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The failure to know what isn't known: negative publication bias with lamotrigine and a glimpse inside peer review
Correspondence to:
Dr S N Ghaemi, Tufts Medical Center, Department of Psychiatry, 800 Washington St, Box 1007, Boston, MA 02111, USA; nghaemi@tuftsmedicalcenter.org
| The first 150 words of the full text of this article appear below. |
"There is a type of interaction between human beings which proceeds not from knowledge, or even lack of knowledge, but from failure to know what isn’t known." John Kenneth Galbraith1
The medical literature meets Galbraith’s description. Some things we know, and know that we know. Other things we do not know, and know that we do not know. But perhaps the largest class involves those things we do not know, and do not realise that we do not know.
This latter state of affairs is exemplified by the problem of negative studies. It has become increasingly clear that the medical literature is biased toward positive studies; negative studies are less frequently published.2 Sometimes this may reflect loss of passion, as disappointed researchers file away their negative results. Sometimes it may be systematic, as pharmaceutical sponsors may actively suppress negative data which would adversely impact their marketplace sales. And journals may
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