Experimental Assessment of Carbon Dioxide Content in Inhaled Air With or Without Face Masks in Healthy Children: A Randomized Clinical Trial
Authors: Andreas Diemer
Helmut Traindl
Juliane Prentice
Stefan Hockertz
Anna Kappes
Ronald Weikl
Harald Walach
Journal: JAMA Pediatrics (2021)
Discipline: CLINICAL MEDICINE
Keywords: randomized clinical trial; inhaled carbon dioxide; exhaled carbon dioxide; children; face masks
Affiliations: Poznan University of the Medical Sciences, Pediatric Clinic, Poznań, Poland, Obstetric, Gynecological, and General Practice, Passau, Germany, Psychotherapeutic Practice, Müllheim, Germany, General Practice, Gernsbach, Germany, Traindl Consult, Vienna, Austria, Psychotherapeutic Practice for Children and Youth, Müllheim, Germany, tpi consult GmbH, Bollschweil, Germany

Abstract:  This randomized clinical trial measured inhaled and exhaled carbon dioxide in children with and without face masks. 

Retracted: Yes

PubPeer comments:
 Would claim that their results are data resulting from poor placement of the equipment (dead space) as the results considering the actual dead volume of a mask and even the volume of air moved during shallow breathing are physically impossible. If this in fact not the case the authors should supply the information as to how the C02 concentration was in fact measured and also information as to the response speed and data processing of the equipment used. , 
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 Many comments at the section comments alongside this article, see https: jamanetwork.com journals jamapediatrics fullarticle 2781743 (open access). One of these comments is from the Editors:  We are reviewing and evaluating the many comments and concerns about this study and are asking the authors to respond and provide additional information. Dimitri Christakis, MD, MPH | Editor, JAMA Pediatrics . This comment was posted on 6 July 2021. , 
 See https: retractionwatch.com 2021 07 08 authors-of-widely-panned-study-of-masks-in-children-respond-to-critics for a response from the authors. , 
 Aside from the flaws that have already been pointed out, the published report is an extremely pared down, truncated version of the study described in their trial protocol (included as a supplement). Which either suggests that they deviated significantly from their proposed and approved protocol (which should have been noted and explained), or that these values were in fact measured and then excluded (which again should have been noted and explained). Some of these, like blood oxygenation and breath frequency, are key when one is suggesting respiratory impairment as the authors do, which makes their absence curious. I will refrain from pointing out the limitations and issues in determining impairment solely from outside the body using the less than ideal equipment mentioned here, since I think thatu2019s been aptly addressed by others. Also mentioned and detailed in the trial protocol but absent from the report is a reference to certain control groups used by previous groups that the authors cite as support for replicating this work in children. This leaves the study with no adequate control which makes their findings difficult to interpret at best. , 
 Copy pasted from https: jamanetwork.com journals jamapediatrics fullarticle 2782288 :  Notice of Retraction. Published online July 16, 2021. The Research Letter, u201cExperimental Assessment of Carbon Dioxide Content in Inhaled Air With or Without Face Masks in Healthy Children: A Randomized Clinical Trial,u201d by Harald Walach, PhD, and colleagues published online in JAMA Pediatrics on June 30, 2021 is hereby retracted. Following publication, numerous scientific issues were raised regarding the study methodology, including concerns about the applicability of the device used for assessment of carbon dioxide levels in this study setting, and whether the measurements obtained accurately represented carbon dioxide content in inhaled air, as well as issues related to the validity of the study conclusions. In their invited responses to these and other concerns, the authors did not provide sufficiently convincing evidence to resolve these issues, as determined by editorial evaluation and additional scientific review. Given fundamental concerns about the study methodology, uncertainty regarding the validity of the findings and conclusions, and the potential public health implications, the editors have retracted this Research Letter. See https: retractionwatch.com 2021 07 16 jama-journal-retracts-paper-on-masks-for-children for responses from the authors. , 
 Republished at http: dx.doi.org 10.1016 j.envres.2022.113564 See https: pubpeer.com publications 604383888DA642A0376BDFA3878807 See https: retractionwatch.com 2022 08 01 one-would-not-want-to-tarnish-another-journal-why-a-republished-covid-19-masks-study-doesnt-say-it-was-retracted for some backgrounds. ,