Towards a reduction in publication bias.

Current practice results in the publication of many research studies in medical and related disciplines which may be criticised on the grounds of inadequate sample size and statistical power. Small studies continue to be carried out with little more than a blind hope of showing the desired effect. Nevertheless, papers based on such work are submitted for publication, especially if the results turn out to be statistically significant. There is confusion about what makes a result suitable for publication. Often there is a preference for statistically significant results at the peer review stage. Consequently published reports of small studies tend to contain too many false positive results and to exaggerate the true effects. The use of a criterion of a posteriori power does not eliminate the bias; a priori power is the criterion of choice. This could be implemented by peer review of study protocols at the planning stage by funding bodies and journals.