RIAT is an international effort to tackle bias in the way research is reported with the goal of providing more accurate information to patients and other healthcare decision makers.
Randomized controlled trials are known as medicine’s “gold standard” for reliable evidence. However, they are falling short of that standard, in large part due to two fundamental problems:
- MISREPORTING: many trials that are published are inaccurately or incompletely reported (misreported trials)
- INVISIBILITY: not all trials conducted are published (unpublished trials)
When the original investigators or sponsors do not correct misreporting, or even leave the entire trial unpublished, they can be considered to have abandoned their trial. And the downstream effects can be substantial, drawing to false conclusions about the effectiveness and safety of medical interventions.
The RIAT initiative aims to address these problems by offering a methodology that allows other people to responsibly correct the record. Anyone who can access trial data and document trial abandonment can use RIAT to:
- CORRECT MISREPORTING by republishing a trial (or just those sections of a trial where misreporting has occurred)
- CORRECT INVISIBILITY by publishing an unpublished trial
Some RIAT projects will be large, while others will be far more focused. It all depends on the nature of the trial abandonment. To get a sense of the effort involved, see How to RIAT.
What makes RIAT different than other forms of trial reanalysis?
Reanalysis of trial data is not a new concept. Here’s what makes RIAT distinct:
- Reanalysis with independence from the original investigators/sponsor
- Reanalysis that sticks to the original trial protocol (RIAT is not about data mining, it’s about ensuring the literature contains trustworthy publications of trials that are reported according to the trial’s original protocol)
- Reanalysis with underlying data available (RIAT authors publish trials with underlying data publicly available, for maximum transparency.)
- Reanalysis with an audit trail (RIAT authors make clear how they selected data with an auditable record of decisions)
- Reanalysis with impact through discoverability by systematic reviews and clinical practice guidelines (RIAT publications are expected to be credible reports of trials that will be used by systematic reviewers and others conducting evidence synthesis)
The Case for RIAT
Although publication bias (invisibility) is perhaps the most notorious form of reporting bias there are other types of reporting bias which distort contemporary clinical trial literature. The evidence for this has been accumulating in the last decade or so. Below is a non systematic collection of the review papers which have looked at how different types of reporting bias affect clinical trials literature across a whole range of interventions. The reviews did this by comparing different sources of information (usually regulatory) with publications. Grouping is by study main finding, but many of the conclusions overlap.
- Reviews showing differences between submissions to regulators and published equivalent trials. The differences are enough to change the study conclusions: Turner 2008, Eyding 2010, Jefferson 2014, Beaumier 2015, Mayo Wilson 2017
- Reviews showing under and non reporting of harms associated with interventions: Coyne 2012, Golder 2016, Hodkinson 2016, Schroll 2016
- Reviews showing the different degree of data granularity between data sources, especially clinical study reports compared to register entries and publications: Wieseler 2012, Wiesler 2013, Doshi 2013, Kohler 2015
- Reviews showing early publications misreporting of an interventions’ profile in its favour: Rodgers 2013, Fu 2013
- Reviews showing major unexplained discrepancies between trial protocols and subsequent publication: Chan 2004, Vedula 2013, Jureidini 2016
- Reviews showing selective reporting of the effects of invasive cardiovascular devices: Chang 2015
- Reviews or case studies showing the impact of accessing underlying clinical study reports on study conclusions: Vedula 2009, Maund 2014 Le Noury 2015 Cosgrove 2016
The RIAT Support Center
“RIATing” a trial (i.e., fixing misreporting/non-publication) is a large and complex undertaking. The RIAT Support Center aims to provide support to researchers working towards the complete and accurate dissemination of misreported or unpublished clinical trials. We aim to do this by:
- Raising awareness of misreporting or invisibility of clinical trials, which are experiments on human beings
- Providing instruments for the identification of misreported or invisible trials
- Making sponsors and authors take responsibility for the misreporting or invisibility of their trials
- Publishing a restoration of misreported or invisible trials if sponsors refuse to take responsibility (abandonment)
- Supporting the restoration of the written record with advice and resources