Comparison of registered and published primary outcomes in randomized controlled trials.
BACKGROUND
As of 2005, the International Committee of Medical Journal Editors required investigators to register their trials prior to participant enrollment as a precondition for publishing the trial's findings in member journals.


OBJECTIVE
To assess the proportion of registered trials with results recently published in journals with high impact factors; to compare the primary outcomes specified in trial registries with those reported in the published articles; and to determine whether primary outcome reporting bias favored significant outcomes.


METHODS
MEDLINE via PubMed was searched for reports of randomized controlled trials (RCTs) in 3 medical areas (cardiology, rheumatology, and gastroenterology) indexed in 2008 in the 10 general medical journals and specialty journals with the highest impact factors.


METHODS
For each included article, we obtained the trial registration information using a standardized data extraction form.


RESULTS
Of the 323 included trials, 147 (45.5%) were adequately registered (ie, registered before the end of the trial, with the primary outcome clearly specified). Trial registration was lacking for 89 published reports (27.6%), 45 trials (13.9%) were registered after the completion of the study, 39 (12%) were registered with no or an unclear description of the primary outcome, and 3 (0.9%) were registered after the completion of the study and had an unclear description of the primary outcome. Among articles with trials adequately registered, 31% (46 of 147) showed some evidence of discrepancies between the outcomes registered and the outcomes published. The influence of these discrepancies could be assessed in only half of them and in these statistically significant results were favored in 82.6% (19 of 23).


CONCLUSIONS
Comparison of the primary outcomes of RCTs registered with their subsequent publication indicated that selective outcome reporting is prevalent.
Mathieu
Sylvain
S
INSERM, U738, Assistance Publique des Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Département d'Epidémiologie Biostatistique et Recherche Clinique, Paris, France.
Boutron
Isabelle
I
Moher
David
D
Altman
Douglas G
DG
Ravaud
Philippe
P
D015706:Bibliometrics; D010506:Periodicals as Topic / Q000592:standards / Q000706:statistics & numerical data*; D017594:Publication Bias; D011643:Publishing / Q000592:standards / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic / Q000592:standards / Q000706:statistics & numerical data*; D012042:Registries / Q000592:standards; D016896:Treatment Outcome