Hiding negative trials by pooling them: a secondary analysis of pooled-trials publication bias in FDA-registered antidepressant trials
Open accessAbstract
Background: Previous studies on reporting bias generally examined whether trials were published in stand-alone publications. In this study, we investigated whether pooled-trials publications constitute a specific form of reporting bias. We assessed whether negative trials were more likely to be exclusively published in pooled-trials publications than positive trials and examined the research questions, individual trial results, and conclusions presented in these articles. Methods: Data from a cohort of 105 randomized controlled trials of 16 antidepressants were extracted from earlier publications and the corresponding Food and Drug Administration (FDA) reviews. A systematic literature search was conducted to identify pooled-trials publications. Results: We found 107 pooled-trials publications that reported results of 23 (72%) of 32 trials not published in stand-alone publications. Only two (3.8%) of 54 positive trials were published exclusively in pooled-trials publications, compared with 21 (41.1%) of 51 negative trials (p < 0.001). Thirteen (12%) of 107 publications had as primary aim to present data on the trial's primary research question (drug efficacy compared with placebo). Only four of these publications, reporting on five (22%) trials, presented individual efficacy data for the primary research question. Additionally, only five (5%) of 107 pooled-trials publications had a negative conclusion. Conclusions: Compared with positive trials, negative trials of antidepressants for depression were much more likely to be reported exclusively in pooled-trials publications. Pooled-trials publications flood the evidence base with often-redundant articles that, instead of addressing the original primary research question, present (positive) results on secondary questions. Therefore, pooled-trials publications distort the apparent risk–benefit profile of antidepressants.
AI snapshot
Written from the paper’s full text.
TL;DR
Pooled-trials publications were used disproportionately to report negative antidepressant trials: 21 of 51 not-positive trials appeared exclusively in such publications versus 2 of 54 positive trials. These publications rarely addressed the original primary efficacy question or reported individual trial results, and almost never reached negative conclusions, potentially distorting apparent risk–benefit.
Key findings
- Of 105 FDA-registered antidepressant trials, 32 were not published in stand-alone articles; 107 pooled-trials publications reported results of 23 (72%) of these 32 trials.
- Not-positive trials were much more likely than positive trials to be published exclusively in pooled-trials publications: 21/51 (41.1%) vs. 2/54 (3.8%), Fisher’s exact p < 0.001.
- Only 13/107 (12%) pooled-trials publications had the trial’s original primary research question as their primary aim; only four publications presented individual efficacy data for that primary question, covering five (22%) trials.
- Only 5/107 (5%) publications had a negative conclusion; 14 (13.1%) were neutral and 88 (82.2%) were positively framed. Also, 97/107 (91%) had at least one industry-employed author.
Methods
- Secondary analysis of a cohort of 105 randomized controlled trials of 16 second-generation antidepressants, extracted from Turner et al. (2008) and FDA reviews; 54 trials were considered positive and 51 not-positive.
- Systematic literature search in PubMed, EMBASE, and Cochrane CENTRAL until 15 August 2017 for pooled-trials publications, defined as publications analyzing individual patient data from two or more trials; aggregate-data meta-analyses were excluded. Trials were matched by drug, comparator, dosage groups, sample sizes, duration, and investigators.
- Extracted whether the publication’s primary endpoint was the original trial primary efficacy question, whether individual trial results for that outcome were reported, and classified conclusions as positive, neutral, or negative from abstracts (96% inter-rater agreement); Fisher’s exact test used for publication-status comparison.
Limitations
- Stated: some pooled-trials publications may have been missed because they provided too little information for matching; 22 pooled-trials publications were excluded because included trials were unclear. The authors also did not count five publications that reported individual primary-outcome results but focused on a secondary research question, covering three additional trials.
- Stated: most included trials predated trial-registration requirements, and more recent negative trials were more often published as stand-alone articles; older antidepressants remain clinically relevant. The study did not conduct a meta-analysis and assessed a narrow field (antidepressants).
- Evident: conclusion classification relied on abstracts rather than full texts, and inclusion was restricted to FDA-registered trials, so findings may not generalize to non-FDA-registered trials or other medical fields.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
0 of 11 cited sources checked · 0 supported · 0 flagged
- Findingown data
All five pooled-trials publications with negative conclusions concluded that the drug was associated with more adverse events than placebo.
“All five concluded that the drug was associated with more adverse events than placebo.”
Quote in the paperNot a substantial claim - Findingown data
97 (91%) of 107 pooled-trials publications had at least one industry-employed author.
“In our study, 97 (91%) of 107 pooled-trials publications had at least one industry-employed author and, as noted, only five publications had negative conclusions.”
Quote in the paperSubstantial claim - Findingown data
Thirteen of 107 (12.1%) pooled-trials publications had the same research question as the included trial's original primary research question (drug efficacy compared with placebo).
“Thirteen of 107 (12.1%) pooled-trials publications, including 10 (43%) of 23 trials published exclusively in pooled-trials publications, had the same research question as the included trial's original primary research question (drug efficacy compared with placebo) (Table 1).”
Quote in the paperSubstantial claim - Findingown data
Of 105 FDA-registered antidepressant trials, 32 were not published in stand-alone publications.
“As shown in the flow diagram (Fig. 1), of 105 FDA-registered antidepressant trials, 32 were not published in stand-alone publications.”
Quote in the paperSubstantial claim - Findingown data
Negative (not-positive) trials were more likely than positive trials to be published exclusively in pooled-trials publications (21/51, 41.1% vs 2/54, 3.8%; Fisher's exact p < 0.001).
“Only two (3.8%) of 54 positive trials were published exclusively in pooled-trials publications, compared with 21 (41.1%) of 51 negative trials (p < 0.001).”
- Also stated in: § Pooled-trials publications · plain
“Compared with positive trials, not-positive trials were more likely to be published exclusively in pooled-trials publications (Fisher's exact p < 0.001).”
Quote in the paperSubstantial claim - Also stated in: § Pooled-trials publications · plain
- Findingown data
Only five (4.7%) of 107 pooled-trials publications reported a negative conclusion.
“Only five pooled-trials publications (4.7%) reported a negative conclusion (online Supplementary Table S1).”
Quote in the paperSubstantial claim - Findingown data
Of the 32 trials not published in stand-alone publications, 23 (71.9%) were included in 107 pooled-trials publications.
“Of these, 23 (71.9%) were included in 107 pooled-trials publications (Table 1).”
- Also stated in: § Results · plain
“We found 107 pooled-trials publications that reported results of 23 (72%) of 32 trials not published in stand-alone publications.”
Quote in the paperSubstantial claim - Also stated in: § Results · plain
- Premisecitation
The link between antidepressants and suicidality was convincingly established only by pooling trials.
“The link between antidepressants and suicidality, for instance, was convincingly established only by pooling trials (Hammad et al., 2006; Stone et al., 2009).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites Hammad et al., 2006
Not checked in the free run.
- cites Stone et al., 2009
Not checked in the free run.
- Premisecitation
Because pharmaceutical companies must preregister trials they intend to conduct in support of US marketing approval, FDA reviews can be used as a registry and results database.
“Because pharmaceutical companies must preregister trials they intend to conduct in support of US marketing approval, FDA reviews can be used as a registry and results database (Turner, 2004).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Turner, 2004
Not checked in the free run.
- Interpretationown data
Pooled-trials publications are biased toward positive conclusions.
“Meta-analyses on reporting bias have been criticized by some for excluding pooled-trials publications, but our study shows that these publications are biased toward positive conclusions.”
Quote in the paperSubstantial claim - Premisecitation
Pooled-trials publications were excluded from that previous meta-analysis.
“However, pooled-trials publications were excluded from that study.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Turner et al., 2008
Not checked in the free run.
- Interpretationown data
Inclusion of pooled-trials publications in meta-analyses could lead to biased results.
“Therefore, inclusion of pooled-trials publications in meta-analyses could lead to biased results, and caution is warranted.”
Quote in the paperSubstantial claim - Interpretationown data
Pooled-trials publications distort the apparent risk-benefit profile of antidepressants.
“Therefore, pooled-trials publications distort the apparent risk–benefit profile of antidepressants.”
- Also stated in: § Conclusions · plain
“In summary, the practice of pooling trials distorts the apparent risk–benefit profile of antidepressants by flooding the literature with publications that highlight positive results and obscure negative results.”
Quote in the paperSubstantial claim - Also stated in: § Conclusions · plain
- May combine two claims. 13
- Classified as probably not a substantial claim. 9
May combine two claims.
Findingown dataAmong novel antidepressants, we found 12 pooled-trials publications for desvenlafaxine, but none for vilazodone.
“Among novel antidepressants, we also found 12 pooled-trials publications for desvenlafaxine, but none for vilazodone.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataFor some drugs, particularly duloxetine, the number of pooled-trials publications was very high; trials HMAT-A and HMAQ-B were included in 44 and 36 publications, respectively.
“For some drugs, particularly duloxetine, the number of pooled-trials publications was very high. Trials HMAT-A and HMAQ-B were included in 44 and 36 publications, respectively.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataAll positive trials were published in some form (either stand-alone or pooled), as were 82.4% of not-positive trials.
“Consequently, all positive trials were published in some form (either stand-alone or pooled), as were 82.4% of not-positive trials.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataFourteen (13.1%) pooled-trials publications had neutral conclusions, while the remaining 88 (82.2%) were positively framed.
“Fourteen (13.1%) publications had neutral conclusions (predictors of efficacy = 5; other efficacy = 7; safety = 2) while the remaining 88 (82.2%) were positively framed.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataOther pooled-trials publications reported on secondary efficacy outcomes (27 publications), predictors of efficacy (26 publications), other efficacy data (13 publications), or safety outcomes (28 publications).
“Other publications reported on secondary efficacy outcomes (27 publications), predictors of efficacy (26 publications), other efficacy data (13 publications), or safety outcomes (28 publications) (Table 1).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataOnly four (3.7%) pooled-trials publications presented individual efficacy data for the primary research question, reporting efficacy results for five (21.7%) trials.
“Only four (3.7%) publications presented individual efficacy data for the primary research question, reporting efficacy results for five (21.7%) trials.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataWe found many pooled-trials publications for venlafaxine (18 publications for immediate- and extended-release combined) and escitalopram (16 publications).
“We also found many pooled-trials publications for venlafaxine (18 publications for immediate- and extended-release combined) and escitalopram (16 publications).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningWe specifically excluded 22 pooled-trials publications because it was unclear which trials were included.
“We specifically excluded 22 pooled-trials publications because it was unclear which trials were included.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
InterpretationcitationThe practice of pooling trials in many separate publications is relatively new, perhaps developing concurrently with physicians' growing skepticism of advertising and sales representatives and greater trust in peer-reviewed publications.
“This suggests that the practice of pooling trials in many separate publications is relatively new, perhaps developing concurrently with physicians’ growing skepticism of advertising and sales representatives and greater trust in peer-reviewed publications (Spielmans and Parry, 2010).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Spielmans and Parry, 2010
Not checked in the free run.
May combine two claims.
PremisecitationA study examining trials for five antidepressants approved between 1989 and 1994 found that positive trials were usually reported in stand-alone publications, while negative trials were frequently 'bundled' into pooled-trials publications.
“A study examining trials for five antidepressants approved between 1989 and 1994 found that positive trials were usually reported in stand-alone publications, while negative trials were frequently ‘bundled’ into pooled-trials publications (Melander et al., 2003).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Melander et al., 2003
Not checked in the free run.
May combine two claims.
Interpretationown dataPooled-trials publications flood the evidence base with often-redundant articles that, instead of addressing the original primary research question, present (positive) results on secondary questions.
“Pooled-trials publications flood the evidence base with often-redundant articles that, instead of addressing the original primary research question, present (positive) results on secondary questions.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim. May combine two claims.
Study design and conductcitationWe did not conduct a meta-analysis, but focused on the apparent risk-benefit profile.
“We also did not conduct a meta-analysis, but focused on the apparent risk–benefit profile, following previous work in which the effect of reporting biases on apparent efficacy was larger than the effects on the meta-analytic effect size.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningWe did not count pooled-trials publications that reported individual trial results for the original primary outcome but focused on a secondary research question.
“A second limitation is that we did not count pooled-trials publications that reported individual trial results for the original primary outcome but focused on a secondary research question, as it seemed unlikely that these results would be found by researchers or clinicians interested in the primary outcome.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisecitationStudy publication bias occurs when trials with positive results are more likely to be published than those with negative results.
“An important form of reporting bias is study publication bias, which occurs when trials with positive results are more likely to be published than those with negative results (Higgins and Green, 2011).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Higgins and Green, 2011
Not checked in the free run.
Classified as probably not a substantial claim.
PremisecitationA previous meta-analysis found that 31% of antidepressant trials for major depressive disorder remained unpublished.
“A previous meta-analysis found that 31% of antidepressant trials for major depressive disorder remained unpublished (Turner et al., 2008).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Turner et al., 2008
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationReporting bias has been demonstrated in many medical fields.
“Reporting bias has been demonstrated in many medical fields (McGauran et al., 2010; Hart et al., 2012; Dwan et al., 2013).”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites McGauran et al., 2010
Not checked in the free run.
- cites Hart et al., 2012
Not checked in the free run.
- cites Dwan et al., 2013
Not checked in the free run.
May combine two claims.
Interpretationown dataThe negative efficacy results of trials published exclusively in pooled-trials publications are obscured, even though the trials have technically been published.
“Therefore, although these trials have technically been published, the negative efficacy results are obscured, thus distorting the drugs’ apparent risk–benefit profile.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim. May combine two claims.
Study design and conductown dataAR and YV classified each pooled-trials publication as positive, neutral, or negative, based on the abstract, with 96% inter-rater agreement.
“Additionally, AR and YV classified each pooled-trials publication as positive, neutral, or negative, based on the abstract (96% inter-rater agreement).”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Interpretationown dataPooled-trials publication bias constitutes a specific form of reporting bias.
“To our knowledge, this study is the first to show that pooled-trials publication bias constitutes a specific form of reporting bias, which results in the publication of many positively framed articles supporting use of a drug, while the original, negative efficacy results of included trials remain obscured.”
- Also stated in: § Conclusions · plain
“Together with study publication bias, selective outcome reporting, and spin, pooled-trials publication bias is a form of reporting bias that should be taken into account in future research.”
Quote in the paperSubstantial claim- Also stated in: § Conclusions · plain
The paper relies on this without support.
Individual trial results are never included in pooled-trials publications that could not be matched.
“however, individual trial results are never included in these publications.”
The paper relies on this without support.
Adverse events are often dose-dependent.
“Since adverse events are often dose-dependent, this is likely to paint an overly optimistic picture.”
The paper relies on this without support.
Older antidepressants are still in common use, so the results of older trials continue to be relevant to clinicians.
“However, older antidepressants are still in common use, so the results of these older trials continue to be relevant to clinicians.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The authors tried to retrieve all unpublished information and contact study authors, but some unpublished studies may still be missing.
“We did our best to retrieve all available unpublished information and contacted study authors for supple mentary data, but we cannot rule out the possibility that some unpublished studies are still missing.38”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Discussion gives 74 trials instead of 105
MinorThe discussion says the 32 trials lacking stand-alone publications came from 74 antidepressant trials, but the Results identifies those same 32 trials as part of the 105-trial cohort.
“Although 32 of 74 antidepressant trials were not published in stand-alone articles, only nine were completely unpublished, while the other 23 were included in pooled-trials publications.”
“As shown in the flow diagram (Fig. 1), of 105 FDA-registered antidepressant trials, 32 were not published in stand-alone publications.”
Abstract miscalculates percentage of positive trials
MinorTwo of 54 is 3.7% when rounded to one decimal place, not the reported 3.8%. The Results section gives 3.7%.
Reported 3.8 · recomputed 3.703704
“Only two (3.8%) of 54 positive trials were published exclusively in pooled-trials publications”
Duloxetine trial has two publication counts
MinorThe discussion gives 44 pooled-trials publications for HMAT-A, whereas Table 1 gives 45.
“Trials HMAT-A and HMAQ-B were included in 44 and 36 publications, respectively.”
“| Duloxetine | HMAT-A | Not positive | 45 | 4 | 2 | 8 | 14 | 5 | 14 |”
Cites
Selective publication of antidepressant trials and its influence on apparent efficacy
Turner, E. H., Matthews, A. M., Linardatos, E., Tell, R. A., & Rosenthal, R. (2008) · New England Journal of Medicine · doi:10.1056/nejmsa065779 · Cited by 2,435 · see citing works
Self-citationNegative results are disappearing from most disciplines and countries
Fanelli, D. (2012) · Scientometrics · doi:10.1007/s11192-011-0494-7 · Cited by 1,248 · see citing works
Dwan, K., Gamble, C., Williamson, P. R., Kirkham, J. J., & the Reporting Bias Group (2013) · PLoS ONE · doi:10.1371/journal.pone.0066844 · Cited by 1,127 · see citing works
Suicidality in Pediatric Patients Treated With Antidepressant Drugs
Hammad, T. A., Laughren, T., & Racoosin, J. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.3.332 · Cited by 1,054 · see citing works
Melander, H., Ahlqvist-Rastad, J., Meijer, G., & Beermann, B. (2003) · BMJ · doi:10.1136/bmj.326.7400.1171 · Cited by 626 · see citing works
Stone, M., Laughren, T., Jones, M. L., Levenson, M., Holland, P. C., Hughes, A., Hammad, T. A., Temple, R., & Rochester, G. (2009) · BMJ · doi:10.1136/bmj.b2880 · Cited by 609 · see citing works
Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies
Smith, R. W. (2005) · PLoS Medicine · doi:10.1371/journal.pmed.0020138 · Cited by 499 · see citing works
Reporting bias in medical research - a narrative review
McGauran, N., Wieseler, B., Kreis, J., Schüler, Y.-B., Kölsch, H., & Kaiser, T. (2010) · Trials · doi:10.1186/1745-6215-11-37 · Cited by 452 · see citing works
Noury, J. C. L., Nardo, J. M., Healy, D., Jureidini, J. N., Raven, M. K., Tufănaru, C., & Abi‐Jaoude, E. (2015) · BMJ · doi:10.1136/bmj.h4320 · Cited by 329 · see citing works
Rising, K., Bacchetti, P., & Bero, L. (2008) · PLoS Medicine · doi:10.1371/journal.pmed.0050217 · Cited by 328 · see citing works
Ghosts in the Machine: Publication Planning in the Medical Sciences
Sismondo, S. (2009) · Social Studies of Science · doi:10.1177/0306312708101047 · Cited by 297 · see citing works
Effect of reporting bias on meta-analyses of drug trials: reanalysis of meta-analyses
Hart, B., Lundh, A., & Bero, L. (2012) · BMJ · doi:10.1136/bmj.d7202 · Cited by 255 · see citing works
Saini, P., Loke, Y. K., Gamble, C., Altman, D. G., Williamson, P. R., & Kirkham, J. J. (2014) · BMJ · doi:10.1136/bmj.g6501 · Cited by 209 · see citing works
From Evidence-based Medicine to Marketing-based Medicine: Evidence from Internal Industry Documents
Spielmans, G. I., & Parry, P. I. (2010) · Journal of Bioethical Inquiry · doi:10.1007/s11673-010-9208-8 · Cited by 143 · see citing works
Ebrahim, S., Bance, S., Athale, A., Malachowski, C., & Ioannidis, J. P. A. (2016) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2015.08.021 · Cited by 107 · see citing works
Turner, E. H., Knoepflmacher, D., & Shapley, L. (2012) · PLoS Medicine · doi:10.1371/journal.pmed.1001189 · Cited by 106 · see citing works
Self-citationRoest, A. M., de Jonge, P., Williams, C. D., de Vries, Y. A., Schoevers, R. A., & Turner, E. H. (2015) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2015.15 · Cited by 101 · see citing works
Self-citationGolden, R. N., Nemeroff, C. B., McSorley, P., Pitts, C. D., & Dube, E. M. (2002) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v63n0707 · Cited by 101 · see citing works
Safety profile of sustained-release bupropion in depression: Results of three clinical trials
Settle, E. C., Stahl, S. M., Batey, S. R., Johnston, J. A., & Ascher, J. A. (1999) · Clinical Therapeutics · doi:10.1016/s0149-2918(00)88301-0 · Cited by 83 · see citing works
Publication Bias, with a Focus on Psychiatry: Causes and Solutions
Turner, E. H. (2013) · CNS Drugs · doi:10.1007/s40263-013-0067-9 · Cited by 64 · see citing works
Self-citationGhostwriting: The Dirty Little Secret of Medical Publishing That Just Got Bigger
Editors, T. P. M. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000156 · Cited by 60 · see citing works
How to access and process FDA drug approval packages for use in research
Turner, E. H. (2013) · BMJ · doi:10.1136/bmj.f5992 · Cited by 59 · see citing works
Self-citationA Taxpayer-Funded Clinical Trials Registry and Results Database
Turner, E. H. (2004) · PLoS Medicine · doi:10.1371/journal.pmed.0010060 · Cited by 56 · see citing works
Self-citationA Case Study of Salami Slicing: Pooled Analyses of Duloxetine for Depression
Spielmans, G. I., Biehn, T. L., & Sawrey, D. L. (2009) · Psychotherapy and Psychosomatics · doi:10.1159/000270917 · Cited by 48 · see citing works
Vedula, S. S., Goldman, P. S., Rona, I. J., Greene, T. M., & Dickersin, K. (2012) · Trials · doi:10.1186/1745-6215-13-136 · Cited by 46 · see citing works
Miller, S. M., Naylor, G. J., Murtagh, M., & Winslow, G. S. (1989) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1989.tb07197.x · Cited by 17 · see citing works
Thaler, K. J., Morgan, L. C., Noord, M. V., Jonas, D. E., McDonagh, M. S., Peterson, K., Glechner, A., & Gartlehner, G. (2013) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2013.05.002 · Cited by 5 · see citing works
Spielmans, G. I., Olson, S., & Keicher, R. M. (2017) · Psychotherapy and Psychosomatics · doi:10.1159/000464251 · Cited by 3 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Higgins, 2011, Cochrane Handbook for Systematic Reviews of Interventions
Cited by
Sorted by citations
Zhou, X., Teng, T., Zhang, Y., Del Giovane, C., Furukawa, T. A., Weisz, J. R., Li, X., Cuijpers, P., Coghill, D., Xiang, Y., et al. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30137-1 · Cited by 367 · see citing works
Xiang, Y., Cipriani, A., Teng, T., Del Giovane, C., Zhang, Y., Weisz, J. R., Li, X., Cuijpers, P., Liu, X., Barth, J., et al. (2021) · Evidence-Based Mental Health · doi:10.1136/ebmental-2021-300346 · Cited by 47 · see citing works
- Authors
- de Vries, Y. A., Roest, A. M., Turner, E. H., & de Jonge, P.
- Affiliations
- University Medical Center Groningen (NL)
- Oregon Health & Science University (US)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2018-09-28
- Volume
- 49
- Issue
- 12
- Pages
- 2020-2026
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC6712952
- OpenAlex
- W2893796401
- Semantic Scholar
- daee17e121e64ae0eec9f44f86c58c87db10e0b5
- Cited by
- 28
- References
- 28
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 3 · 2020: 2 · 2019: 16
- FWCI
- 4.00
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Psychological Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Topics
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmaceutical industry and healthcare
- Social Sciences › Decision Sciences › Information Systems and Management › Academic Publishing and Open Access
- Keywords
- reporting bias, publication bias, negative trials, antidepressants, depression, FDA drug review, randomized controlled trials, clinical trial registration, risk-benefit profile
- MeSH terms
- Antidepressive Agents, Depression, Depressive Disorder, Humans, United States, United States Food and Drug Administration, Randomized Controlled Trials as Topic, Treatment Outcome, Publication Bias, Research Report
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
