Why accurate reporting is an ethical duty
Last week saw the EQUATOR network launch meeting at the Royal Society of Medicine and its first inaugural lecture, given by Iain Chalmers. EQUATOR is the first systematic attempt to bring together all the myriad guidelines that are available for reporting studies. If you’ve been puzzled by CONSORT, STARD, MOOSE, etc then this is the place for you.
And if you think that reporting guidelines are only of relevance to a small number of academics and editors, the meeting would have disabused you of that. The day’s speakers eloquently made the case for accurate and complete reporting as being not just a scientific duty, but also a moral one that everyone involved in research – funders, researchers, ethics committees, editors and, most importantly, authors – need to take responsibility for. These are not new ideas. As Doug Altman, one of the leaders of the EQUATOR initiative and others have said, back in 1938 Donald Mainland, an eminent statistician, noted that “incompleteness of evidence is not merely a failure to satisfy a few highly critical readers. It not infrequently makes the data that are presented of little or no value.” In 1990 Iain Chalmers similarly noted that “Failure to publish an adequate account of a well-designed clinical trial is a form of scientific misconduct which can lead to those caring for patients to make inappropriate treatment decisions.”
In his lecture at the meeting Doug Altman said that accurate and complete reporting is not the norm must be considered a system failure that a number of parties must take responsibility for. However, the good news is that things are changing, and rapidly. EQUATOR is just one of a number of initiatives that are changing how research, especially clinical research, is reported. The days of only positive studies being incompletely reported in journals that restrict access seem to be coming to an end. The EQUATOR initiative comes at a time when trial registration is now required, when results reporting, as required by the FDA Amendment Act 2008
will shortly be mandatory, and when funders such as the Wellcome, NIH, ERC are increasingly requiring open access to the work they fund .
An excellent end to the day and a reminder of the wider context of reporting of research was the inaugural lecture given by Iain Chalmers entitled “Meeting the research information needs of patients and clinicians more effectively” Iain is now director of the James Lind Library, named after James Lind, the 18th century British doctor who in 1747 did a controlled trial of potential treatments for scurvy in 12 seamen and who went onto publish a systematic review – possibly the first one – of the published evidence for treating scurvy. Sadly though, despite this systematic review and the trial, it was more than 40 years before Naval ships were systematically supplied with lemon juice. The story in the end is a reminder that even if initiatives such as EQUATOR address the systems failure of poor reporting, then, as now, transferring evidence into practice is not simple.
The human organism is highly resilient and broadly adaptable to a wide range of structural imperfections, and it is only after a rather high threshold of deformity is surpassed, that function is degraded.”
Virginia Treatment Centers