Table 2

Possible consequences of dubious editorial practice on evidence-based medicine

Increase publication bias and ‘garbage in, garbage out’Low-quality studies (eg, studies with high risk of bias or underpowered studies) lead to biased intervention effect estimates and increased between-trial heterogeneity in meta-analyses.
Decreased confidence in trusted sourcesThe overabundance of low-quality publications with conflicting data may be particularly confusing for patients, which may decrease confidence in trusted sources of health information.
Misdirected researchOnce published, low-quality positive studies may distort the rationales of future clinical trials, leading to waste of effort, time and resources, and are hence unethical to patients who participated in these clinical studies.
Inflate the influence of Scientists that do not respect clinical best practicesA larger total number of scientific publications is perceived as giving a legitimacy to being recognised as an expert, regardless of the quality of publications. By promoting some authors by accepting large numbers of publications, editors risk advancing some pseudoexperts.
Influence patient care decisionsPatients are often not trained to detect bias and low-quality studies and could be influenced by low-quality studies.
Influence medical practiceLow-quality positive studies may be used to support prescriptions of drugs with limited benefit/possible harms.