Introduction
What is new?
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Clinical researchers from 41 countries reported high rates of nonpublication of their own trials (36%) and admitted to selective reporting of trial results (30%), confirming that publication bias remains a serious problem.
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Researchers are aware of being the main culprits for publication bias but feel strongly that the blame rests with the system that allows such practices —from research funders and institutions to journals and trial registries.
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To preserve the integrity and transparency of clinical research, researchers call for radical changes in the process of communicating the trial results to the professional and general public, including legal actions and alternatives to journals.
Results from clinical trials are necessary to provide unbiased information for making decisions about medical therapies and diagnostic procedures. Yet, despite the need for greater transparency of clinical research and recent strong initiatives to increase this transparency, for example, mandatory registration and posting of results from clinical trials [1], [2], there is still a long way to go before 100% of studies are published [3]. Recently updated systematic review on biases in clinical trials [4] confirmed that the extent of publication bias remains unchanged and that studies with significant or positive results are more likely to be published. The blame has been put on investigators as “almost all failure to publish is due to the failure of investigators to submit reports for publication” [5]. Even Cochrane Collaboration researchers—experts acutely aware of publication bias—publish only about a third of results presented at annual meetings [6].
Despite a number of studies investigating the prevalence and causes of nonpublication [7], [8], [9], [10], [11], investigators have not been asked about possible solutions. To address this knowledge gap and contribute to the discussion on how to achieve full transparency of clinical research [3], we used an online survey to assess how clinical researchers and Cochrane systematic reviewers explain the reasons behind publication bias and propose methods to prevent it. We further explored the themes that emerged in the survey in a focus group discussion held at a research conference on transparency in health research.