The knowledge system underpinning healthcare is not fit for purpose and must change

@article{Roberts2015TheKS,
  title={The knowledge system underpinning healthcare is not fit for purpose and must change},
  author={Ian Roberts and Katharine Ker and Phil Edwards and Deirdre Beecher and Daniela Manno and E. A. Sydenham},
  journal={BMJ : British Medical Journal},
  year={2015},
  volume={350}
}
The medical literature is biased and inundated with poor quality trials. Ian Roberts and colleagues explain how these problems affect systematic reviews and how they might be overcome 

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References

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Seventy-Five Trials and Eleven Systematic Reviews a Day: How Will We Ever Keep Up?

Hilda Bastian and colleagues examine the extent to which critical summaries of clinical trials can be used by health professionals and the public.

Doubts over head injury studies

Patients are receiving treatment that may be unsound as investigations by Ian Roberts and colleagues raise questions about whether influential trials of high dose mannitol ever took place

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The take-home message is that meta-analyses that include multiple studies with practically identical results should be viewed with great caution, especially when multiple studies in a meta-analysis come from the same team of investigators and all of them find exactly the same conclusion.

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The authors need less research, better research, and research done for the right reasons, and researchers who use the wrong techniques, use the right techniques wrongly, misinterpret their results, report their results selectively, cite the literature selectively, and draw unjustified conclusions.

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Underreporting research is scientific misconduct.

An extended use of prospective registration of trials at inception, as well as benefiting clinical research in other ways, could help people to play their respective roles in reducing underreporting of clinical trials.

Dissemination and publication of research findings: an updated review of related biases.

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