Psychological Medicine


Publication bias and the integrity of psychiatry research



The cornerstone of evidence-based medicine is the belief that good quality research should form the basis of clinical practice and decision-making (Muir Gray, 1997). Psychiatry has kept abreast of this movement (Geddes et al. 1997) and claims have been made that randomized-controlled trials (the highest quality primary evaluative research) can be used to justify 65% of routine clinical decisions (Geddes et al. 1996). However, it is largely published research that forms the ‘knowledge base’ of the evidence movement. A fundamental difficulty arises when published research results are a biased sample of all research results – published and unpublished. Publication bias presents one such threat and has been much discussed in wider healthcare (Easterbrook et al. 1991; Dickersin & Min, 1993; Dickersin, 1997), but has been little discussed or researched in psychiatry, despite the fact that psychiatry is likely to be at least as prone to publication bias as other specialities.

c1 Address for correspondence: Dr Simon M. Gilbody, NHS Centre for Reviews and Dissemination, University of York, York YO10 5DD.