Publication bias and other stories

BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f3227 (Published 22 May 2013) Cite this as: BMJ 2013;346:f3227

Minerva finds it outrageous that the results of many clinical trials are never published or published in such a way that false conclusions can be drawn. Publication bias is so common that we have come to accept it as a fact of life, but it is deeply unethical and fraught with potential harm to patients. In 2002, three authors completed a meta-analysis of the published literature on the effects of erythropoiesis stimulating agents in patients with cancer. In Swiss Medical Weekly they revisit their conclusions in the light of information that was available in 2002 but unpublished (2013;143:w13776; doi:10.4414/smw.2013.13776). The overall survival benefit they reported in their first analysis disappeared. “If the published data are so incomplete that we cannot use them for a meta-analysis how can we possibly use them to make healthcare decisions for patients?” they ask, adding that “Unrestricted access to clinical study protocols including amendments, to clinical study reports as well as to IPD [individual patient data] is needed to ensure timely detection of both beneficial and harmful effects of healthcare interventions.” Minerva strongly agrees and hopes that this …

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