Table 1 Problems in medical research and how they can be mitigated by authors’ proposed strategy

Publication bias

Results deemed ‘negative’ or ‘uninteresting’ are not published

Registered reports

Study accepted for publication based on methods, not results

Research registry

Study results and documents made available, regardless of article publication status

Misaligned incentives

Researchers are rewarded based on quantity of publications and journal-based metrics rather than on the quality of methods and processes used in research, and healthcare professionals are encouraged to author scientific publications in order to advance in clinical careers

Cease the use of reductionistic metrics like journal impact factor, H-index, and publication counts in assessing researchers. Cease the use of publications in selection criteria for health professionals

Researchers incentivised to focus more on methodological rigour and reproducibility of their research. Healthcare professionals who are not interested in research are not incentivised to publish research

HARKing

Researchers generate hypotheses after results are known—allowing publication of “false positive” findings that are the result of noise in the data rather than true findings

Registered reports, research registry

Hypotheses and aims are agreed prior to undertaking research. Any further post hoc analyses are declared as such

P-hacking

Researchers test many possible hypotheses until one is significant by chance alone, allowing publication of “false positive” findings that are the result of noise in the data rather than true findings

Registered reports

Analyses methods evaluated and approved prior to generation of results

Research registry

Analysis plans and code available to peers for scrutiny

Outcome switching

Researchers do not report all pre-registered outcomes, or switch primary and secondary outcomes, to highlight results that may be ‘noise’ in the data rather than true findings

Registered reports

Outcomes of interest declared in public prior to undertaking research

Research registry

Protocols and analysis plans made available to peers for scrutiny

National register of interests

Conflicting interests which could engender bias made known to public and peers

Spin

Misrepresentation of study results, regardless of motive, that overemphasises the beneficial effects of the intervention and overstates safety compared with that shown by the results [48]

Registered reports

Reduced incentive to ‘spin’ to obtain publication

Research registry

Study documentation available to allow greater scrutiny of researchers’ claims

National register of interests

Information on possible conflicts of interest allows peers to judge if researchers have vested interest in applying spin to study

Undisclosed conflicts of interest

Researchers may have vested interest in obtaining certain outcome in their results

National register of interests

Researchers compelled to made comprehensive statement of their pecuniary interests, gifts and hospitality received and non-financial interests

Insufficient methodological details reported and other causes of non-replicable research

Results that cannot be evaluated, either because of insufficient information to reproduce methods or because of biases in original study produced significant results by chance rather than by detecting a true signal

Research registry reporting guidelines

Adequate study documentation made available and in enough detail such that the study can be reproduced or analyses repeated