Advocating for transparency and integrity in research

What does this topic cover?

Advocacy for transparency and integrity in research is about calling for improvements in the way that research is prioritized, funded, planned, conducted and published.

It touches upon key topics such as:

The need for unconflicted and independent research
Clinical trial transparency
Access to clinical study reports (CSRs)
Reducing research waste
Addressing research misconduct
Highlighting gaps in evidence

Why does it matter?

These issues are integral to Cochrane’s mission of producing trustworthy evidence to tackle pressing global health issues and build a healthier, more equitable world together.

Without access to relevant, unconflicted and accurate data, our reviews will not be of sufficient quality to support evidence informed decision-making.

Our vision for this area of work is a world in which all information needed for high quality reviews is accurate, unconflicted and accessible; that gaps in evidence are defined and used for guiding decisions on investment in research; and that the research community also contributes to reducing waste.

Clinical trial transparency

Findings from clinical trials are fundamental to understanding the effectiveness and safety of different medical interventions.

Registering and reporting the results of clinical trials is an ethical, and often legal, responsibility. A joint statement issued by the World Health Organization (WHO) and signed by multiple research funders and NGOs, state that findings from all clinical trials should be published within 12 months of completion. The Declaration of Helsinki also affirms that the registration of clinical trials and reporting of results is an ethical obligation.

In 2022, countries passed World Health Assembly resolution 75.8 which emphasized the urgent need to enhance both global and national clinical trial ecosystems to generate high-quality evidence on health interventions – including through transparent research practices. WHO has since launched guidance on best practices for clinical trials, including on registering and reporting.

However, it is well documented that many clinical trial results are never published. Not only does this leave gaps in our knowledge, but it also harms patients, undermines public health and wastes resources.

Cochrane's systematic reviews rely upon the results of clinical trials. To assess the effectiveness and safety of healthcare interventions, we need to know what trials were done, how they were conducted and what their findings were. Without access to detailed information from all clinical trials, we limit our ability to make evidence-informed decisions.

All clinical trials should be registered and reported in accordance with the following:

Clinical trials registered, with protocols, prior to start date
Studies should be added to a publicly accessible registry (which meets WHO standards) before the first participant is recruited, with a detailed protocol. Information on the registry should be kept up-to-date and be accurate for the duration of the trial.
Summary results posted within 12 months
A summary of results should be posted to the registry within 12 months of the study ending, even if the trial was stopped prematurely or did not meet its objectives. This will ensure that results are publicly available as soon as possible.

Reports must be clear, complete, and accurate. They should comprehensively describe the study design, methods and results in a transparent manner, and should declare any possible conflicts of interest by those involved in designing, conducting or reporting trials.
Academic publication
Findings of the study should also be published in an academic journal as soon as possible – and at least within 24 months. The Trial ID or registry identifier code should be included in the publication, so that it can easily be linked to the registry record.

Researchers often cite a lack of interest from scientific journals as a reason for non-publication. However, there are other publication options to explore in such cases.

Examples of our advocacy work

Supporting global policy
Cochrane is supporting WHO with the implementation of resolution WHA75.8 on strengthening clinical trials globally, which contains recommendations on trial transparency and ethical trial conduct. This includes helping WHO launch new guidance on best practices for clinical trials. Cochrane’s Editor in Chief, Dr Karla Soares-Weiser, contributed to the technical advisory group established to support the resolution and this guidance.

Cochrane Denmark, Norway and Sweden advocating to end research waste in Nordic countries
Cochrane Denmark, Cochrane Norway, and Cochrane Sweden, along with the AllTrials campaign, the Dam Foundation, Melanomföreningen, and TranspariMED, jointly published a report that found that 475 academically led clinical trials involving 83,903 patients completed during 2016-19 in Denmark, Iceland, Finland, Norway and Sweden have never made their results public in any form. This gained widespread media coverage, including calls from the Norwegian State Secretary for the Ministry of Health to action the findings from the report.

Cochrane Germany pushes for German university hospitals to publish all clinical trial data
Cochrane Germany, alongside the German Network for Evidence-Based Medicine, HTA.de and the BIH Quest Center, published a policy position paper that highlighted that one third of all clinical trials led by German university hospitals between 2014-2017 remained unpublished for five years after completion. They called on the Federal Ministry of Health and the Federal Ministry of Education and Research to create appropriate framework conditions for complete study registration and timely publication of results in Germany and to propose a regulation.

Cochrane positions and policies

Conflict of interest policy for Cochrane Library content

Cochrane statements and publications