Early Recognition of the Effects of Publication Bias

To the Editor: Dr Antman's editorial on Dr Simes' article on the potentially confounding effects of publication bias in evaluating the efficacy of various cancer therapies referred to what is probably the earliest published reference to a prospective clinical trial in the biblical book of Daniel. Some two millenia later, another outstanding individual, whose major contributions lie outside the area of clinical therapeutics, was also concerned with these issues. Abraham Lincoln recognized the value of disseminating the results of unsuccessful as well as successful experiments, as recounted in Sandberg's biography. Finding Herndon [Lincoln's law partner] reading a new book, "The Annual of Science," he glanced through it and commented that the book was on the right track because it took account of failures as well as successes in its field. "Too often we read only of successful experiments in science and philosophy, whereas if the history of failure and defeat was included there would be a saving of brain-work as well as time. The evidence of defeat, the recital of what was not as well as what cannot be done serves to put the scientist or philosopher on his guard—sets him to thinking on the right line." Given the fiscal constraints under which he operated, we do not know whether President Lincoln would have supported the funding of an international registry of clinical trials (as suggested by Dr Simes) from the federal budget. It is likely, however, that he would have been sympathetic to such a proposal.