Fixing publication bias

Ben Goldacre of Bad Science notes recent studies exposing publication bias:

The key issue is simple. In any situation, to make any kind of sensible decision about which treatment is best, a doctor must be able to take into account all of the available information. But drug companies have repeatedly been shown to bury unflattering data.

Sometimes they bury data which shows drugs to be actively harmful. This happened in the case of Vioxx and heart attacks, and SSRIs and suicidal thoughts. Such stories feel, intuitively, like cover ups. But there are also more subtle issues at stake, in the burying of results showing minimal efficacy, and these have only been revealed through the excellent investigative work of medical academics.

And says there are two quick fixes:

The first is obvious. Nobody should get ethical approval to perform a clinical trial unless there is a clear undertaking that the results will be published, in full, in a publicly available forum, and that the researchers will have full academic freedom to do so. Any company trying to silence academics should be named and shamed, and even attempting to do so should be a regulatory offence.

That’s the butch solution. But there is also a more elegant one, which is arguably even more important: a compulsory international trials register. Give every trial an ID number, so we can all see that a trial exists, they can’t go quietly missing in action, and we know when and where to look if they do.