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Examining the impact of unpublished research on medicine

Over on Thriving, the blog of Children’s Hospital Boston, physician Clarie McCarthy, MD, takes a closer look at the impact of unpublished research in shaping physicians and patients’ understandings of new medical treatments and therapies.

In the post, she highlights a recent Pediatrics article (subscription required) showing how separately searching published and unpublished studies about the use of serotonin receptor inhibitors to reduce repetitive behaviors of autism leads to conflicting answers on whether such a treatment is effective. Additionally, a recent study (subscription required) that analyzed 3,428 other studies involving children found that results were unavailable for more than half. McCarthy writes:

As a pediatrician, this worries me. I’m making medical decisions for my patients based on less than half of the information out there?

There is a database, ClinicalTrials.gov, where researchers are supposed to “register” their studies before they even start. That way, there is a record of it–and even if they stop it, or if it never gets published, there is a way to at least know it existed and find out more about it. Unfortunately, not all studies get registered. Many journals, including Pediatrics, won’t publish a study unless it was registered–if all journals would do that, maybe all researchers would register their studies.

This doesn’t mean that you can’t trust medical research. Medical research has brought us antibiotics and heart surgery and drugs that cure many cancers; medical research saves and improves countless lives every single day. But it does mean you have to be a savvy and skeptical consumer of health information. It means that you need to ask questions, learn about the sources of the information, read widely and–always–talk to your doctor before you make a health decision based on a study.

Previously: Studies reveal that what studies reveal can be wrong
Photo by Giulia Forsythe

2 Responses to “ Examining the impact of unpublished research on medicine ”

  1. Marilyn Mann Says:

    Actually, at least in some cases, I think it *does* mean that you can’t trust medical research. If the unpublished data were randomly distributed it would be one thing, but generally negative studies are less likely to get published, making the effect sizes derived from meta-analyses of published research unreliable.

  2. Dick Miller Says:

    Lane Library plans to load records for the unpublished results subset of ClinicalTrials.gov in our local database. There is a logistical problem of how long to wait before deciding a given study is indeed not going to be published.

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