Holiday review. How random is the toss of a coin?

Background: The toss of a coin has been a method used to determine random outcomes for centuries. It is still used in some research studies as a method of randomization, although it has largely been discredited as a valid randomization method. We sought to provide evidence that the toss of a coin can be manipulated.

Methods: We performed a prospective experiment involving otolaryngology residents in Vancouver, Canada. The main outcome was the proportion of "heads" coin tosses achieved (out of 300 attempts) by each participant. Each of the participants attempted to flip the coin so as to achieve a heads result.

Results: All participants achieved more heads than tails results, with 7 of the 13 participants having significantly more heads results (p
Interpretation: Certain people are able to successfully manipulate the toss of a coin. This throws into doubt the validity of using a coin toss to determine a chance result.