When a patient considers his options for a surgical procedure, the patient assumes their doctor is making recommendations based on the most updated research from hundreds of surgical trials. But what if those surgical trials left out pertinent information because it didn't support the trial's goal, or skewed the reporting in order to maintain the researcher's reputation in the healthcare community?
Generally, those conducting surgical trials are required to provide some basic information about their desired outcome in a clinical trial registry in order to be able to publish their results. But in a study of 327 published surgical trials, a group of researchers from the Radboud University Nijmegen Medical Center in Nijmegen, The Netherlands found that half of the trials were never registered or registered after the study was completed. And while 152 of the surgical trials were registered with a clearly defined goal, half of those trials changed the goal by publication or completely omitted it. The medical industry is well aware that positive results from clinical drug trials are selectively reported, but researchers were surprised to discover the high level of reporting bias with clinical surgical trials.
So why should the average patient be concerned about the selective reporting? While regulatory agencies pay close attention to the results of drug trials, surgical procedures have no similar system of checks and balances. Healthcare professionals often refer to information published in medical journals to help their patients--if that information is modified to support a company's financial interest in a particular product, or to benefit a researcher's theory, patients can suffer the consequences. Surgical errors, unnecessary or needlessly expensive procedures, and dangerous treatments can result from incorrect and incomplete research.
Selective reporting of trial results is not a new problem in the medical industry, but some healthcare professionals are calling for further regulation to ensure patients' safety. When clinical trials only publish information that presents a particular procedure or treatment in the best possible light, it makes it more difficult for physicians and patients to make informed decisions about health care. Until medical journals enforce their own rules and hold researchers accountable for the information they present, results will continue to be skewed, and patients and their doctors will find it difficult to advocate for the best possible care.
Medscape.com, Surgery Clinical Trial Results Selectively Reported, 3-15-13