Intended for healthcare professionals

Feature Feature

The bias busters

BMJ 2014; 349 doi: (Published 23 July 2014) Cite this as: BMJ 2014;349:g4748
  1. Gavin Yamey, associate professor, Evidence to Policy Initiative, Global Health Group, University of California, San Francisco, USA
  1. Correspondence to: YameyG{at}

The quality, reliability, and value of the medical research enterprise have all come under scrutiny. Too much research funding continues to be wasted on poorly designed, poorly reported studies or studies plagued with biases and conflicts of interest. Gavin Yamey investigates a new center trying to address some of the problems at the heart of the crisis

In 2005, the open access medical journal PLOS Medicine published an essay provocatively titled, “Why most published research findings are false.”1 The article gained over a million views and more than 1200 citations in the academic literature. The Boston Globe called it “an instant cult classic.”2

The essay, by John Ioannidis, now a professor of medicine and of health research and policy at Stanford University, came to a startling conclusion. Based on a mathematical proof, Ioannidis showed that it is inevitable that researchers come up with wrong findings most of the time. A litany of problems plaguing medical research, from small sample sizes and weak methods to scientific prejudices and conflicts of interest, means that most of the medical literature is just not to be trusted.

Ioannidis’ work is the most visible example of an emerging field of inquiry devoted to studying the biomedical research enterprise itself. This field has uncovered glaring problems at all stages of the production and reporting of clinical evidence.

One analysis suggests that 85% of the $100bn (£59bn; €74bn) invested in health research each year is wasted.3 The wrong questions often get chosen for research, studies may be poorly designed or simply redundant, data frequently remain unpublished, and many research reports are biased or unusable in other ways.

It’s a depressing state of affairs. Is there any hope that the current …

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