Surgisphere: the data firm in the eye of the hydroxychloroquine storm3 min read . Updated: 07 Jun 2020, 10:06 PM IST
The World Health Organization had suspended clinical trial programmes using hydroxychloroquine following the initial reports by the 12-year-old data analytics company
The founder of Surgisphere Corp., a data analytics firm based outside Chicago, quoted Sun Tzu’s Art of War in remarks to Utah’s Western Governors University.
“Opportunities multiply as they are seized," Sapan Desai told fellow graduates in 2012. Desai, who obtained an MBA and also holds a medical degree and a Ph.D., sought to apply the Chinese strategist’s advice to his own career.
Now the 41-year-old surgeon and entrepreneur is at the center of a controversy with global health implications. On Thursday, doubts about data from Surgisphere prompted the retraction of two scientific articles, including an influential study in The Lancet that had shown antimalarial drugs promoted by President Donald Trump could be harmful in the treatment of covid-19.
The World Health Organization had suspended clinical trial programmes using hydroxychloroquine following the initial report, as did the UK and France. The Lancet’s peer-reviewed study, published on 22 May, claimed to have analysed Surgisphere data collected from almost 96,000 covid-19 patients across the globe.
But in the days after publication, concerns over the underlying data bubbled up. Questions arose over how Surgisphere, a little-known company that claims to have 11 employees, could have reached agreements on sharing sensitive patient information with some 1,200 hospitals around the world, much less received and processed the data so quickly.
Late Thursday, co-authors Mandeep Mehra, Frank Ruschitzka, and Amit Patel requested the paper be retracted after Surgisphere declined to submit its full dataset and other information to independent peer reviewers because of client and confidentiality agreements. In a statement, The Lancet said many outstanding questions surround the company and the data used in the study. “Institutional reviews of Surgisphere’s research collaborations are urgently needed," it said.
The scrutiny has placed Surgisphere and Desai, who was listed as a co-author on both of the articles, under a microscope, and also raised questions about research standards during the coronavirus pandemic.
“There is an almighty rush to understand this new disease -- everybody is trying to get data quickly," said Nicholas Day, a professor of tropical medicine at the University of Oxford’s branch in Bangkok. “All the journals are desperate to publish because there is a thirst to know about this disease. Therefore mistakes are made, stuff is rushed through."
In emailed remarks before the articles were retracted, Desai defended his 12-year-old company, which consolidates medical records from around the world. He told Bloomberg the firm relied on artificial intelligence (AI) and machine learning to automate its processes, “which is the only way a task like this is even possible."
“It is important to understand the nature of this database," he added. “We are not responsible for the source data, thus the labour intensive task required for exporting the data from an EHR (electronic health record), converting it into the format required by our data dictionary, and fully de-identifying the data is done by the healthcare partner. Surgisphere does not reconcile languages or coding systems."
No AI or machine learning experts were listed as authors of the now-retracted Lancet paper. The article also indicated that of the four authors named on the study, Desai was the person who acquired and analysed the data.
Scientists have highlighted potential inconsistencies in the data used in The Lancet study, from an unrealistically high number of electronic patient records in Africa to the doubtful origin of European figures given the continent’s strict rules around health privacy. Moreover, the data set had more patients than would appear likely given the dates and progress of the virus, especially in the UK.
Desai said the official figures “could have been under-reported early on during the pandemic, thus leading to the appearance that we are over-reporting numbers when in actuality we are capturing the true total number of Covid-19 infections at the hospital level, which is the true source for this data."
Still, the Surgisphere studies were highly unusual in that they claimed to quickly assemble data from hundreds of anonymous hospitals, using numerous electronic medical records systems, under different privacy laws across many countries on multiple continents. And even more strangely, for studies that claimed a massive feat of data integration in record-setting time, they had no biostatisticians listed as authors that might have helped pull all this data together.