Cochrane Collaboration influential in a revision of the Lancet’s publication criteria

For the last 12 years a project led by the UK Cochrane Centre, which is part of the National Institute for Health Research, has examined whether reports of randomised trials in five high-profile, general medical journals discuss the findings of the new trial in the context of the totality of the existing, related evidence. Their latest findings have been published in the Lancet and reveal little if any progress since 1997 ^[1].

The great majority of trials reported in Annals of Internal Medicine, BMJ, JAMA, Lancet and New England Journal of Medicine during the month of May in 1997, 2001, 2005 and 2009 failed to provide the reader with a comprehensive account, with minimal bias, of how the trial adds to existing research and how its findings compare to the current evidence base from other similar trials. Of the 29 trial reports in these five journals in May 2009, five appeared to have been the first trial but only one of the other 24 used an updated systematic review to discuss the new trial’s findings. Ten referred to an existing systematic review without attempting to integrate the new findings, while 13 had no apparent systematic attempt to place the new trial in context.

These findings have been influential in a revised policy, announced in the same issue of the Lancet, in which the journal will ask authors of all research reports submitted after August 1 2010 to put their work into context of what has gone before, by either reporting their own, up-to-date systematic review or citing a recent systematic review done by others.

Professor Mike Clarke, Director of the UK Cochrane Centre and one of the authors of the paper said,              “The most straightforward and reliable way to put research findings in context are in an up-to-date systematic review. This can be especially important for randomised trials. The researchers who do these trials, the funders who pay for them and the journals who publish them need to do this, so that the people who use them have ready access to the evidence they need to take well-informed decisions about health care. We welcome the Lancet’s stance on this and look forward to considerable improvement when we conduct the fifth survey in 2013.”

1. Clarke M, Hopewell S, Chalmers I. Clinical trials should begin and end with systematic reviews of relevant evidence: 12 years and waiting. The Lancet 2010; 376: 20-21.