioned by WHO has found that research ethics misconduct occurred in a study on foetal growth standards.”1 The study in question was the INTERGROWTH-21st study, led by researchers at the University of Oxford, UK, funded by the Bill & Melinda Gates Foundation (BMGF), and reported in several journals, including our own.2–5 Such a judgment by the world’s foremost global health agency was serious, casting damaging light on a study of international importance On Nov 16, 2016, we wrote to Ian Smith, Executive Director of the Office of the WHO Director-General, to request a copy of the review report, but were told that it was confidential and had been supplied only to the University of Oxford, BMGF, and the UK General Medical Council, which was considering whether to open an investigation of its own We then wrote, on Nov 23, 2016, to the researchers, Stephen Kennedy and José Villar at the University of Oxford, to request their response to the review’s findings We subsequently received a letter from the University’s Registrar, Ewan McKendrick, reiterating the history of the dispute, which (as we were aware) dates back to 2008 and has been the subject of previous investigations by the University of Oxford, the Committee on Publication Ethics (COPE), and other journals In brief, the dispute surrounds allegations of plagiarism and disputes over intellectual ownership concerning two research protocols with joint origins: those of the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) and the WHO Multicentre Study for the Development of Growth Standards from Fetal Life to Childhood Both protocols were drawn up in response to a 1995 WHO Expert Committee report6 that recommended, among other things, “Assessment and development of fetal growth reference data suitable for international applications” Both protocols also built on the methods of the WHO Multicentre Growth Reference Study,7 which produced growth curves for children from birth to years Much of the bases of the protocols are therefore in the public domain Kennedy and Villar are accused of having plagiarised the WHO Multicentre Study protocol in developing the INTERGROWTH-21st protocol and of obtaining rival funding while still involved with the WHO work McKendrick’s responses to us, on Nov 29, 2016, and Dec 13, 2016, were robust It is clear from this response that the University of Oxford looked into these serious allegations at a high level, methodically dissected the claims, closely examined four pairs of protocols at different stages of development, engaged with the WHO Director-General, and retrieved supporting documentation before concluding that the allegations were unfounded The Oxford researchers clearly stated the methodological foundations of INTERGROWTH21st in their reports We were aware, however, that we had only heard the University’s version of events, and again pressed WHO for their inquiry report This document was eventually shared with us in confidence on Jan 16, 2017, but we found it disappointingly insubstantial We have therefore concluded that its far-reaching judgment of research misconduct is unproven, and gives no cause for concern regarding the reliability of the published data Plagiarism of words and ideas is a serious academic offence However, on the basis of the evidence we have seen, we cannot agree that an idea (namely the construction of growth curves for fetuses) has been plagiarised from WHO: an international group of experts (including Villar) posed the question in 1995.6 Furthermore, building on work that has gone before is what drives advances in knowledge As for the overlap between the protocols, we have not repeated the direct comparisons of the University of Oxford and the WHO independent expert review panel, the former having produced percentage overlap data and critical content analysis However, recent publication of the headline growth curves from the WHO Multicentre Study8 indicates that the key aims were somewhat different: while INTERGROWTH-21st only reports ultrasound measures of head circumference, biparietal diameter, occipitofrontal diameter, abdominal circumference, and femur length, the WHO Multicentre Study additionally shows estimated fetal weight The episode seems to us a sad example of academic rivalry and miscommunication, one that has been www.thelancet.com/lancetgh Published online February 9, 2017 http://dx.doi.org/10.1016/S2214-109X(17)30071-2 Lancet Glob Health 2017 Published Online February 9, 2017 http://dx.doi.org/10.1016/ S2214-109X(17)30071-2 Comment repeatedly investigated and previously put to rest As far as we can ascertain, the recent inquiry by the WHO independent expert review panel has shed no new light on the matter and does not give us any reason at this stage to question the veracity of the papers we have published *Richard Horton, Sabine Kleinert, Sarah Linklater, Zoë Mullan The Lancet (RH, SK), The Lancet Diabetes & Endocrinology (SL), and The Lancet Global Health (ZM), London EC2Y 5AS, UK editorial@lancet.com ZM is a Trustee and Council Member of COPE The other authors declare no competing interests Copyright © The Author(s) Published by Elsevier Ltd This is an Open Access article under the CC BY license 2 WHO Research dispute on fetal growth standard studies referred to the UK General Medical Council Oct 20, 2016 http://www.who.int/ reproductivehealth/topics/maternal_perinatal/research-dispute/en/ (accessed Feb 1, 2017) Villar J, Ismail LC, Victora CG, et al International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project Lancet 2014; 384: 857–68 Papageorghiou AT, Ohuma EO, Altman DG, et al International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project Lancet 2014; 384: 869–79 Villar J, Papageorghiou AT, Pang R, et al The likeness of fetal growth and newborn size across non-isolated populations in the INTERGROWTH21st Project: the Fetal Growth Longitudinal Study and Newborn Cross-Sectional Study Lancet Diabet Endocrinol 2014; 2: 781–92 Villar J, Giuliani F, Bhutta ZA, et al Postnatal growth standards for preterm infants: the Preterm Postnatal Follow-up Study of the INTERGROWTH21st Project Lancet Glob Health 2015; 3: e681–91 WHO Physical status: the use and interpretation of anthropometry Geneva: World Health Organization, 1995 http://apps.who.int/iris/ bitstream/10665/37003/1/WHO_TRS_854.pdf (accessed Feb 1, 2017) De Onis M, Garza C, Victora CG, et al The WHO Multicentre Growth Reference Study: planning, study design, and methodology Food Nutr Bull 2004; 25 (suppl 1): S15–26 Kiserud T, Piaggio G, Carroli G, et al The World Health Organization Fetal Growth Charts: a multinational longitudinal study of ultrasound biometric measurements and estimated fetal weight PLoS Med 2017; 14: e1002220 www.thelancet.com/lancetgh Published online February 9, 2017 http://dx.doi.org/10.1016/S2214-109X(17)30071-2