Researchers/authors | Publish or perish
The importance of scientists’ work is often judged by the amount of papers they publish. Journal publications not only improve the visibility and reputation of investigators, but also represent an increasingly important prerequisite for faculty positions and research funding.15 Therefore, researchers might be pushed to preferably submit manuscripts with positive results, as they are more likely to be published Career status of authors
Junior researchers may be less experienced and therefore may fear consequences less if biased analyses are detected. They might also be in a hurry to generate the most publications possible Junior and especially mid-career researchers are in need of frequent publications to progress their academic careers, as survival in the system of science depends on reaching a critical amount of publications within a certain time16 Senior researchers have to make less effort to maintain their already well-established careers. On the other hand, they might be in charge of an institution and therefore try to enhance its publication record Winner takes all
Novel research findings are especially rewarded.16 Thus, authors will rush such results to a journal. In order to be the first to publish with a minimum expenditure of resources, they will try to anticipate which results are likely to be most impressive to reviewers and editors. On the other hand, authors have no interest in ‘wasting their time’ in preparing manuscripts with results they consider not sufficiently interesting to achieve publication. Tendency to confirm own expectations and hypotheses
Confirmations of one's own expectations with significant results might be used as proof by researchers that the procedure and findings are sound. Furthermore, a non-significant finding may be interpreted as failure and therefore less ‘valuable’ or less ‘publishable’, as various surveys and experiments have described15 Intellectual interest
Financial interests
Researchers/authors might be pushed by funders/industry/lobby to report/submit research findings in favour of the product and not submit unfavourable data.17 Furthermore, conflicts of interest related to companies producing competing products may influence interpretation and reporting of data by researchers/authors Professional interests
Miscellaneous
Researchers might decide not to share their data, as they want to benefit from the data themselves, or do not want data to be scrutinised by others, or do not have time or resources to make data available
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Journal editors | Frequent citations
Editors are interested in publishing articles that accrue many citations, since frequent citations increase the journal's prestige and attract more readers, authors and subscribers.18 It is known that ‘significant’ and theory-confirming results are more often cited by other authors Reader interest
Tendency to confirm own expectations and hypotheses19
Financial interests20
Conflict of interests
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Peer reviewers | Tendency to confirm own expectations and hypotheses19
Maximising reputation while minimising effort
Peer reviewers have a very labour-intensive task18 and they inevitably have less insight into the research done than the original authors. To minimise their workload they might solve the information problem by relying on proxies to indicate the quality of research work. For example, the status and reputation of authors, the strength and significance of results of the main results as opposed to the scientific merit of the investigation, or even the tendency to confirm the peer reviewer's own expectations and hypotheses might serve as proxies Consequently, at times, well-designed and conducted studies may not be published if they report null or negative results21 Conflict of interests
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(pharmaceutical and device) manufacturers | Marketing of their product
Commercial sponsors are interested in results supporting their product, and try to use such results in the most favourable way for the marketing of their product. Likewise, they may wish to suppress studies when the results do not favour their product It has been shown that industry-supported research is more likely to present ‘positive’ results than research funded from non-industry sources, furthermore, industry sponsorship was strongly associated with pro-industry conclusions.22–24 There is evidence that commercially sponsored research is less frequently published if the results are ‘negative’22 24
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Funding agencies | Increase in visibility
Conflict of interests
Funding agencies, in particular public funders such as hospitals, might be influenced by economic considerations, and therefore favour less expensive treatment options over new and more costly alternatives
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Research ethics committees | Lack of financial and personal resources
Insufficient legal basis to require trial registration and unbiased dissemination
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Research institutions | Increase in visibility
Conflict of interests
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Regulatory agencies | Lack of realising the public interest in unbiased research
While regulatory agencies need to protect commercial interests, their transparency policies explicitly state that the public interest in unbiased clinical data can overrule the commercial interests (especially after marketing approval has been granted). Nevertheless, recent decision making of the European Medicines Agency on more or less restricted access to trial data did not consider ‘public interest’ arguments25
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Decision making bodies* | Have an interest in transparency and try to add to the dissemination process through their submission and publishing procedures |
Readers/patients/patient organisations | Readers and patients might be more interested in ‘positive’ or new research findings |