The hidden research paper.

CONTEXT To determine whether the views expressed in a research paper are accurate representations of contributors' opinions about the research being reported. METHODS Purposive sampling of 10 research articles published in The Lancet; qualitative analysis of answers to 6 questions about the meaning of the study put to contributors who were listed on the byline of these articles. Fifty-four contributors listed on the bylines of the 10 articles were evaluated, and answers to questions were compared between contributors within research groups and against the published research report. RESULTS A total of 36 (67%) of 54 contributors replied to this survey. Important weaknesses were often admitted on direct questioning but were not included in the published article. Contributors frequently disagreed about the importance of their findings, implications, and directions for future research. I could find no effort to study systematically past evidence relating to the investigators' own findings in either survey responses or the published article. Overall, the diversity of contributor opinion was commonly excluded from the published report. I found that discussion sections were haphazardly organized and did not deal systematically with important questions about the study. CONCLUSIONS A research paper rarely represents the opinions of those scientists whose work it reports. The findings described herein reveal evidence of (self-)censored criticism, obscured meanings, confused assessment of implications, and failures to indicate directions for future research. There is now empirical support for the introduction of structured discussion sections in research papers. Editors might also explore ways to recover the plurality of contributors' opinions.