No one likes to admit when they’re wrong — particularly after weeks, or months, or years of intensive research. However, when we don’t acknowledge our failings, we can’t grow; instead, we continue to make the same mistakes. This is especially true for the medical field.

“Evidence-based medicine is the cornerstone of clinical practice, but it is dependent on the quality of evidence upon which it is based,” wrote YA de Vries, PhD, of the Department of Psychology at the University of Groningen in The Netherlands, in a study published in the journal Psychological Medicine. “Unfortunately, up to half of all randomized controlled trials have never been published.”

By allowing bias and spin to dictate negative results, accuracy of research weakens.

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The research outlines the biases that influence publishing results. They used antidepressants as an example.

The researchers followed 105 studies of antidepressants, all registered with the US Food and Drug Administration (FDA) before the findings were published. The results they identified showed the tendency to hide or twist negative outcomes.

Although the FDA characterized the studies as an even split positive and negative, only 48% of the negative trials were published, while nearly all of the positive trials were published. Many of the studies (40%) that the FDA considered negative were reported as positive by the study researchers. The other portion of the negatives studies (60%) fell victim to “spin.” For those, the researchers used creative language to make the results sound positive even though they weren’t statistically significant at all.

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To an outside observer only witnessing the published results, it would seem as if many antidepressant trials had positive outcomes even though that is far from the truth.

“Researchers and clinicians across medical fields must be aware of the potential for bias to distort apparent treatment efficacy,” the researchers said. “Which poses a threat to practice of evidence-based medicine.”


de Vries YA, Roest AM, de Jonge P, Cuijpers P, Munafò MR, Bastiaansen JA, The cumulative effect of reporting and citation biases on the apparent efficacy of treatments: the case of depression. Psychol Med. 2018;48(15):2453-2455.