Research integrity and transparency in SCAM journals

So-called alternative medicine (SCAM) remains widely used worldwide, yet longstanding concerns persist regarding the balance and reliability of the evidence presented in SCAM journals. This investigation examined long-term trends in publication practices within leading SCAM journals, with particular attention to changes in publication types and the prevalence of positive versus negative study outcomes as indirect indicators of potential publication bias.

The authors conducted a complete census of articles published in four leading SCAM journals at two contemporary time points (2018 and 2023), replicating the design and classification framework of a seminal 2001 analysis covering 1995 and 2000. Articles were categorised by publication type, subject area, and author-reported study outcome (positive, negative, or inconclusive, corresponding to the “open” category used in the original 2001 study). Descriptive analyses were used to compare trends over time and with earlier findings.

The total number of published articles increased substantially between the earlier and contemporary periods. The proportion of empirical studies, particularly clinical trials, rose over time. However, the prevalence of positive outcomes also increased markedly, with positive findings accounting for over 80% of published articles in the contemporary period, compared with 49% in the earlier study. Negative and inconclusive outcomes remained relatively infrequent.

The authors concluded that despite growth in publication volume and a shift toward empirical study designs, SCAM journals continue to exhibit a pronounced predominance of positive outcome reporting. These findings suggest that longstanding concerns regarding publication bias in SCAM publishing have not diminished over time and appear to have intensified, with selective publication and related reporting and dissemination practices plausibly contributing to the observed patterns. This has important implications for research integrity and evidence-based decision-making in medical practice.

It is great to see that our past research [the 2001 study mentioned above is one of my team] is being continued. It is less great, of course, to learn that the SCAM-bias continues and might even be on the increase. The reasons why there are so few negative results in SCAM journals might be complex. Two possible clues are:

1. The quality of SCAM research tends to be low, and poor quality research tends to generate positive findings, particularly if it is conducted by pseudo-researchers who abuse science for confirming their beliefs rather than for testing hypotheses (see also the ALTERNATIVE HALL OF FAME on this blog).
2. If nonetheless a high quality study emerges in SCAM – which, of course, does happen every now and then – it tends to produce a negative result and is likely to get published in a good quality journal rather than in one of the dodgy SCAM journals.

As I have often noted, the end-effect is bad for all concerned: SCAM and SCAM journals are slowly becoming the laughing stock of science. Consequently, nobody takes them seriously. If one day an effective therapy should emerge, we all might faile to notice. In a nutshell: publication bias harms us all!