The Tainted Legacy of Paul McCrory

Update 11/16/2022: In an update posted on Retraction Watch, The BMJ has said that it was in error to indicate that it was just 38 articles that would carry the statement of concern and that, instead, it would be all.

According to Retraction Watch, former prominent concussion researcher Paul McCrory has drawn another 9 transactions as the British Journal of Sports Medicine and its publisher, BMJ, continues their investigation into his library of work.

The nine retractions all involve opinion pieces that he authored for the journal while serving as editor-in-chief between 2001 and 2008. Five of the retractions were for plagiarism, three were for duplicative publication and another one was for misrepresenting a cited reference.

In addition to the retractions, the journal has placed an expression of concern on all of McCrory’s other work in the journal that lists him as the only author. According to a press release, this includes some 38 articles, though Retraction Watch counts 78 articles of his in the journal. 

Formerly a prominent researcher in the space of brain injury in sports, McCrory was the head of the Concussion in Sports Group (CISG) and a frequent advisor to a wide array of sports leagues, including FIFA, the NFL and the International Olympic Committee.

However, that began to unravel in March, when researcher Steve Haake published an op-ed in Retraction Watch, accusing McCrory of plagiarizing his earlier work. At the time, McCrory claimed that the plagiarism was an isolated incident but a pair of follow up investigations into McCrory’s work by researcher Nick Brown found a total of 20 other incidents of plagiarism, self plagiarism and other ethical violations in McCrory’s work. 

As the allegations mounted, McCrory’s prominence began to falter. He resigned from the CISG and many of the groups he had prominently worked with were actively distancing themselves from him. 

With all this in mind, the latest action by the BJSM is just the latest blow to a career that’s most likely already shattered. 

But all this raises a serious question: How did a scientist with so many issues get put in a position of such high prominence? The most likely answer centers around his controversial views on chronic traumatic encephalopathy, better known as CTE.

Saying What People Want to Hear

According to an article by Ken Belson at the New York Times, the rise of McCrory began about 20 years ago. 

A neurolotigst at the Florey Institute of Neuroscience and Mental Health and the team doctor for the Collingwood Football Club, an Australian Rules Football Team, he found himself in a position to offer advice to the Ausstralian Football League itself, as well as other sports organizations.

His status was further bolstered by becoming editor in chief of the BJSM, a title he would hold until 2008. During his tenure, he would go on to publish hundreds of journal articles, many in the BJSM itself, and become a global leader in the space.

However, the reason McCrory was so well liked by those in power was likely because of his views. He was a seemingly credible voice in brain trauma research that minimized the impacts of CTE. Many of his colleagues, in particular those in North America and Europe, were critical of this, saying that he was ignoring or minimizing evidence that countered his views.

This became obvious when he became a founding member of the CISG, which was organized by various athletic organizations. In 2001, the organization released their first consensus statement, which McCrory was the lead author on.

Though other researchers have questioned the work of the CISG, athletic organizations long relied on their advice. The group’s influence grew over the years, bringing more leagues under its fold and McCrory remained the lead author on the group’s consensus statements, including the fifth and most recent, published in 2016.

It is highly unlikely that McCrory would have had this much prominence and influence if he had taken a tougher line on CTE. His published views were enticing to his benefactors, who in turn helped elevate his voice as much as possible.

This also explains why McCrory was able to get away with so many acts of plagiarism for so long. There was simply no reason to investigation. Those backing him only cared about research integrity as far as it impacted credibility. As long as McCrory was credible and took a soft line on CTE, there was no reason to investigate his work.

Couple this with the fact that McCrory’s prominence made him a difficult person to challenge, something Haake pointed out in his original op-ed, it’s easy to see why he was able to survive so long despite having serious ethical lapses in his work.

Difficult Questions

In the New York Times article, David Michaels, a former assistant secretary of labor for the Occupational Safety and Health Administration, said it best, “There’s no basis to say it’s a consensus, it’s a consensus of people who were given a lot of money to do this. It doesn’t mean they’re intentionally hiding the truth. But we know that financial self-interest blinds them to what’s there.”

McCrory and those he worked with had their voices elevated despite serious ethical issues in the work. However, their voices weren’t elevated solely or primarily by the research community. Instead, it was the very groups that the research was meant to guide gave him such a big platform. 

Research is meant to be a process and one that guides better judgment and greater wisdom. However, it can’t be that when the very people it’s meant to guide are the ones picking and choosing which findings deserve attention.

While there are many opportunities for sports leagues to participate in CTE research ethically, with McCrory it’s clear that they found a voice they liked and threw their support behind, ignoring both ethical issues and other research to the contrary.

This doesn’t mean that McCrory was lying or trying to run a scam, but it does mean that he had every motivation to ignore and minimize findings to the contrary, something his colleagues say he did regularly.

While the continued examination of McCrory’s work is important and needs to be completed, there also needs to be difficult discussions about the role of sports organizations in this research space. While their cooperation is necessary, their influence is toxic and that toxicity has consequences for athletes.

McCrory has been a prominent voice in this field for over 20 years. During that time, the science has evolved quickly, but his voice has had an outsized weight behind it due to sports organizations putting their thumbs on the scale.

There is simply no way to know how CTE policies and concussion protocols would be different today if McCrory had never reached the heights he did. However, it is almost certain that they would be different.

Bottom Line

The latest allegations against McCrory come against a grim backdrop. Just two weeks ago, Miami Dolphins quarterback Tua Tagovailoa was carted off the field after hitting his head on the ground. It was his second head injury in four days, but he had been cleared just hours after the first injury and even finished that game. 

The doctor who cleared Tagovailoa has been fired, with the NFL Players Association citing multiple mistakes in his work. 

Tagovailoa’s injury is a stark reminder of what is at stake here. This is a rapidly evolving field, and policies need to be created to protect athletes while relying on the best science available.

However, that’s impossible when the organizations that are implementing those policies are picking and choosing which voices to elevate.

In the end, that is what McCrory’s legacy will be. Not just that of a researcher with serious ethical issues in his work, but that of a voice that was elevated by the very people seeking his guidance, creating, at the very least, a conflict of interest.

Here’s hoping that, with McCrory’s credibility in tatters, sports organizations will listen to a broader array of voices in the space and start working to find solutions that protect athletes rather than protect their product.