Bias, perhaps best described as ‘any process at any stage of inference which tends to produce results or conclusions that differ systematically from the truth,’ can pollute the entire spectrum of research, including its design, analysis, interpretation and reporting.1 It can taint entire bodies of research as much as it can individual studies.2 3 Given this extensive detrimental impact, effective efforts to combat bias are critically important to biomedical research’s goal of improving healthcare. Champions for such efforts can currently be found among individual investigators, journals, research sponsors and research regulators. The central focus of this essay is assessing the effectiveness of some of the efforts currently being championed and proposing new ones. Current efforts fall mainly into two domains, one meant to prevent bias and one meant to detect it. Much like a proverbial chain, efforts in either domain are hampered by their weakest components. Hence, it behoves us to constantly probe antibias tools so that we can identify weak components and seek ways to compensate for them. Further, given the high stakes—conclusions that align with rather than diverge from truth—it further behoves the biomedical research community to prioritise to the extent possible bias prevention over bias detection. The less likely any given study is to be tainted by bias, the fewer research publications reporting biased results there will be. The value of detected bias pales in comparison, for it extends only as far as those who are aware of that detection after the fact, meaning that biased conclusions at variance with the truth can mislead those unaware of the bias that taints them for as long as the affected publications endure. With these preliminary considerations about bias in mind, let us first examine some current antibias efforts and probe their weaknesses. Doing so will show why …

中文翻译：

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转向偏少的研究

偏见，也许最好被描述为“任何推理阶段的任何过程，往往会产生与事实有系统性差异的结果或结论”，它可能会污染整个研究范围，包括其设计、分析、解释和报告。 1 它可以尽可能多地污染整个研究机构。2 3 鉴于这种广泛的有害影响，有效消除偏见对于生物医学研究改善医疗保健的目标至关重要。目前可以在个人研究人员、期刊、研究赞助商和研究监管机构中找到此类努力的拥护者。本文的中心焦点是评估目前正在倡导的一些努力的有效性并提出新的努力。目前的努力主要分为两个领域，一种是为了防止偏见，一种是为了检测偏见。就像众所周知的链条一样，任何一个领域的努力都受到其最薄弱部分的阻碍。因此，我们应该不断探索抗偏工具，以便我们能够识别薄弱组件并寻求补偿它们的方法。此外，考虑到高风险——与事实一致而不是背离真相的结论——生物医学研究界进一步应该优先考虑可能的偏见预防而不是偏见检测。任何给定研究被偏见污染的可能性越小，报告有偏见结果的研究出版物就越少。相比之下，检测到的偏差的价值相形见绌，因为​​它只延伸到那些在事后意识到检测的人，这意味着只要受影响的出版物持续存在，与事实不一致的有偏见的结论就会误导那些不知道会污染他们的偏见的人。考虑到这些关于偏见的初步考虑，让我们首先检查一些当前的反偏见努力并探究它们的弱点。这样做将说明为什么……