COMPare aims to fix the prevalent and ongoing problem of outcome switching in clinical trials. In short, outcome switching is when trialists report something different to what they originally said they were going to: it increases the risk of false positive results and exaggerated findings, and is therefore a bad thing.
For 6 weeks we assessed every trial published in the top 5 medical journals for discrepancies between pre-specified and reported outcomes. Of 67 trials, we found that 58 (87%) contain misreported outcomes .
That was phase 1 of COMPare. We are now in phase 2: blogging on our findings and engaging the journals and authors in public discussion on our specific assessments and their attitudes and policies on outcome reporting. The range of responses this has generated has been fascinating and enlightening; from best practice demonstrated by the BMJ , to extremely concerning views expressed and actions taken by Annals of Internal Medicine . We are beginning to see a set of recurring themes in these responses that shed light on the underlying reasons for this prevalent problem; largely based on a fundamental misunderstanding of the importance of pre-specification and correct reporting of outcomes.