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Ann Intern Med. 2002 Jun 18;136(12):888-95.

Truth survival in clinical research: an evidence-based requiem?

Author information

  • 1Service d'Hépato-Gastroentérologie, Groupe Hospitalier Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75651 Paris Cedex 13, France. tpoynard@teaser.fr

Abstract

PURPOSE:

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.

DATA SOURCES:

MEDLINE and hand searches of journals with studies on cirrhosis and hepatitis.

STUDY SELECTION:

Original articles and meta-analyses published from 1945 to 1999 about cirrhosis or hepatitis in adults.

DATA SYNTHESIS:

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.

Comment in

  • Truth survival. [Ann Intern Med. 2002]
  • Truth is not determined by a majority vote. [Gastroenterology. 2003]
PMID:
12069563
[PubMed - indexed for MEDLINE]
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