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

From: Improving medical research in the United Kingdom

Problem Problem description Relevant proposed solutions How the proposed solutions address the problem
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