SynthesisJournal of clinical epidemiology2021
A metaresearch study revealed susceptibility of Covid-19 treatment research to white hat bias: first, do no harm.
Synthesis in Journal of clinical epidemiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Methodological assessment of systematic reviews and meta-analyses on COVID-19: A meta-epidemiological study.Journal of evaluation in clinical practice · 2021Pooled it
- The Algorithm's Blindspot: An Ethical Critique of Data-Fetishism and the Deskilling of the Clinical Gaze in Ophthalmology.Journal of bioethical inquiry · 2026Article
- Risk of bias and low reproducibility in meta-analytic evidence from fast-tracked publications during the coronavirus disease 2019 pandemic.PNAS nexus · 2025Article
- Article
- Challenges of evidence synthesis during the 2020 COVID pandemic: a scoping review.Journal of clinical epidemiology · 2022Article
- An update on drugs with therapeutic potential for SARS-CoV-2 (COVID-19) treatment.Drug resistance updates : reviews and commentaries in antimicrobial and anticancer chemotherapy · 2021Review
- Patient and Citizen Participation in the Identification of Ethical Considerations Aiming to Address Uncertainty in the Evaluation of Promising Interventions in a Pandemic Context.Frontiers in medical technology · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate the presence of white hat bias in Covid-19 treatment research by evaluating the effects of citation and reporting bias. STUDY DESIGN AND
settingCitation bias was investigated by assessing the degree of agreement between evidence provided by a remdesivir randomized controlled trial and its citing articles. The dissimilarity of outcomes derived from nonrandomized and randomized studies was tested by a meta-analysis of hydroxychloroquine effects on mortality. The differential influence of studies with beneficial over those with neutral results was evaluated by a bibliometric analysis.
resultsThe articles citing the ACTT-1 remdesivir trial preferentially presented its positive outcomes in 55.83% and its negative outcomes in 6.43% of cases. The hydroxychloroquine indicated no significant effect by randomized studies, but a significant survival benefit by nonrandomized ones. Citation mapping revealed that the study reporting survival benefit from the hydroxychloroquine-azithromycin combination was the most influential, despite subsequent studies reporting potential harmful effects.
conclusionThe present study raises concerns about citation bias and a predilection of reporting beneficial over harmful effects in the Covid-19 treatment research, potentially in the context of white hat bias. Preregistration, data sharing and avoidance of selective reporting are crucial to ensure the credibility of future research.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.