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

I would like to respond to Elizabeth Wager's statements.

As I stated, there is no robust evidence on the effects of clinical trial registration on reducing publication bias.

Getting biomedical journals to enforce the clinical trial registration put unfair onus on individual journal resources, particularly for smaller publishing companies.

While specific research of trial publication highlights the potential selective reporting of results, there is yet any evidence involving of journal companies to put up another submission barrier will lead to better outcome.

An clinical analogy is this:

Cardiac arrhythmia post myocardial infarction is associated with higher mortality.

Drug A is a proven antiarrhythmic agent.

So giving Drug A to patients with cardiac arrhythmia should reduce mortality.

The CAST study by National Heart, Lung, and Blood Institute (NHLBI) proved that this kind of logic is not always true. (Ironically the CAST trial from 1986-98 is registered with ClinicalTrials.gov retrospectively in 1999)

Sure, there is a problem with publication bias, but getting individual journal companies spending a lot more time and money to vet submitted papers may be akin to the Y2K syndrome; where the problem matters to a limited few, but someone seemed to think everyone have to get theirs checked anyway.

Besides, a big part of the problem is certain registered trials did not lead to publication of results: there is no legal obligation to report results in the registry or other publications, or to compel authors to publish. The paper submission rules certainly does not affect those trials/ authors!