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Comment & Response
September 25, 2013

Focusing on the Body of Evidence

Author Affiliations
  • 1Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey
JAMA. 2013;310(12):1289-1290. doi:10.1001/jama.2013.278047

To the Editor The Viewpoint by Drs Murad and Montori suggested emphasizing bodies of evidence as a whole rather than individual study results.1 However, the current research culture undermines the goal of synthesized evidence.

First, the authors mentioned publication bias but understate the difficulty of overcoming it. Journals may preferentially publish positive studies over negative ones, and scientists may be less likely to submit a paper if their hypothesis is not confirmed.2 Synthesizing biased literature into a meta-analysis makes those meta-analyses equally biased. Funnel plots and homogeneity analyses are helpful, though imperfect.