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Lies, damned lies and epidemiology: why global health needs good epidemiological practice guidelines
  1. Sandra Alba,
  2. Christina Mergenthaler
  1. Health Unit, KIT Royal Tropical Institute, Amsterdam, The Netherlands
  1. Correspondence to Dr Sandra Alba; s.alba{at}

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  • Epidemiology, like any other discipline, is liable to malpractice. Questionable research practices have no place in global health as they steer research in the wrong direction, misguide public policy and undermine society’s trust.

  • Guidelines can address part of the problem by facilitating structured and transparent processes.

  • Key features of global health epidemiology revolve around the transnational and interdisciplinary nature of global health, its focus on equity, large-scale use and sustainability.

  • Guidelines for good epidemiological practice (GEP) in global health are not available, but a number of documents have laid the foundations for their development. Stakeholders involved in the commissioning, conduct, appraisal and publication of global health research should endorse a common set of GEP guidelines.

"Figures often beguile me, particularly when I have the arranging of them myself."

Mark Twain, Chapters from my Autobiography (1906)


Epidemiology is the cornerstone of global health. It shapes policy decisions and evidence-based practice by identifying disease risk factors and preventive healthcare targets. Most epidemiological findings are genuine and make an important contribution to global health, but some findings are obtained from ill-designed, poorly implemented, inappropriately analysed or selectively reported studies. These practices in the grey zone between deliberate misconduct (which includes fabrication, falsification and plagiarism) and ideal scientific behaviour are commonly referred to as ‘questionable research practices’.1

The only systematic review available on scientific research misconduct to date2 pooled 21 surveys mostly in biomedical, medical and clinical sciences from the UK, USA and Australia. The review suggested that 2%–14% of scientists may have fabricated or falsified data, with nearly three-quarters admitting other questionable research practices. The few data available from low-income and middle-income countries suggest that research misconduct is just as common in those countries.3

There is little research into the quality of global health research, but what it …

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