"Publication Bias, with a Focus on Psychiatry: Causes and Solutions" (Turner, 2013)

[Dolphin]

I saw James C.Coyne ‏@CoyneoftheRealm highlight this.

It has no direct mention of ME/CFS, but a few of us (e.g. who followed the PACE Trial closely) are interested in publication bias

http://link.springer.com/article/10.1007/s40263-013-0067-9

Publication Bias, with a Focus on Psychiatry: Causes and Solutions

CNS Drugs
May 2013

Erick H. Turner

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Abstract

Publication bias undermines the integrity of the evidence base by inflating apparent drug efficacy and minimizing drug harms, thus skewing the risk–benefit ratio.

This paper reviews the topic of publication bias with a focus on drugs prescribed for psychiatric conditions, especially depression, schizophrenia, bipolar disorder, and autism.

Publication bias is pervasive; although psychiatry/psychology may be the most seriously afflicted field, it occurs throughout medicine and science.

Responsibility lies with various parties (authors as well as journals, academia as well as industry), so the motives appear to extend beyond the financial interests of drug companies.

The desire for success, in combination with cognitive biases, can also influence academic authors and journals.

Amid the flood of new medical information coming out each day, the attention of the news media and academic community is more likely to be captured by studies whose results are positive or newsworthy.

In the peer review system, a fundamental flaw arises from the fact that authors usually write manuscripts after they know the results.

This allows hindsight and other biases to come into play, so data can be “tortured until they confess” (a detailed example is given).

If a “publishable” result cannot be achieved, non-publication remains an option.

To address publication bias, various measures have been undertaken, including registries of clinical trials.

Drug regulatory agencies can provide valuable unpublished data.

It is suggested that journals borrow from the FDA review model.

Because the significance of study results biases reviewers, results should be excluded from review until after a preliminary judgment of study scientific quality has been rendered, based on the original study protocol.

Protocol publication can further enhance the credibility of the published literature.

 

[alex3619]

Didn't Goldacre have a book on this published in February or something?

 

[Dolphin]

Didn't Goldacre have a book on this published in February or something?

He wrote "Bad Pharma": http://en.wikipedia.org/wiki/Bad_Pharma which would cover some of the same areas all right.

 

[Esther12]

The Bad Pharma book covers these sorts of problems from pharmaceutical companies. He so far seems less concerned about cognitive/behavioural interventions.

 

[alex3619]

Yet the book should cover psychiatric drugs if its going to cover pharma. I was planning on ordering it sometime.

 

[Esther12]

Yeah - it does cover psychiatric drugs. Sorry, I'd just edited my post as I realised I'd not been clear.

David Healy, who seems to have been got at for being too critical of psychiatric medication in the past, is critical of Goldacre for giving pharmaceutical companies a too easy ride, and of the All Trials campaign.

 

[Sean]

Because the significance of study results biases reviewers, results should be excluded from review until after a preliminary judgment of study scientific quality has been rendered, based on the original study protocol.

"...based on the original study protocol."

 

[Snow Leopard]

"...based on the original study protocol."

Who does that though? Things are normally changed at least a little bit, it is just that the reinterpretation in the PACE trial was so far from reasonable, that it should be considered a joke.