Why does medical research sometimes get it so wrong

Douglas Altman, back in 1994, wrote a highly influential paper in the British Medical Journal entitled ‘the scandal of poor medical research’ (1). It focused on the prevalence of poor design and analysis in medical research. Altman believed the reason was a general failure to appreciate the principles underlying scientific research, coupled with the ‘publish or perish climate’ where scientific merit was measured by quantity not quality. He argued that, since this system encouraged poor research, it needed to change. The ‘system’ proved resistant to such fundamental change, and the main outcome of his plea was the introduction of accepted standard reporting formats for randomised trials (CONSORT) and observational studies (STROBE).