title: Truth survival in clinical research: an evidence-based requiem?
abstract: OBJECTIVE
  Factors associated with the survival of truth of clinical conclusions in the medical literature are unknown. The authors hypothesized that conclusions derived from studies using better methodology should have a longer half-life.
  
  
  METHODS
  MEDLINE and hand searches of journals with studies on cirrhosis and hepatitis.
  
  
  METHODS
  Original articles and meta-analyses published from 1945 to 1999 about cirrhosis or hepatitis in adults.
  
  
  RESULTS
  In 2000, 285 of 474 conclusions (60%) were still considered to be true, 91 (19%) were considered to be obsolete, and 98 (21%) were considered to be false. The half-life of truth was 45 years. The 20-year survival of conclusions derived from meta-analysis was lower (57% +/- 10%) than that from nonrandomized studies (87% +/- 2%) (P < 0.001) or randomized trials (85% +/- 3%) (P < 0.001). The survival of conclusions was not different when studies of high methodologic quality were compared with those of low quality. In randomized trials, the 50-year survival rate was higher for 52 negative conclusions (68% +/- 13%) than for 118 positive conclusions (14% +/- 4%) (P < 0.001).
  
  
  CONCLUSIONS
  Contrary to the authors' hypothesis, conclusions based on recognized, good methodology had no clear survival advantage. To better convince clinicians of the long-term utility of evidence-based medicine, better prognostic factors should be developed.
authors.affiliation: Service d'Hépato-Gastroentérologie, Groupe Hospitalier Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75651 Paris Cedex 13, France. tpoynard@teaser.fr
authors.forename: Thierry
authors.initials: T
authors.lastname: Poynard
authors.forename: Mona
authors.initials: M
authors.lastname: Munteanu
authors.forename: Vlad
authors.initials: V
authors.lastname: Ratziu
authors.forename: Yves
authors.initials: Y
authors.lastname: Benhamou
authors.forename: Vincent
authors.initials: V
authors.lastname: Di Martino
authors.forename: Julien
authors.initials: J
authors.lastname: Taieb
authors.forename: Pierre
authors.initials: P
authors.lastname: Opolon
mesh_terms: D002986:Clinical Trials as Topic / Q000592:standards*; D019317:Evidence-Based Medicine / Q000592:standards*; D006505:Hepatitis; D006801:Humans; D008103:Liver Cirrhosis; D015201:Meta-Analysis as Topic; D016032:Randomized Controlled Trials as Topic / Q000592:standards; D012107:Research Design / Q000592:standards*; D013997:Time Factors