Investigations suggest that, in some fields, at least one-quarter of clinical trials might be problematic or even entirely made up, warn some researchers. They urge stronger scrutiny.

The issue is, in part, a subset of the notorious paper-mill problem: over the past decade, journals in many fields have published tens of thousands of suspected fake papers, some of which are thought to have been produced by third-party firms, termed paper mills.

But faked or unreliable RCTs are a particularly dangerous threat. They not only are about medical interventions, but also can be laundered into respectability by being included in meta-analyses and systematic reviews, which thoroughly comb the literature to assess evidence for clinical treatments. Medical guidelines often cite such assessments, and physicians look to them when deciding how to treat patients.

https://www.nature.com/articles/d41586-023-02299-w