# Exposing Publication Bias: The Unflattering Data that Gets Lost in Action
%% [[(Ben Goldacre, 2014)]]%%
In his fascinating (and infuriating) Ted Talk “[[(Ben Goldacre, 2014)| What doctors don't know about the drugs they prescribe]]”, Ben Goldacre talks about Publication Bias. Something we should all know about he defines Publication Bias as,
%%[[publication bias]] %%
> “….the technical term for the phenomenon where unflattering data gets lost, gets unpublished, or is left missing in action.”
He continues to explain about a drug called Reboxetine. This is an anti-depressant that he had previously prescribed to his patients. And being the self-confessed “nerdy doctor”, he read all the studies he could find on this drug.
He had read the one positive trial. The only one that was *published*. But there were actually seven trials that tested the drug against a placebo. Hence there were six unpublished trials.
Could the fact that they showed *negative* results have something to do with it? I'll leave that question for you to answer.
He also read the studies that compared Reboxetine against other antidepressants. Three studies showed that the drug was 'just as good' as any other anti-depressants, and they *were* published. BUT 3 times as many studies showed that Reboxetine was *worse* than other drugs, and guess what? These were not published!
Other researchers found the trials on all antidepressants presented to the FDA. ^[That's not all trials ever conducted on these drugs. We can never know about all the ones hidden in bottom drawers or "accidentally" lost. But these were the ones that were conducted in order to get the marketing authorisation.] There were 38 trials with positive results. And 36 with negative results.
![[publication bias antidepressants.excalidraw.svg]]
They searched to see which of these were *published* in the academic literature (where most people find their research). And it was a very different story.
Thirty-seven of the *positive* trials were published in full within the academic literature. But only three negative trials were ever published.
The fact is positive findings are more likely to be published. This ladies and gentlemen, is publication bias! And something we all need to be aware exists.