要求《The Lancet》立即更正錯誤，共同捍衛台灣主權與學術尊嚴
世界頂尖學術期刊《The Lancet》（刺胳針）於6月25日刊登一篇中國的醫學研究，由於該研究將台灣納為中國的一省，嚴重矮化台灣的國際地位，除引發數千網友在其臉書上留言抗議並要求更正外，衛福部也將正式行文給《The Lancet》抗議，說明「台灣是台灣、中國是中國」。
雖然《The Lancet》回應表示，這是根據聯合國（UN）和世界衛生組織（WHO）的方針，才將台灣列為中國一省，和其它的國際衛生分析沒有不同。但必須嚴正指出的是，除了政治上的錯誤之外，正因為台灣和中國為各自獨立的兩個不同國家，有各自獨立不同的行政、健保體系，在健保相關資料的完整性與正確性上，台灣與中國更是有許多差異，因此，這篇研究將不同方法所蒐集的健康資料放在同一個層級的模型來作研究，不但產生許多方法學上與研究結果的偏差，更已犯了學術研究的大忌，我們認為頂尖的《The Lancet》期刊不應該犯這樣的錯誤才對。
因此，我和中央研究院陳定信院士、廖運範院士、楊泮池院士等人，特別聯名致函《The Lancet》編輯部，要求該期刊立即更正錯誤，因為，這不只關係到台灣的主權尊嚴，更關係著國際學術研究的專業與倫理。
我也要在此呼籲所有關心這個事件的國人同胞，踴躍到 《The Lancet》的臉書粉絲專業表答您的意見，
https://www.facebook.com/374651963469/posts/10157661625328470/?substory_index=0
以下是致函《The Lancet》編輯部全文：
To the Editor:
We read the recent article by Zhou et al. comparing mortality, morbidity and risk factors in China and its provinces, 1990-2017. The authors used data from Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to analyse health patterns in 34 province-level administrative units in China. This is a misleading and biased report due to the inclusion of Taiwan in the analyses.
The authors made an obvious flaw by including Taiwan in the study. The national health system, government system and administrative system are independent in Taiwan. The completeness and accuracy of national databases of health insurance, cancer registry, death certification, cancer screening and health surveillance in Taiwan is totally different from those of China. The health outcomes measured by different methods should not be included in the same hierarchical models. Taiwan has its own cancer and death registration system, and the information were not collected by the Chinese Center for Disease Control and Prevention as described wrongly in the article. The data source from the Global Health Data Exchange (http://ghdx.healthdata.org/countries) that the authors used in this paper also clearly showed Taiwan and China are two distinguished countries under the category of Eastern Asia.
Taiwan has an independent National Health Insurance system which covers more than 95% of 23 million people since 1995. Taiwan has also implemented a series of public health programs to reduce mortality and morbidity which are not implemented in China. For example, Taiwan is the first country in the world to implement universal newborn hepatitis B vaccination program since 1984 whereas China started in 1992. We reimbursed antiviral treatment for chronic viral hepatitis since 2003 and decreased liver disease burdens continuously. Taiwan started to reimburse direct antiviral agents for chronic hepatitis C patients with advance fibrosis since 2017 and for all chronic hepatitis C patients since 2019, and has committed to eliminating hepatitis C infection in 2025, 5 years earlier than the 2030 deadline set by WHO.
The inclusion of Taiwan in the analysis leads definitely to a significant bias of the findings of Zhou et al. In their similar publication in 2016 (Lancet 387:251-272), Taiwan was not included in the analyses. We would like to urge the authors to re-run the analyses and remove Taiwan from their analyses in order to yield unbiased estimates of mortality, morbidity and risk factors in China. Lancet, as an esteemed medical journal, has the reputation to publish accurate and precise research findings. Such a major categorization mistake in the methods section by Zhou et al. should be rectified.
Maggie Dai-Hua TSAI RIEDIKER
Mei-Hsuan LEE
Ding-Sing CHEN
Yun-Fan LIAW
Pan-Chyr YANG
Yi-Hao HUANG
Chien-Jen CHEN
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