Underpowered studies
Open accessAbstract
It is frequently argued that underpowered trials are unethical, that they are poor science and unreliable,
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
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?
Lilford & Stevens suggest that small studies, provided they are well designed, nevertheless contribute to the topic and field in which they are published.
“Despite the study being underpowered, Lilford & Stevens’ suggest that small studies, provided they are well designed, nevertheless contribute to the topic and field in which they are published [62].”
From Dual N-back working memory training in healthy adults: A randomized comparison to processing speed training. (2016) · cites this paper as [62]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Schulz (1995) · doi:10.1001/jama.1995.03520290060030 · Cited by 5,634 · see citing works
Effectiveness and Efficiency: Random Reflections on Health Services
L'Etang, H. (1973) · Public Health · doi:10.1016/s0033-3506(73)80082-4 · Cited by 1,925 · see citing works
Antman, E. M. (1992) · JAMA · doi:10.1001/jama.268.2.240 · Cited by 1,535 · see citing works
Statistics and ethics in medical research: III How large a sample?
Altman, D. G. (1980) · BMJ · doi:10.1136/bmj.281.6251.1336 · Cited by 581 · see citing works
Publication and Related Biases
Song, F., Eastwood, A. J., Gilbody, S. M., Duley, L., & Sutton, A. J. (2001) · SAGE Publications Ltd eBooks · doi:10.4135/9781848608344.n21 · Cited by 470 · see citing works
Assessing the Quality of Randomized Controlled Trials:<i>Current Issues and Future Directions</i>
Moher, D., Jadad, A. R., & Tugwell, P. (1996) · International Journal of Technology Assessment in Health Care · doi:10.1017/s0266462300009570 · Cited by 436 · see citing works
Clinical trials and rare diseases: A way out of a conundrum
Lilford, R. J., Thornton, J. G., & Braunholtz, D. (1995) · BMJ · doi:10.1136/bmj.311.7020.1621 · Cited by 237 · see citing works
Self-citationAntiplatelet drugs for prevention of pre-eclampsia and its consequences: systematic review
Duley, L., Henderson-Smart, D., Knight, M., & King, J. (2001) · BMJ · doi:10.1136/bmj.322.7282.329 · Cited by 236 · see citing works
Equipoise and the ethics of randomization.
Lilford, R. J., & Jackson, J. (1995) · PubMed · Cited by 201 · see citing works
Self-citationCLASP Collaborative Group CLASP Coordinating Centre, R. I. (1995) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1995.tb10872.x · Cited by 122 · see citing works
Why “underpowered” trials are not necessarily unethical
Edwards, S., Lilford, R. J., Braunholtz, D., & Jackson, J. E. (1997) · The Lancet · doi:10.1016/s0140-6736(97)02290-3 · Cited by 102 · see citing works
Self-citationLilford, R. J. (1989) · International Journal of Technology Assessment in Health Care · doi:10.1017/s0266462300007510 · Cited by 6 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 1
- The Cochrane Controlled Trials Register. In: The Cochrane Library, Issue 3. Oxford: Update Software, 2001.
Cited by
Sorted by citations
Ellis, P. D. (2010) · doi:10.1017/cbo9780511761676 · Cited by 2,461 · see citing works
The systemic immune response to trauma: an overview of pathophysiology and treatment
Lord, J. M., Midwinter, M. J., Chen, Y., Belli, A., Brohi, K., Kovacs, E. J., Koenderman, L., Kubes, P., & Lilford, R. J. (2014) · The Lancet · doi:10.1016/s0140-6736(14)60687-5 · Cited by 865 · see citing works
Self-citationMaxwell, S. E. (2004) · Psychological Methods · doi:10.1037/1082-989x.9.2.147 · Cited by 655 · see citing works
“In fact, this perspective has led some medical researchers to maintain that conducting underpowered clinical trials is unethical to research participants (Halpern, Karla-wish, & Berlin, 2002; but for contrary views see Janosky, 2002; Lilford & Stevens, 2002).”
BackgroundTreatment of periodontal disease for glycaemic control in people with diabetes
Simpson, T. C., Needleman, I. G., Wild, S. H., Moles, D. R., & Mills, E. J. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004714.pub2 · Cited by 285 · see citing works
Demark‐Wahnefried, W., Clipp, E. C., Morey, M. C., Pieper, C. F., Sloane, R. J., Snyder, D. C., & Cohen, H. J. (2006) · Journal of Clinical Oncology · doi:10.1200/jco.2006.05.7224 · Cited by 243 · see citing works
Bacchetti, P. (2005) · American Journal of Epidemiology · doi:10.1093/aje/kwi014 · Cited by 162 · see citing works
Duodénopancréatectomie céphalique pour cancer
Huguier, M., Barrier, A. J., Gouillat, C., Suc, B., Jaeck, D., & Launois, B. (2008) · Journal de Chirurgie · doi:10.1016/s0021-7697(08)70282-5 · Cited by 157 · see citing works
Pillai, R. K., & Jayasree, K. (2017) · The Indian Journal of Medical Research · doi:10.4103/ijmr.ijmr_915_14 · Cited by 94 · see citing works
Strategy for randomised clinical trials in rare cancers
Tan, S. B., Dear, K. B. G., Bruzzi, P., & Machin, D. (2003) · BMJ · doi:10.1136/bmj.327.7405.47 · Cited by 83 · see citing works
Monitoring patients using control charts: a systematic review
Tennant, R., Mohammed, M. A., Coleman, J. J., & Martin, U. (2007) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzm015 · Cited by 83 · see citing works
Lawlor-Savage, L., & Goghari, V. M. (2016) · PLOS ONE · doi:10.1371/journal.pone.0151817 · Cited by 74 · see citing works
Bedard, P. L., Krzyzanowska, M. K., Pintilie, M., & Tannock, I. F. (2007) · Journal of Clinical Oncology · doi:10.1200/jco.2007.11.3670 · Cited by 61 · see citing works
Roche, T., Gardner, G. E., & Jack, L. (2017) · BMC Health Services Research · doi:10.1186/s12913-017-2395-9 · Cited by 48 · see citing works
Randomised clinical trials in plastic surgery: Survey of output and quality of reporting
Karri, V. (2006) · Journal of Plastic Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2005.11.027 · Cited by 46 · see citing works
Halligan, S., & Altman, D. (2007) · Radiology · doi:10.1148/radiol.2431051823 · Cited by 41 · see citing works
Parker, S. G., Wood, C. P. J., Butterworth, J. W., Boulton, R., Plumb, A., Mallett, S., Halligan, S., & Windsor, A. C. J. (2018) · Hernia · doi:10.1007/s10029-017-1718-4 · Cited by 35 · see citing works
Antibiotic Lock-Technique for the Treatment of Catheter-Related Bloodstream Infections
Viale, P., Pagani, L., Petrosillo, N., Signorini, L., Colombini, P., Macrì, G., Cristini, F., Gattuso, G., Carosi, G., & The Italian Hospital And HIV Infection Group (Gruppo Italiano Infezioni Ospedaliere E HIV (GHIO)) (2003) · Journal of Chemotherapy · doi:10.1179/joc.2003.15.2.152 · Cited by 29 · see citing works
McCaskey, M. A., Wirth, B., Schuster‐Amft, C., & de Bruin, E. D. (2018) · PLoS ONE · doi:10.1371/journal.pone.0193358 · Cited by 28 · see citing works
Invited Commentary: Ethics and Sample Size--Another View
Prentice, R. L. (2005) · American Journal of Epidemiology · doi:10.1093/aje/kwi015 · Cited by 19 · see citing works
Systematic reviews and meta-analysis of diagnostic tests
Halligan, S. (2005) · Clinical Radiology · doi:10.1016/j.crad.2005.04.013 · Cited by 8 · see citing works
Bestimmung von Teststärke, Effektgröße und optimalem Stichprobenumfang
Döring, N. M., & Bortz, J. (2015) · Springer-Lehrbuch · doi:10.1007/978-3-642-41089-5_14 · Cited by 7 · see citing works
Coleman, C. H. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108620024.017 · Cited by 6 · see citing works
Burt, J. (2010) · UCL Discovery (University College London) · Cited by 5 · see citing works
Lilford, R. J., Nepogodiev, D., Chilton, P. J., Watson, S., Erlangga, D., Diggle, P. J., Girling, A. J., & Sculpher, M. J. (2021) · BMJ Global Health · doi:10.1136/bmjgh-2020-004723 · Cited by 3 · see citing works
Self-citationMesh repair for lateral inguinal hernias: a non-evidence-based practice
Tripoloni, D. E., García, M. I. C., Cassani, F., Zanni, M., & Mercado, A. S. (2021) · Hernia · doi:10.1007/s10029-021-02423-7 · Cited by 3 · see citing works
“As stated by Lilfort [28] referring to underpowered studies, “no evidence of effect” should not be confused with “evidence of no effect”.”
BackgroundBestimmung von Teststärke, Effektgröße und optimalem Stichprobenumfang
Döring, N. M. (2023) · Springer eBooks · doi:10.1007/978-3-662-64762-2_14 · Cited by 3 · see citing works
Boisseau, W., Darsaut, T. E., & Raymond, J. (2024) · World Neurosurgery · doi:10.1016/j.wneu.2024.04.009 · Cited by 1 · see citing works
“Sunbreaks” for critical care in the modern era of genetic epidemiology*
Chien, J. W. (2008) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181810479
Approaches to Clinical Research in Pediatric Nephrology
Sander, A., & Sutherland, S. M. (2016) · Springer eBooks · doi:10.1007/978-3-662-52972-0_7
Dove, E. S., & Sethi, N. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108620024.013
Eastwood, B., Terrington, I., Young, R. K., Cox, O., Webb, E., Mckenzie, C., Saeed, K. B. A., Morris, A. C., Grocott, M. P. W., & Dushianthan, A. (2026) · European Respiratory Review · doi:10.1183/16000617.0259-2025
- Authors
- Lilford, R., & Stevens, A. J.
- Affiliations
- University of Birmingham (GB)
- Venue
- British journal of surgery
- Publisher
- Oxford University Press (OUP)
- Published
- 2002-02
- Volume
- 89
- Issue
- 2
- Pages
- 129-131
- ISSN
- 0007-1323 (ISSN-L)
- 1365-2168
- OpenAlex
- W3195407949
- Cited by
- 31
- References
- 13
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 1 · 2021: 4 · 2018: 2 · 2017: 2 · 2016: 2 · 2015: 1 · 2014: 1
- FWCI
- 2.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- British journal of surgery (publishedVersion)
- PubMed (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Topics
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Keywords
- underpowered studies, clinical trial design, statistical power, research ethics, surgical research
- MeSH terms
- Clinical Trials as Topic, Humans, Reproducibility of Results, Publication Bias, Sample Size
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.
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