The study has now at last been reported.11 And this week the BMJ reports on the failure of US academics to publish protocol defined follow up data from a trial of sentinel node biopsy in malignant melanoma.12What can explain this failure to publish academic trials? Journals have been blamed for a bias towards accepting positive results, and some of the blame does lie with them. Despite the billions of pounds wasted, there has been too little systematic effort to monitor the extent of non publication, let alone investigate the reasons for it. Research ethics committees were challenged long ago to behave ethically by ensuring that results of trials were published,16 yet these committees have been noticeable by their absence among those exposing under reporting of clinical trials and taking steps to tackle the problem. It is clear from the figure that academic institutions and funders of research have similarly failed in their responsibilities.

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