[1] If there are a large number of outcomes to choose from, it is likely at least one will show significant findings, assuming no correction is made for multiple testing.
Registered reports—a type of journal article where editors pledge to publish clinical trials irrespective of their results—may help combat this pressure to produce positive results.
Journal editors and clinical trial authors typically responded dismissively when concerns were raised, misrepresenting ethical standards and including ad hominem attacks.
[8] A drug against major depressive disorder, paroxetine, was marketed for children and teenagers for years, based on a flawed trial that involved outcome switching.
According to Melanie Newman, writing for the BMJ, "[t]he drug only produced a positive result when four new secondary outcome measures, which were introduced following the initial data analysis, were used instead.
"[a][11] "The drug only produced a positive result when four new secondary outcome measures, which were introduced following the initial data analysis, were used instead.