Cover story | WHY RESEARCH IS WRONG Continued from Page 13 public. In that report, you see a long list of different strategies that can be used to corrupt the evidence base,” said Dr. Mark Helfand, director of the Oregon EvidenceBased Practice Center and editor of the journal Medical Decision Making. “But we have this problem that we don’t know how common those are and we don’t know when they’re there or not, so they undermine confidence in virtually all of the literature.” Helfand said there is often little a journal can do to prevent researchers from gaming the system. A research article will typically go through multiple layers of review before a journal will publish it, including the peer-review process, where other experts review the study looking for methodological flaws. “The budget of a journal like the Annals of Internal Medicine probably has $1 million a year in it that can be used for higher-level editorial vigilance,” Helfand said. “And that’s the budget of 10 to 15 other journals combined.” Journal editors cannot know whether authors are holding back on research that shows no effect, submitting only those studies that support the intervention, or whether they changed their study protocols midway through to have their intended research findings match the data. “Somebody can get a broker to look at 20, 30 data sets and find the one that’s going to be the most agreeable to the hypothesis,” Helfand said. “They can actually ask people who study the data sets to help them find a match to the data set that they’re more likely to get a positive result in.” Helfand’s journal has a reputation for a very demanding peer review process, because it deals with issues of how data can inform clinical practice. The editors frequently send submissions back to authors asking them to do additional work. Yet authors know they can get the article published as-is at a journal with less-demanding standards. “There are so many models now for getting things out into journals, including some models that border on vanity press,” Helfand said. “We’re competing
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