Center for Medical Ethics and Health Policy Staff Publications

Language

English

Publication Date

8-25-2026

Journal

The Journal of Allergy and Clinical Immunology: In Practice

DOI

10.1016/j.jaip.2026.08.021

PMID

42641984

Abstract

Randomized controlled trials underpin evidence-based medicine, but a growing proportion of trials contain implausible, inaccurate, or fabricated data. When such studies are incorporated into systematic reviews, they distort effect estimates, inflate evidence certainty, and can mislead the guideline recommendations that the reviews aim to inform. Within 8 recent American Academy of Allergy, Asthma & Immunology and American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters (JTFPP) systematic reviews, 17% of trials published between 2021 and 2024 were problematic, and in a network meta-analysis of antihistamines for chronic urticaria, 39% of recent trials were excluded because of implausible data, statistical anomalies, and discrepancies between protocols and the final publication. The proliferation of generative artificial intelligence further facilitates the ability to produce superficially credible but flawed reports. Standardized tools have been developed to offer systematic approaches to detecting problematic trials, but robust safeguards such as verifiable ethics approval, prospective protocol registration, and adherence to structure reporting guidelines remain essential. As part of efforts to ensure quality research, the JTFPP will continue to update our systematic reviews to remove problematic trials as they are identified. We believe that this approach will promote the development of trustworthy guideline recommendations.

Keywords

Asthma, Evidence-based medicine, GRADE, Generative artificial intelligence, Guideline, Meta-analysis, Problematic trials, Randomized controlled trial, Research integrity, Systematic review, Urticaria

Published Open-Access

no

Download

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.