High quality, complete reports of research are needed to provide maximum return on the public’s substantial investment in research on the effects of treatments.
The Medical Research Council’s randomised trial comparing bed rest alone with bed rest and streptomycin for treating pulmonary tuberculosis (MRC 1948) is renowned for several reasons. As far as the research methods used are concerned, it is because it introduced secure methods for assuring that the comparison groups would be similar (Chalmers 2010). However, another feature of the report of the study was that it was exceptionally clearly drafted. This reflected the care taken by the three members of the research team. One of them, Marc Daniels, went on to publish papers commenting on the inadequacy of many reports of research, and recommending reporting standards (Daniels 1950; 1951). Some years later, Austin Bradford Hill, one of Daniels’ two senior colleagues, also offered guidance (Hill 1965).
It was not until the 1980s that formal surveys of the quality of reports of research began to reveal just how common deficiencies were (Hemminki 1981; 1982). Remedies began to be suggested in proposed reporting standards (Chalmers TC et al. 1981; Ad Hoc Working Group 1987). The 1990s witnessed concerted international initiatives to improve the quality of reports of research (Standards of Reporting Trials Group 1994; The Consort Group 1996). In a BMJ editorial in 1994, Douglas Altman commented on “the scandal of poor medical research” – “we need less research, better research and research done for the right reasons”, he suggested (Altman 1994). Since then, he and his colleagues in the Equator Network (www.equator-network.org) have created a library of guidelines for reporting health research. Promoting adherence to these guidelines by researchers and journals remains a challenge.
The text in these essays may be copied and used for non-commercial purposes on condition that explicit acknowledgement is made to The James Lind Library (www.jameslindlibrary.org).
Ad Hoc Working Group for Critical Appraisal of the Medical Literature (1987). A proposal for more informative abstracts of clinical articles. Annals of Internal Medicine 106:598-604.
Altman (1994). The scandal of poor medical research. BMJ 308:283-284.
Chalmers I (2010). Why the 1948 MRC trial of streptomycin used treatment allocation based on random numbers. JLL Bulletin: Commentaries on the history of treatment evaluation (www.jameslindlibrary.org).
Chalmers TC, Smith H, Blackburn B, Silverman B, Schroeder B, Reitman D, Ambroz A (1981). A method for assessing the quality of a randomized control trial. Controlled Clinical Trials 2: 31-49
Daniels M (1950). Scientific appraisement of new drugs in tuberculosis. American Review of Tuberculosis 61:751-756.
Daniels M (1951). Clinical evaluation of chemotherapy in tuberculosis. British Medical Bulletin 7:320-326.
Hemminki E (1981). Quality of reports of clinical trials submitted by the drug industry to the Finnish and Swedish control authorities. European Journal of Clinical Pharmacology 19:157-165.
Hemminki E (1982). Quality of clinical trials – a concern of three decades. Methods of Information in Medicine 21:81-85.
Hill AB (1965). The reasons for writing. BMJ 2:870.
Medical Research Council (1948b). Streptomycin treatment of pulmonary tuberculosis: a Medical Research Council investigation. BMJ 2:769-782.
Standards of Reporting Trials Group (1994). A proposal for structured reporting of randomized controlled trials. JAMA 272:1926-31.
The CONSORT Group (1996). Improving the quality of reporting of randomized controlled trials. The CONSORT Statement. JAMA 276:637-639.