### Problems in medical research:Tracking outcome switching

Posted:

**Sun Feb 07, 2016 11:19 am UTC**http://compare-trials.org/

Ben Goldacre (author of the book Bad Science) and a team recently set up a website for tracking improperly switched/unreported/added outcomes in clinical trials.

The reactions of some (supposedly respectable) journals has been surprisingly poor while others have published corrections.

So far of 67 trials checked 9 were perfect, and in the remaining 58 trials a total of 301 prespecified outcomes were silently not reported and 357 were silently added .

58 letters have been sent to journals about switched outcomes of which only 6 have been published.

It is a major problem in modern clinical trial publishing since outcome switching destroys statistical validity.

Part of the challenge of getting public support for fixing the problem is that in order to understand why it's such a big problem people have to wade through a great deal of tedium.

Ben Goldacre (author of the book Bad Science) and a team recently set up a website for tracking improperly switched/unreported/added outcomes in clinical trials.

Outcome switching in clinical trials is a serious problem. Between October 2015 and January 2016, the COMPare team systematically checked every trial published in the top five medical journals, to see if they misreported their findings:

We compared each clinical trial report with its protocol or registry entry. Some trials reported their outcomes perfectly. For the others, we counted how many of the outcomes pre-specified in the protocol or registry were never reported. We also counted how many new outcomes were silently added.

When we detected unreported or added outcomes, we wrote a letter to the journal pointing them out. We tracked which journals published our letters – and which did not.

The reactions of some (supposedly respectable) journals has been surprisingly poor while others have published corrections.

So far of 67 trials checked 9 were perfect, and in the remaining 58 trials a total of 301 prespecified outcomes were silently not reported and 357 were silently added .

58 letters have been sent to journals about switched outcomes of which only 6 have been published.

It is a major problem in modern clinical trial publishing since outcome switching destroys statistical validity.

Part of the challenge of getting public support for fixing the problem is that in order to understand why it's such a big problem people have to wade through a great deal of tedium.