Recent studies of the medical literature have revealed numerous and serious problems. Errors in the design, methods and interpretation of studies can frequently be identified. A huge hidden problem is publication bias, the tendency for positive articles to be published, while negative articles are either not written or submitted. This can systematically lead to an overestimation of the value of treatments, of diagnostic or prognostic studies. Even more worrisome is selective reporting: only a subset of a wide array of tested hypotheses are presented (the ones that turned out to be positive with significance testing). This is particularly true for secondary endpoints and subgroup findings, but even the primary endpoints of trials have been modified when publications are compared to protocols. The peer-review process is fallible. Even if it were strengthened, reviewers cannot examine what is not reported. Hence many problems can only be mitigated with better reporting. Numerous initiatives have proposed guidelines to promote transparent reporting, but progress is slow.

最近对医学文献的研究揭示了许多严重的问题。研究的设计、方法和解释中的错误经常被识别出来。一个巨大的隐藏问题是发表偏见，即发表正面文章的趋势，而负面文章要么不写，要么不提交。这可能会系统地导致高估治疗、诊断或预后研究的价值。更令人担忧的是选择性报告：仅提出了一系列经过检验的假设中的一个子集（通过显着性检验证明为阳性的假设）。对于次要终点和亚组结果尤其如此，但是当将出版物与协议进行比较时，即使是试验的主要终点也已被修改。同行评审过程是错误的。即使得到加强，审稿人也无法检查未报告的内容。因此，许多问题只能通过更好的报告来缓解。许多倡议提出了促进透明报告的指导方针，但进展缓慢。