Editor's Choice | This Week in BMJ | Press releases
BMJ No 7109 Volume 315 Press Releases Saturday 13 September 1997 Embargoed: 00.01 Hrs 12 September 1997 UK time Researching research
Researching researchThis week the BMJ joins the Institute of Child Health and over 100 medical journals worldwide, in declaring an amnesty for unpublished trials. Doctors discover if treatments work by conducting trials. They communicate their results by publication in medical journals. However, it is now well established that doctors are more likely to publish good news (the treatment works), than bad news (the treatment is useless). Not surprisingly, drug companies are also guilty of this. As a result of this tendency, known as publication bias', patients may be given useless or even harmful treatments and may be asked to take part in new studies designed to answer questions that, in fact, have already been answered. The worldwide amnesty is an attempt to flush out as many unreported trials as possible. All researchers of unpublished trials are urged to register those trials with the BMJ and other journals, which will make this information publicly available on a web-site and in other ways.The BMJ invites readers to send information on unpublished trials to its editorial office by post, fax or via an email address (meta@ucl.ac.uk).
Contact: Dr Richard Smith, Tel: 0171 383 6002
Dr Ian Roberts,
Tel: 0171 242 9789; Continuing the theme of the validity of systematic reviews, the BMJ also publishes materials dealing with the research methodology of meta-analysis. The controversy of combining data - researching clinical research(Meta-analysis and the meta-epidemiology of clinical research)In an editorial in this week's BMJ, Professor David Naylor assesses the validity of meta-analysis in clinical research. Naylor writes that meta-analysis has a major contribution to make to medical research, clinical decision making and standards of research reportage, but he issues a warning. He says that readers need to examine any meta-analysis with a critical eye:- have the researchers overlooked any important sources of research data and have the authors undertaken a comprehensive search, both avoiding data that has already been published and unearthing unpublished trials? He concludes that not all systematic reviews of research should lead to a meta-analysis as sometimes the pooling of data can drown the important evidence, rendering a meta-analysis more harmful than useful.
Contact: Professor C David Naylor Tel: 001 416 480 4297/4055 (Canada); fax: 001 416 480 6048; email: cdn@ices.on.ca
Call for registration of all randomised trials(Publication bias: evidence of delayed publication in a cohort study of clinical research projects)It is known that studies with statistically significant outcomes are more likely to be published than non-significant studies. In this week's BMJ, Stern and Simes show that even when studies with negative results are published, they take longer to publish than positive ones. Thus, any meta-analysis based solely on published trials, will produce biased results. Stern and Simes argue that the most practical solution to ensure that both negative and positive trials are published and that patients' participation efforts are not wasted, is to introduce registration of all randomised trials at the time they receive ethical approval. Contact: Professor R John Simes, Director, National Health and Medical Research Council Trials Centre, University of Sydney. Tel: 00 61 2562 5000 (Australia); fax: 00 61 2955 23881 or 2565 1863
The deviousness of duplicate data(Impact of covert duplicate publication on meta-analysis: a case study)In a systematic review of the effects of the drug ondansetron on post-operative sickness, in this week's BMJ, Tramer et al show the flip-side of publication bias - just as negative' trials are less likely to be published, it seems that positive' trials are more likely to be subject to duplication. The authors found that data from nine of the 84 trials researched appeared in 23 separate publications, including four pairs of identical reports, with completely different authors. Only one paper openly acknowledged the duplicate publication of the same data. The authors conclude that this practice obviously has implications for meta-analysis in that results can be biased.
Contact: Dr Martin R Tramer, Tel: 01865 226161; fax: 01865 226160; email: martin.tramer%mailgate.jr2@ox.ac.uk
Easing the pain for children with sickle cell(Evaluation of fast track admission policy for children with sickle cell crises: questionnaire survey of parents' preferences)In Britain, most people with painful sickle cell crises are admitted to hospital through an accident and emergency department, writes Dr Caroline Fertleman in her paper in this week's BMJ. In a study conducted at the North Middlesex Hospital in London in 1994, results showed that many children in pain waited for over an hour to receive analgesia. In consequence of this study, the hospital set up a fast-track' system, whereby children in severe pain from sickle cell crises are admitted directly to the ward, after a warning call from a parent. The child is then given pre-prescribed intramuscular pethidine, by a nurse, on arrival (if appropriate). A doctor is then able to assess and admit a calmer child. Contact: Dr Caroline Fertleman, paediatric registrar, North Middlesex Hospital. Tel: 0181 341 9696 (home); email: c.fertleman@ucl.ac.uk
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or telephone (8.30am -
6.00pm): 0171 383 6254 Or fax requests to Public Affairs Division, BMA on 0171 383 6403. If you currently receive your British Medical Journal press release by mail and you would like it faxed to you please telephone (0)171 383 6123, Fax: (0)171 554 6123 or E-mail: LRiviere@mail.bma.org.uk When dialling the UK from abroad, remember to delete the first zero from the local area code, eg, (00 44) 171... BMA on Internet page: http://www.bma.org.uk If you intend to use any article publicised in this press release, ensure you quote the British Medical Journal as source
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