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“Hardly worth the effort”? Medical journals’ policies and their editors’ and publishers’ views on trial registration and publication bias: quantitative and qualitative study

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f5248 (Published 06 September 2013) Cite this as: BMJ 2013;347:f5248

Re: “Hardly worth the effort”? Medical journals’ policies and their editors’ and publishers’ views on trial registration and publication bias: quantitative and qualitative study

Elizabeth Wager and Peter Williams report some quite shocking evidence of cavalier attitudes to biased under-reporting of research among medical journal editors (1). These attitudes were reflected in the fact that only 55 (28%) of the 200 journal websites they surveyed required clinical trial registration.

Some of their 16 interviewees (mainly senior editors) felt that trial registration would do little to reduce publication bias. When asked what other measures might be used to tackle the problem, some suggested having clear journal instructions to authors. In 2012, we assessed the extent to which healthcare journals encourage authors to submit reports of scientifically robust research, regardless of the direction or strength of the results. We scrutinised instructions to authors on the websites of the 121 high quality and clinically relevant journals included in the McMaster Online Rating of Evidence system (http://hiru.mcmaster.ca/more_new/). Only 14 (12%) of the websites encouraged submission of research reports regardless of the direction or strength of the results. Eleven of the 14 statements were within the ‘information for authors’.

In an applied field of research such as health care, reporting biases can result in avoidable morbidity and mortality and waste of resources because they lead to overestimates of beneficial effects and underestimates of harmful effects of care. These biases result principally from biased decisions by research sponsors and researchers to submit reports for publication (2, 3), but journal editors are contributing to the problem, both by failing even to recognise publication bias as a problem, and by not taking practical steps to make clear that they understand the scientific and ethical reasons for dealing with it.

Nearly three decades ago one of us proposed in a letter published in the BMJ (4) that the term ‘negative trial’ should be outlawed, commenting that all trials that have been well conceived and well conducted – whatever their results – represent positive contributions to knowledge. Should it be surprising that useful clinical discoveries are so rare when researchers have access to only a biased sample of existing evidence? Journal editors who have not already done so should make clear on their websites and at www.alltrials.net that, for scientific and ethical reasons, they support the demand for all trials to be registered and reported.

References

1 Wager E, Williams P. “Hardly worth the effort”? Medical journals’ policies and their editors’ and publishers’ views on trial registration and publication bias: quantitative and qualitative study. BMJ 2013;347:f5248.

2 Dickersin K, Chalmers I. Recognising, investigating and dealing with incomplete and biased reporting of clinical research: from Francis Bacon to the World Health Organisation. JLL Bulletin: Commentaries on the history of treatment evaluation (www.jameslindlibrary.org), 2010. Accessed 6 September 2013.

3 Song F, Parekh S, Hooper L, Loke YK, Ryder JJ, Sutton AJ, Hing CB, Kwok CS, Pang C, Harvey I. Dissemination and publication of research findings: an updated review of related biases. Health Technology Assessment 2010;14(8).

4 Chalmers I. Proposal to outlaw the term 'negative trial'. BMJ 1985;290:1002.

Competing interests: No competing interests

08 September 2013
Anne Brice
Information Specialist
Iain Chalmers
James Lind Initiative
Summertown Pavilion, Middle Way, Oxford OX2 7LG