Document Detail

Testing for the presence of positive-outcome bias in peer review: a randomized controlled trial.
MedLine Citation:
PMID:  21098355     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: If positive-outcome bias exists, it threatens the integrity of evidence-based medicine.
METHODS: We sought to determine whether positive-outcome bias is present during peer review by testing whether peer reviewers would (1) recommend publication of a "positive" version of a fabricated manuscript over an otherwise identical "no-difference" version, (2) identify more purposefully placed errors in the no-difference version, and (3) rate the "Methods" section in the positive version more highly than the identical "Methods" section in the no-difference version. Two versions of a well-designed randomized controlled trial that differed only in the direction of the finding of the principal study end point were submitted for peer review to 2 journals in 2008-2009. Of 238 reviewers for The Journal of Bone and Joint Surgery and Clinical Orthopaedics and Related Research randomly allocated to review either a positive or a no-difference version of the manuscript, 210 returned reviews.
RESULTS: Reviewers were more likely to recommend the positive version of the test manuscript for publication than the no-difference version (97.3% vs 80.0%, P < .001). Reviewers detected more errors in the no-difference version than in the positive version (0.85 vs 0.41, P < .001). Reviewers awarded higher methods scores to the positive manuscript than to the no-difference manuscript (8.24 vs 7.53, P = .005), although the "Methods" sections in the 2 versions were identical.
CONCLUSIONS: Positive-outcome bias was present during peer review. A fabricated manuscript with a positive outcome was more likely to be recommended for publication than was an otherwise identical no-difference manuscript.
Gwendolyn B Emerson; Winston J Warme; Fredric M Wolf; James D Heckman; Richard A Brand; Seth S Leopold
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Archives of internal medicine     Volume:  170     ISSN:  1538-3679     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2010-12-23     Revised Date:  2011-09-01    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1934-9     Citation Subset:  AIM; IM    
Department of Orthopaedics, University of Washington, Seattle, 98195-6500, USA.
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MeSH Terms
Logistic Models
Outcome Assessment (Health Care)*
Peer Review, Research*
Periodicals as Topic
Publication Bias*
Randomized Controlled Trials as Topic*
Comment In:
Arch Intern Med. 2011 Jul 11;171(13):1213-4; author reply 1214   [PMID:  21747021 ]

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