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Poor-Quality Medical Research
What Can Journals Do?
or even wrong, despite their clear im-
portance.1The results of several re-
and reporting are widespread.
Similar problems afflict other study
types. A review of 308 phase 2 trials in
cancer (295 of which were single-arm
ies with no reported design (P=.003).3
Of 40 molecular genetics articles pub-
15 (38%) failed to meet at least 2 of 7
expected benefits of molecular genetic
testing may not be achieved.”4
In recent years, systematic reviews
pret their findings narrowly, failing to
Douglas G. Altman, DSc
HERE IS CONSIDERABLE EVI-
ports of randomized con-
trolled trials (RCTs) are poor
ity of the individual (primary) studies.6
able evidence is of poor scientific qual-
rors were found in 40% of 164 articles
in 19% of 145 articles published in an
obstetrics and gynecology journal.11I
come more complex, and there is evi-
dence of frequent misapplication of
newer advanced techniques.12
ers need to know how it relates to ex-
their findings in the context of those
Why Are There So Many
Errors in Medical Articles?
peer-review process. But the problems
arise earlier, so a more important ques-
Much research is done without the
benefit of anyone with adequate train-
Author Affiliation: Cancer Research UK/NHS Cen-
tre for Statistics in Medicine, Oxford, England.
man, DSc, Cancer Research UK/NHS Centre for Sta-
tistics in Medicine, Institute of Health Sciences, Old
The aim of medical research is to advance scientific knowledge and hence—
directly or indirectly—lead to improvements in the treatment and preven-
tion of disease. Each research project should continue systematically from
previous research and feed into future research. Each project should con-
tribute beneficially to a slowly evolving body of research. A study should
not mislead; otherwise it could adversely affect clinical practice and future
research. In 1994 I observed that research papers commonly contain meth-
odological errors, report results selectively, and draw unjustified conclu-
sions. Here I revisit the topic and suggest how journal editors can help.
©2002 American Medical Association. All rights reserved.
(Reprinted) JAMA, June 5, 2002—Vol 287, No. 21