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Concussions Doctor Under Scrutiny in Plagiarism Scandal

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For greater than 20 years, Paul McCrory has been the world’s foremost doctor shaping the concussion protocols which might be utilized by sports leagues and organizations globally.

Because the leader of the Concussion in Sport Group, McCrory helped select the members of the international group and write its quadrennial consensus statement on the most recent research on concussions — a veritable bible for leagues, trainers, doctors and academics that an N.F.L. spokesman once called “the muse of all sports-related research.”

But McCrory’s status as a number one gatekeeper for concussion treatment and research is under attack as he faces multiple accusations that he plagiarized other scientists, including in articles for a medical journal that he edited. He has denied intentionally lifting copy without credit, and has called one since-retracted piece an “isolated and unlucky incident.”

Credit…International Concussion & Head Injury Research Foundation

The scandal facing the pre-eminent doctor, who has long forged doubt on the legitimacy of C.T.E., or chronic traumatic encephalopathy, has raised questions on his relationship to sports leagues and the influence they could have in shaping how the research on brain trauma is interpreted.

“It’s concerning because he’s taken the lead on writing a consensus statement that’s so influential, and we must always have access to his insights,” said Kathleen Bachynski, who teaches public health at Muhlenberg College and has written about head trauma in sports. “McCrory’s research agenda and published statements and work as an authority witness come from a standpoint of minimizing C.T.E.”

McCrory’s rise to power in concussion circles is notable partly because he is predicated in Australia, removed from the research centers studying head trauma in Europe and America. A neurologist on the Florey Institute of Neuroscience and Mental Health, McCrory worked for 15 years as a team doctor for the Collingwood Football Club, an Australian rules football team in Melbourne, starting around 1990. He got here to advise the Australian Football League, in addition to Formula 1 racing, boxing, soccer, rugby and a who’s who of sports organizations, including the International Olympic Committee, FIFA and the International Ice Hockey Federation, on the turn of the century.

He expanded his influence by writing a whole bunch of journal articles, often based on other doctors’ research, not his own, and by editing the British Journal of Sports Medicine from 2001 to 2008, which allowed him to put in writing editorials and help determine which articles were published.

The everlasting damage attributable to brain injuries to athletes can have devastating effects.

McCrory’s stature grew globally due to his position with the Concussion in Sport Group. He rarely speaks within the news media, which he accused of distorting the risks of concussions in a way that “creates a way of fear,” and has taken shots at researchers at Boston University who’ve done probably the most work on C.T.E., calling the consequences of concussions “transitory.”

Peter Jess, who represents former Australian Football League players fighting for advantages, has battled McCrory and the league for years. Jess said McCrory casts doubt on C.T.E. by suggesting that players’ neurological problems may stem from alcohol or drug abuse, or genetics.

Jess compared McCrory’s approach to the “big tobacco playbook,” and questioned whether McCrory’s connections to sports leagues influenced his judgment.

McCrory was a founding member of the concussion group, which issued its first consensus statement at a 2001 meeting organized by the International Ice Hockey Federation, the I.O.C. and FIFA. Because the sports world became increasingly aware of research on the long-term effects of concussions in the course of the last decade, leagues searched for recommendations from the group, which billed itself as scientific leaders offering a consensus on the most recent research.

“Meanwhile, sport was completely satisfied to let this fly as these were ‘independent experts and leaders in concussion’ providing them with industry standards for concussion management,” said Willie Stewart, a neuropathologist at Queen Elizabeth University Hospital in Glasgow who runs the most important sports-related brain bank in Europe.

The primary consensus statement released by the concussion group, in 2001, had 10 authors. By 2016, when the fifth and most up-to-date statement was issued, the list of authors had grown to 36 and included Richard Ellenbogen, a co-chairman of the N.F.L.’s head, neck and spine committee on the time, and Allen Sills, who became chief medical officer of the league in 2017.

But because the group’s impact grew, more of its members were supported by the sports leagues the group was meant to advise. Those relationships prompted critics to query whether the group could truly offer a rigorous and unbiased interpretation of the research on head trauma.

“There’s no basis to say it’s a consensus, it’s a consensus of people that got a number of money to do that,” said David Michaels, a former assistant secretary of labor for the Occupational Safety and Health Administration and the creator of “The Triumph of Doubt: Dark Money and the Science of Deception.” “It doesn’t mean they’re intentionally hiding the reality. But we all know that financial self-interest blinds them to what’s there.”

The primary accusation of plagiarism against McCrory was for an editorial he wrote in 2005 for the British Journal of Sports Medicine, which he edited on the time. But Steve Haake, a professor of sports engineering in Sheffield, England, noticed that about half the piece was lifted from an article Haake published five years earlier in Physics World.

That publication didn’t pursue the matter. Last yr, Haake raised the problem with the British Journal of Sports Medicine, which eight months later, on Feb. 28, retracted McCrory’s piece due to “illegal and indefensible breach of copyright.”

Haake was not satisfied.

“I would love there to be some punishment for such blatant plagiarism, as there’s for college kids,” Haake wrote on the web site Retraction Watch. “If anyone can steal our words at any time and get away with it, what’s the purpose?”

McCrory didn’t reply to a request for comment, but he told Retraction Watch that the instance of plagiarism was “isolated.” By then, Nick Brown, a health care provider who runs a well-liked blog documenting flaws in published research, had unearthed two more papers McCrory published within the British Journal that had potentially been plagiarized. McCrory said that in a single, the draft of the article was uploaded prematurely and that he had asked the journal to retract the piece. In the opposite, he said, the typesetting didn’t include the mandatory quotation marks.

“In each cases, the errors weren’t deliberate or intentional but nevertheless require redress as what has been published is plagiarism,” McCrory told Retraction Watch. “Once more I apologize for my error.”

Since then, Brown posted what he said were much more cases of McCrory lifting wholesale the work of other writers. Chris Nowinski, a co-founder of the Concussion Legacy Foundation, cited other examples of McCrory distorting data from researchers at Boston University to play down the seriousness of C.T.E.

“I even have never seen anyone make the mistakes that McCrory has made in referencing our studies, including members of the media without medical training, bloggers and even laypersons on their social media accounts,” Nowinski wrote.

A spokeswoman for the corporate that publishes the British Journal of Sports Medicine said the publication is “currently looking into the allegations and can investigate and act accordingly.”

With accusations of plagiarism mounting, McCrory resigned this month from the concussion group. Last week, the medical regulator in Australia acknowledged McCrory was barred from performing “neurodiagnostic procedures” in May 2018, without providing a reason. Jess said McCrory had examined 10 of his clients after the ban.

McCrory’s employer, the Florey Institute, said in an announcement that his articles were published in 2005, before he joined the institute, but that the institute “treats all matters concerning scientific integrity with the utmost seriousness.” A spokeswoman declined to say if McCrory can be penalized.

Spokesmen for FIFA and World Rugby said they were reviewing their relationship with the concussion group. The Australian Football League now not has formal ties to McCrory, but it surely still works with three of McCrory’s allies who also signed the latest consensus statement. The league didn’t reply to a request for comment.

Jiri Dvorak, a former chief medical officer at FIFA and founding member of the concussion group, said the group will, for now, proceed its “work and consider the scientific content of the consensus conference” to be held this fall in Amsterdam.

The fees of plagiarism are probably the most serious at undermining McCrory’s credibility on the long-term effects of repeated head hits and C.T.E., and a few say they could force sports organizations to reconsider the rules he and the opposite doctors within the group set forth.

“There’s an insider cabal that the consensus statement enshrines in respectability,” said Stephen Casper, who has written in regards to the history of head trauma in sports, was an authority witness for former N.H.L. players in a concussion lawsuit and is a witness in cases against the N.C.A.A., Rugby League and Rugby Union. “The authors will all have the taint of McCrory.”

Overhauling the concussion group, though, shall be hard because from the beginning it has been supported by organizations that see head trauma as an existential threat. The group just isn’t an independent body with open elections or a rotation of experts, and even with McCrory’s departure there remain lots of his allies who also advised, worked for or received research grants from FIFA, the I.O.C., the N.F.L., the N.H.L. and other organizations.

Still, some members see a likelihood for the group to develop into more transparent about potential conflicts of interest, publicly answer questions on its conclusions and incorporate views from neuropathologists, public health specialists and epidemiologists that higher reflect the science of C.T.E.

“With Paul now not a member of the group, the chance is there,” said Robert Cantu, a charter member of the group and clinical professor of neurology on the Boston University School of Medicine.

Bachynski signed an editorial within the Journal of Law, Medicine & Ethics in 2021 calling on the concussion group to develop into more transparent. She argues that cutting ties to the sports organizations that fund the group can be critical.

For instance, she said, “We in public health have a extremely strict rule that we aren’t going to take our health care guidance from a Philip Morris-funded health care organization” about tobacco.

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