A recent Cochrane systematic review caught my eye, not so much for its conclusions but for what it shows about the state of the medical literature.
According to Paul Garner, one of the review’s authors, they found a study on nearly 28,000 children, which was published in the BMJ in 2006, which concluded that deworming preschool children in Uganda helped them gain weight but, in fact, when correctly analysed, showed no significant difference. They also found that the largest study, of a million Indian children, carried out in 2004, had never been published.
These two findings, which you might find depressing, actually cheer me up in a funny sort of way. That’s because I’ve spent a lot of time in the last few years talking about (and trying to train people in) research reporting and publication ethics. Telling people that you are passionate about publication ethics is similar to admitting that you are a train spotter. Most people think it is a dry, academic discipline, almost totally disconnected from real life and anything interesting. But this systematic review shows how badly reported research and non-publication of research can harm people. Supposing policy makers had based their findings on the wrongly analysed BMJ article they would, at the very least, have wasted money, and perhaps, at worst, harmed some children.
Similarly, without the diligence of reviewers to uncover unpublished research, most clinicians and policy makers would have had access only to a biased selection of the data. This could also force them into reaching the wrong conclusions.
I’m not clever enough to enter the arguments on either the benefits of deworming, or the correctness of the statistical methods (although I plan to follow these discussions as far as I can understand them). But I’m oddly delighted at this clear demonstration that my obsession with good research reporting and publication ethics might seem just a bit more understandable to some people now. Thanks, Paul! (and, by the way, does anybody know if deworming cats is evidence-based?)
Liz Wager PhD is a freelance medical writer, editor, and trainer. She was the chair of the Committee on Publication Ethics (COPE) (2009-2012).