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Registration of health and medical research | BMJ Evidence-Based Medicine

<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE html> <html lang="en" dir="ltr" version="HTML+RDFa+MathML 1.1" xmlns:dc="http://purl.org/dc/terms/" xmlns:foaf="http://xmlns.com/foaf/0.1/" xmlns:og="http://ogp.me/ns#" xmlns:rdfs="http://www.w3.org/2000/01/rdf-schema#" xmlns:sioc="http://rdfs.org/sioc/ns#" xmlns:sioct="http://rdfs.org/sioc/types#" xmlns:skos="http://www.w3.org/2004/02/skos/core#" xmlns:xsd="http://www.w3.org/2001/XMLSchema#" xmlns:mml="http://www.w3.org/1998/Math/MathML"> <head profile="http://www.w3.org/1999/xhtml/vocab"> <!--[if IE]><![endif]--> <link rel="dns-prefetch" href="//securepubads.g.doubleclick.net" /> <link rel="dns-prefetch" href="//d1bxh8uas1mnw7.cloudfront.net" /> <link rel="dns-prefetch" href="//scholar.google.com" /> <meta http-equiv="Content-Type" content="text/html; charset=utf-8" /> <link rel="shortcut icon" href="https://ebm.bmj.com/sites/default/themes/bmjj/favicon.ico" type="image/vnd.microsoft.icon" /> <meta name="viewport" content="width=device-width, initial-scale=1" /> <script>window.dataLayer = window.dataLayer || [];window.dataLayer.push({"page":{"hwTitle":"Registration of health and medical research","hwUrl":"https://ebm.bmj.com/content/28/1/68","hwPath":"/content/28/1/68.long","hwType":"journal page"},"user":{"hwMemberID":"","hwLoggedIntoInstitutionID":"","hwLoggedIntoInstitution":"","hwAccessUsageTerms":"guest","hwRegisteredUser":"no","hwHasFullTextAccess":"no","hwEntitled":"no","mail":"e3b0c44298fc1c149afbf4c8996fb92427ae41e4649b934ca495991b7852b855"},"content":{"hwIssueDate":"2023-02-01","hwIssueDateTime":"2023-02-01 00:00:00","hwPublicationDate":"2023-05-05","hwPublicationDateTime":"2023-05-05 10:08:59","hwNlmArticleType":"research-article","hwDOI":"10.1136/bmjebm-2021-111836","hwAuthors":"Aidan G Cashin,Georgia C Richards,Nicholas J DeVito,David T Mellor,Hopin Lee","hwContributors":"","hwIsEarlyRelease":"no","hwEissn":"2515-4478","hwPissn":"2515-446X","hwVolume":"28","hwIssue":"1","hwArticleType":"Research methods and reporting","hwTabView":"main_tab","hwViewType":"long","hwAccessType":"Paywall","hwOpenAccess":"no","hwFreeAccess":"no","hwTaxonomy":"","hwCorpusCode":"ebmed","hwType":"article","hwSubtitle":null,"hwOverline":null,"hwPisaId":"ebmed;28/1/68","hwFirstPage":"68","hwLastPage":"72","hwIsLatestVersion":"yes","hwIsCurrentIssue":"no","hwIsOpenIssue":"no","hwHasFullText":"yes","hwHasPDF":"yes","hwParentTitle":"BMJ Evidence-Based Medicine: 28 (1)","hwElectronicPubDate":"2023-05-05","hwElectronicPubDateTime":"2023-05-05 10:08:59"}}); //--><!]]></script> <link rel="canonical" href="https://ebm.bmj.com/content/28/1/68" /> <meta name="Generator" content="Drupal 7 (http://drupal.org)" /> <link rel="alternate" type="application/pdf" title="Full Text (PDF)" href="/content/28/1/68.full.pdf" /> <link rel="alternate" type="text/plain" title="Full Text (Plain)" href="/content/28/1/68.full.txt" /> <meta name="issue_cover_image" content="https://ebm.bmj.com/sites/default/files/highwire/ebmed/28/1.cover-source.jpg" /> <meta name="type" content="article" /> <meta name="category" content="research-article" /> <meta name="HW.identifier" content="/ebmed/28/1/68.atom" /> <meta name="HW.pisa" content="ebmed;28/1/68" /> <meta name="DC.Format" content="text/html" /> <meta name="DC.Language" content="en" /> <meta name="DC.Title" content="Registration of health and medical research" /> <meta name="DC.Identifier" content="10.1136/bmjebm-2021-111836" /> <meta name="DC.Date" content="2023-02-01" /> <meta name="DC.Publisher" content="Royal Society of Medicine" /> <meta name="DC.Rights" content="© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ." /> <meta name="DC.AccessRights" content="restricted" /> <meta name="DC.Description" content="Registration of health and medical research is an effective way of improving the transparency and credibility of evidence. Registration involves pre-specifying the research objectives, design, methods and analytic plan on a publicly accessible repository before conducting the study. Registration can reduce bias and improve the transparency and credibility of research findings. Registration is mandated for clinical trials, but it is also relevant to systematic reviews, observational and preclinical experimental research. This paper describes how researchers can register their research and outlines possible barriers and challenges in doing so. Widespread adoption of research registration can reduce research waste and improve evidence-informed clinical and policy decision making. There are no data in this work." /> <meta name="DC.Contributor" content="Aidan G Cashin" /> <meta name="DC.Contributor" content="Georgia C Richards" /> <meta name="DC.Contributor" content="Nicholas J DeVito" /> <meta name="DC.Contributor" content="David T Mellor" /> <meta name="DC.Contributor" content="Hopin Lee" /> <meta name="article:published_time" content="2023-02-01" /> <meta name="article:section" content="Research methods and reporting" /> <meta name="citation_title" content="Registration of health and medical research" /> <meta name="citation_abstract" lang="en" content="&lt;p&gt;Registration of health and medical research is an effective way of improving the transparency and credibility of evidence. Registration involves pre-specifying the research objectives, design, methods and analytic plan on a publicly accessible repository before conducting the study. Registration can reduce bias and improve the transparency and credibility of research findings. Registration is mandated for clinical trials, but it is also relevant to systematic reviews, observational and preclinical experimental research. This paper describes how researchers can register their research and outlines possible barriers and challenges in doing so. Widespread adoption of research registration can reduce research waste and improve evidence-informed clinical and policy decision making.&lt;/p&gt;" /> <meta name="citation_journal_title" content="BMJ Evidence-Based Medicine" /> <meta name="citation_publisher" content="Royal Society of Medicine" /> <meta name="citation_publication_date" content="2023/02/01" /> <meta name="citation_mjid" content="ebmed;28/1/68" /> <meta name="citation_id" content="28/1/68" /> <meta name="citation_public_url" content="https://ebm.bmj.com/content/28/1/68" /> <meta name="citation_abstract_html_url" content="https://ebm.bmj.com/content/28/1/68.abstract" /> <meta name="citation_full_html_url" content="https://ebm.bmj.com/content/28/1/68.full" /> <meta name="citation_pdf_url" content="https://ebm.bmj.com/content/ebmed/28/1/68.full.pdf" /> <meta name="citation_issn" content="2515-446X" /> <meta name="citation_issn" content="2515-4478" /> <meta name="citation_doi" content="10.1136/bmjebm-2021-111836" /> <meta name="citation_pmid" content="34933926" /> <meta name="citation_volume" content="28" /> <meta name="citation_issue" content="1" /> <meta name="citation_article_type" content="Research Article" /> <meta name="citation_section" content="Research methods and reporting" /> <meta name="citation_firstpage" content="68" /> <meta name="citation_lastpage" content="72" /> <meta name="citation_author" content="Aidan G Cashin" /> <meta name="citation_author_institution" content="Centre for Pain IMPACT" /> <meta name="citation_author_institution" content="Neuroscience Research Australia" /> <meta name="citation_author_institution" content="School of Health Sciences" /> <meta name="citation_author_institution" content="University of New South Wales" /> <meta name="citation_author_orcid" content="http://orcid.org/0000-0003-4190-7912" /> <meta name="citation_author" content="Georgia C Richards" /> <meta name="citation_author_institution" content="Global Centre on Healthcare and Urbanisation" /> <meta name="citation_author_institution" content="University of Oxford" /> <meta name="citation_author_institution" content="Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences" /> <meta name="citation_author_institution" content="University of Oxford" /> <meta name="citation_author_orcid" content="http://orcid.org/0000-0003-0244-5620" /> <meta name="citation_author" content="Nicholas J DeVito" /> <meta name="citation_author_institution" content="Primary Care Health Sciences" /> <meta name="citation_author_institution" content="University of Oxford" /> <meta name="citation_author_orcid" content="http://orcid.org/0000-0001-8286-1995" /> <meta name="citation_author" content="David T Mellor" /> <meta name="citation_author_institution" content="Center for Open Science" /> <meta name="citation_author" content="Hopin Lee" /> <meta name="citation_author_institution" content="Centre for Statistics in Medicine &amp; Rehabilitation Research in Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS)" /> <meta name="citation_author_institution" content="University of Oxford" /> <meta name="citation_author_institution" content="School of Medicine and Public Health" /> <meta name="citation_author_institution" content="The University of Newcastle" /> <meta name="citation_reference" content="citation_journal_title=Lancet;citation_author=A-W. 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Dale;citation_title=Compare: a prospective cohort study correcting and monitoring 58 misreported trials in real time;citation_pages=1-16;citation_volume=20;citation_year=2019;citation_pmid=31747967;citation_doi=10.1186/s13063-019-3912-4" /> <meta name="citation_reference" content="citation_journal_title=Front Psychol;citation_author=JM. Wicherts;citation_author=CLS. Veldkamp;citation_author=HEM. Augusteijn;citation_title=Degrees of Freedom in Planning, Running, Analyzing, and Reporting Psychological Studies: A Checklist to Avoid p-Hacking;citation_pages=1832;citation_volume=7;citation_year=2016;citation_pmid=http://www.n;citation_doi=10.3389/fpsyg.2016.01832" /> <meta name="citation_reference" content="Clinicaltrials.Gov. Available: https://clinicaltrials.gov/" /> <meta name="citation_reference" content="International clinical trials registry platform (ICTRP). Available: https://www.who.int/clinical-trials-registry-platform" /> <meta name="citation_reference" content="OSF preregistration. Available: https://osf.io/registries" /> <meta name="citation_reference" content="citation_journal_title=BMJ Evid Based Med;citation_author=KB. Schmaling;citation_author=HS. Landon;citation_author=TB. Nguyen;citation_title=Transparency of results reporting for depression treatment studies in ClinicalTrials.gov: a cross-sectional study;citation_volume=27;citation_year=2022;citation_pmid=33785513;citation_doi=10.1136/bmjebm-2020-111641" /> <meta name="twitter:title" content="Registration of health and medical research" /> <meta name="twitter:card" content="summary_large_image" /> <meta name="twitter:image" content="https://ebm.bmj.com/sites/default/files/highwire/ebmed/28/1.cover-source.jpg" /> <meta name="twitter:description" content="Registration of health and medical research is an effective way of improving the transparency and credibility of evidence. Registration involves pre-specifying the research objectives, design, methods and analytic plan on a publicly accessible repository before conducting the study. Registration can reduce bias and improve the transparency and credibility of research findings. Registration is mandated for clinical trials, but it is also relevant to systematic reviews, observational and preclinical experimental research. This paper describes how researchers can register their research and outlines possible barriers and challenges in doing so. Widespread adoption of research registration can reduce research waste and improve evidence-informed clinical and policy decision making. There are no data in this work." /> <meta name="og-title" property="og:title" content="Registration of health and medical research" /> <meta name="og-url" property="og:url" content="https://ebm.bmj.com/content/28/1/68" /> <meta name="og-site-name" property="og:site_name" content="BMJ Evidence-Based Medicine" /> <meta name="og-description" property="og:description" content="Registration of health and medical research is an effective way of improving the transparency and credibility of evidence. Registration involves pre-specifying the research objectives, design, methods and analytic plan on a publicly accessible repository before conducting the study. Registration can reduce bias and improve the transparency and credibility of research findings. Registration is mandated for clinical trials, but it is also relevant to systematic reviews, observational and preclinical experimental research. This paper describes how researchers can register their research and outlines possible barriers and challenges in doing so. Widespread adoption of research registration can reduce research waste and improve evidence-informed clinical and policy decision making. 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class="highwire-cite highwire-cite-highwire-article highwire-citation-bmjj-title clearfix"> <div class="highwire-cite-title">Registration of health and medical research</div> <span class="highwire-cite-access"><span class="highwire-citation-access highwire-citation-access-check" data-pisa-id="ebmed;bmjebm-2021-111836" data-atom-uri="/ebmed/28/1/68.atom" data-request-view="full"></span></span> </cite> </div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-panel-tabs-container col-narrow-12 clear" > <div class="pane-content"> <div data-panels-ajax-tab-preloaded="jnl_template_bmjj_tab_art" id="panels-ajax-tab-container-highwire_article_tabs" class="panels-ajax-tab-container"><div class="panels-ajax-tab-loading" style ="display:none"><img class="loading" src="https://ebm.bmj.com/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif" alt="Loading" title="Loading" /></div><div class="panels-ajax-tab-wrap-jnl_template_bmjj_tab_art"><div class="panel-display panel-1col clearfix" > <div class="panel-panel panel-col"> <div><div class="panel-pane pane-highwire-markup author-affiliates col-narrow-12 author-affiliates-corresp article" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="contributors"><ol class="contributor-list" id="contrib-group-1"><li class="contributor" id="contrib-1"><a href="http://orcid.org/0000-0003-4190-7912" class="bmjj-markup-orcid-logo" target="_blank">http://orcid.org/0000-0003-4190-7912</a><span class="name">Aidan G Cashin</span><a id="xref-aff-1-1" class="xref-aff" href="#aff-1">1</a><span class="xref-sep">,</span><a id="xref-aff-2-1" class="xref-aff" href="#aff-2">2</a>, </li><li class="contributor" id="contrib-2"><a href="http://orcid.org/0000-0003-0244-5620" class="bmjj-markup-orcid-logo" target="_blank">http://orcid.org/0000-0003-0244-5620</a><span class="name">Georgia C Richards</span><a id="xref-aff-3-1" class="xref-aff" href="#aff-3">3</a><span class="xref-sep">,</span><a id="xref-aff-4-1" class="xref-aff" href="#aff-4">4</a>, </li><li class="contributor" id="contrib-3"><a href="http://orcid.org/0000-0001-8286-1995" class="bmjj-markup-orcid-logo" target="_blank">http://orcid.org/0000-0001-8286-1995</a><span class="name">Nicholas J DeVito</span><a id="xref-aff-5-1" class="xref-aff" href="#aff-5">5</a>, </li><li class="contributor" id="contrib-4"><span class="name">David T Mellor</span><a id="xref-aff-6-1" class="xref-aff" href="#aff-6">6</a>, </li><li class="last" id="contrib-5"><span class="name">Hopin Lee</span><a id="xref-aff-7-1" class="xref-aff" href="#aff-7">7</a><span class="xref-sep">,</span><a id="xref-aff-8-1" class="xref-aff" href="#aff-8">8</a></li></ol><ol class="affiliation-list"><li class="aff"><a id="aff-1" name="aff-1"></a><address> <sup>1</sup> <span class="institution">Centre for Pain IMPACT</span>, <span class="institution">Neuroscience Research Australia</span>, <span class="addr-line">Randwick</span>, <span class="addr-line">New South Wales</span>, Australia </address></li><li class="aff"><a id="aff-2" name="aff-2"></a><address> <sup>2</sup> <span class="institution">School of Health Sciences</span>, <span class="institution">University of New South Wales</span>, <span class="addr-line">Sydney</span>, <span class="addr-line">New South Wales</span>, Australia </address></li><li class="aff"><a id="aff-3" name="aff-3"></a><address> <sup>3</sup> <span class="institution">Global Centre on Healthcare and Urbanisation</span>, <span class="institution">University of Oxford</span>, <span class="addr-line">Oxford</span>, UK </address></li><li class="aff"><a id="aff-4" name="aff-4"></a><address> <sup>4</sup> <span class="institution">Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences</span>, <span class="institution">University of Oxford</span>, <span class="addr-line">Oxford</span>, UK </address></li><li class="aff"><a id="aff-5" name="aff-5"></a><address> <sup>5</sup> <span class="institution">Primary Care Health Sciences</span>, <span class="institution">University of Oxford</span>, <span class="addr-line">Oxford</span>, UK </address></li><li class="aff"><a id="aff-6" name="aff-6"></a><address> <sup>6</sup> <span class="institution">Center for Open Science</span>, <span class="addr-line">Charlottesville</span>, <span class="addr-line">Virginia</span>, USA </address></li><li class="aff"><a id="aff-7" name="aff-7"></a><address> <sup>7</sup> <span class="institution">Centre for Statistics in Medicine &amp; Rehabilitation Research in Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS)</span>, <span class="institution">University of Oxford</span>, <span class="addr-line">Oxford</span>, UK </address></li><li class="aff"><a id="aff-8" name="aff-8"></a><address> <sup>8</sup> <span class="institution">School of Medicine and Public Health</span>, <span class="institution">The University of Newcastle</span>, <span class="addr-line">Callaghan</span>, <span class="addr-line">New South Wales</span>, Australia </address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1"><span class="corresp-label">Correspondence to</span> Aidan G Cashin, Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, NSW 2031, Australia; <span class="em-link"><span class="em-addr">a.cashin{at}neura.edu.au</span></span> </li></ol></div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-markup abstract-with-bc" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" id="content-block" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2><p id="p-1">Registration of health and medical research is an effective way of improving the transparency and credibility of evidence. Registration involves pre-specifying the research objectives, design, methods and analytic plan on a publicly accessible repository before conducting the study. Registration can reduce bias and improve the transparency and credibility of research findings. Registration is mandated for clinical trials, but it is also relevant to systematic reviews, observational and preclinical experimental research. This paper describes how researchers can register their research and outlines possible barriers and challenges in doing so. Widespread adoption of research registration can reduce research waste and improve evidence-informed clinical and policy decision making.</p></div><ul class="kwd-group"><li class="kwd">evidence-based practice</li></ul><div class="section data-availability" id="sec-9"><h2 class="">Data availability statement</h2><p id="p-32">There are no data in this work.</p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-dfp-pane oas-ads oas-ads-mid pull-right" > <div class="pane-content"> <div id="dfp-ad-mpu-wrapper" class="dfp-tag-wrapper"> <div id="dfp-ad-mpu" class="dfp-tag-wrapper"> <script type="text/javascript"> googletag.cmd.push(function() { googletag.display("dfp-ad-mpu"); }); </script> </div> </div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-1" > <div class="pane-content"> <p><a href="https://doi.org/10.1136/bmjebm-2021-111836" target="_new">https://doi.org/10.1136/bmjebm-2021-111836</a></p> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-altmetrics" > <h2 class="pane-title">Statistics from Altmetric.com</h2> <div class="pane-content"> <div data-badge-details="right" data-badge-type="medium-donut" data-doi="10.1136/bmjebm-2021-111836" data-hide-no-mentions="true" class="altmetric-embed"></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-bmjj-jumplinks" > <div class="pane-content"> <div class="highwire-list-wrapper"><div class="highwire-list"><ul></ul></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-2 permissions-box" > <h2 class="pane-title">Request Permissions</h2> <div class="pane-content"> <p>If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center&rsquo;s RightsLink service. 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All authors contributed to data interpretation. AGC wrote the first draft of the manuscript. All authors provided substantive feedback on the manuscript and have read and approved the final version. AGC is the guarantor and attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.</p></li><li class="fn-other" id="fn-3"><p id="p-29"><span class="fn-label">Funding</span> The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.</p></li><li class="fn-conflict" id="fn-4"><p id="p-30"><span class="fn-label">Competing interests</span> GCR was financially supported by the NHS, National Institute of Health Research (NIHR), School for Primary Care Research (SPCR), the Naji Foundation and the Rotary Foundation to study for a Doctor of Philosophy (DPhil) at the University of Oxford (2017-2020), but no longer has interests to declare. 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All other authors declare no competing interests.</p></li><li class="fn-other" id="fn-5"><p id="p-31"><span class="fn-label">Provenance and peer review</span> Not commissioned; externally peer reviewed.</p></li></ul></div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-panels-mini pane-jnl-template-bmjj-challenge article-login" > <h2 class="pane-title">Read the full text or download the PDF:</h2> <div class="pane-content"> <div class="panel-display three-layout " id="mini-panel-jnl_template_bmjj_challenge"> <div class="panel-row-wrapper row"> <div class="left-wrapper col-narrow-12 col-normal-4"> <div class="panel-panel panel-region-left"> <div class="inside"><div class="panel-pane pane-add-to-cart" > <div class="pane-content"> <span class="highwire-foxycart-add-to-cart-ahah highwire-foxycart-add-to-cart-ahah" data-text="Buy this article (%short-price)" data-apath="/ebmed/28/1/68.atom" data-type="link" data-font-icon="" 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