Poor registration and publication practices in clinical trials of targeted therapeutics for endocrine and metabolic diseases: an observational study

OBJECTIVES

To assess the completeness and concordance of reporting in registries and corresponding publications of interventional trials on targeted therapeutics for endocrine and metabolic disorders.

STUDY DESIGN AND SETTING

We searched clinical trial registries in September 2022 for completed interventional trials of target therapeutics for endocrine and metabolic disorders registered from 2005 onwards. We used ClinicalTrials.gov and the World Health Organization International Clinical Trial Registration Platform registration requirements to extract data and assess the completeness of initial entry and final updates to trial registration and concordance with their published journal articles.

RESULTS

Among 149 clinical trials included, 121 (81%) had corresponding publications. Missing mandatory registration data items were identified in 89 (67%) trials at the initial registration entry, 17 (13%) at the final registration update, and in 85 (77%) corresponding publications. All trials showed changes between initial registration entry and final registration update, and 98% showed changes from the initial registration entry to publication. Changes between initial registration entry and final registration update were most common in the categories 'Completion date' (92%), 'Key secondary outcomes' (82%), and 'Date of first enrolment' (70%). Changes between initial registration entry and publication were most common in categories 'Sample size' (91%), 'Key inclusion and exclusion criteria' (81%), 'Key secondary outcomes' (84%), and 'Completion date' (83%).

CONCLUSION

Despite the legal and journal registration requirements, the completeness and consistency of reporting mandatory data items in registries and corresponding publications regarding targeted therapeutics for endocrine and metabolic disorders are inadequate. Our findings raise questions about the integrity and reliability of clinical trials focusing on targeted therapeutics.

PLAIN LANGUAGE SUMMARY

This study evaluated the completeness of reporting of mandatory information about clinical trials of targeted therapies for endocrine and metabolic diseases in trial registries and published articles. Furthermore, we examined whether the information in trial registries aligns with what is reported in scientific journals. Our analysis focused on completed interventional trials registered from 2005 onwards using trial registries. We found that 67% of the included trials were missing mandatory information at the time of initial entry into registry, while 77% of the matching publications also lacked mandatory information. The most common discrepancies between the entry into registry and published data occurred in the mandatory categories of sample sizes and key inclusion and exclusion criteria for participants. Our findings highlight major gaps in how clinical trials for targeted therapies in endocrine and metabolic diseases are conducted. Despite established requirements for accurate registration and publication of mandatory trial information, substantial discrepancies persist between the data in registries and published results. These inconsistencies raise concerns about the reliability of reported findings and underscore the urgent need for improved practices in trial registration and reporting.

GRADE guidance 39: using GRADE-ADOLOPMENT to adopt, adapt or create contextualized recommendations from source guidelines and evidence syntheses

BACKGROUND AND OBJECTIVE

The Grading of Recommendations, Assessment, Development and Evaluations (GRADE)-ADOLOPMENT methodology has been widely used to adopt, adapt, or de novo develop recommendations from existing or new guideline and evidence synthesis efforts. The objective of this guidance is to refine the operationalization for applying GRADE-ADOLOPMENT.

METHODS

Through iterative discussions, online meetings, and email communications, the GRADE-ADOLOPMENT project group drafted the updated guidance. We then conducted a review of handbooks of guideline-producing organizations, and a scoping review of published and planned adolopment guideline projects. The lead authors refined the existing approach based on the scoping review findings and feedback from members of the GRADE working group. We presented the revised approach to the group in November 2022 (approximately 115 people), in May 2023 (approximately 100 people), and twice in September 2023 (approximately 60 and 90 people) for approval.

RESULTS

This GRADE guidance shows how to effectively and efficiently contextualize recommendations using the GRADE-ADOLOPMENT approach by doing the following: (1) showcasing alternative pathways for starting an adolopment effort; (2) elaborating on the different essential steps of this approach, such as building on existing evidence-to-decision (EtDs), when available or developing new EtDs, if necessary; and (3) providing examples from adolopment case studies to facilitate the application of the approach. We demonstrate how to use contextual evidence to make judgments about EtD criteria, and highlight the importance of making the resulting EtDs available to facilitate adolopment efforts by others.

CONCLUSION

This updated GRADE guidance further operationalizes the application of GRADE-ADOLOPMENT based on over 6 years of experience. It serves to support uptake and application by end users interested in contextualizing recommendations to a local setting or specific reality in a short period of time or with limited resources.

Perception of organizational climate by university staff and students in medicine and humanities: A qualitative study

Organizational climate and culture are important for research organizations because they foster research integrity and responsible conduct of research, reduce questionable research practices, and improve job satisfaction. The aim of our study was to explore how employees and students perceive organizational climate and its consequences in the university setting. We conducted semi-structured interviews with senior students and employees (teaching and non-teaching staff) from two different university schools: School of Medicine and Faculty of Humanities and Social Sciences. Participants were asked questions regarding perceived climate, working environment, and the role of the institution. The data were analyzed using reflexive thematic analysis approach. Three themes were identified. The first theme addressed the difference in the perception and understanding of organizational climate. The second theme dealt with institutional issues emanating from organizational climate. The third theme described the behavior of stakeholders in the formation of organizational climate. Organizational climate is important concept in academic organizations as it influences both employees, particularly early career researchers, and students. Institutional leadership can strongly influence organizational climate, which can in turn affect job and job satisfaction. Due to the importance of personal morality on everyday decision-making, virtue-based research integrity training could be useful in improving academic institutions' organizational climate.

Are numerical scores important for grant assessment? A cross-sectional study

Background: In the evaluation of research proposals, reviewers are often required to provide their opinions using various forms of quantitative and qualitative criteria. In 2020, the European Commission removed, for the Marie Skłodowska-Curie Actions (MSCA) Innovative Training Networks (ITN) funding scheme, the numerical scores from the individual evaluations but retained them in the consensus report. This study aimed to assess whether there were any differences in reviewer comments' linguistic characteristics after the numerical scoring was removed, compared to comments from 2019 when numerical scoring was still present. Methods: This was an observational study and the data were collected for the Marie Skłodowska-Curie Actions (MSCA) Innovative Training Networks (ITN) evaluation reports from the calls of 2019 and 2020, for both individual and consensus comments and numerical scores about the quality of the research proposal on three evaluation criteria: Excellence, Impact and Implementation. All comments were analyzed using the Linguistic Inquiry and Word Count (LIWC) program. Results: For both years, the comments for proposal's strengths were written in a style that reflects objectivity, clout, and positive affect, while in weaknesses cold and objective style dominated, and that pattern remained stable across proposal status and research domains. Linguistic variables explained a very small proportion of the variance of the differences between 2019 and 2020 (McFadden R 2=0.03). Conclusions: Removing the numerical scores was not associated with the differences in linguistic characteristics of the reviewer comments. Future studies should adopt a qualitative approach to assess whether there are conceptual changes in the content of the comments.

Promoting research integrity in funding: Co-creating guidelines for research funding organizations

Research Funding Organizations (RFOs) play an important role in promoting research integrity (RI). Not only do they allocate resources to research institutions and researchers, but they also set and monitor research standards in their funded projects. In spite of their crucial role, there is a paucity of guidance on how RFOs can promote research integrity. As part of the EU-Funded SOPs4RI project, we aimed to address this gap by co-creating guidelines to help RFOs promote RI, engaging a diverse group of stakeholders. Based on a Delphi survey, reviews of evidence and stakeholder interviews, three guideline topics were identified: 1) the selection and evaluation of proposals; 2) monitoring of funded projects; and 3) prevention of unjustified interference. Four sets of co-creation workshops were conducted for each guideline topic, and the input revised and finalized. Understanding these debates could help RFOs from diverse cultural and organizational backgrounds who are developing their own RI guidelines. Therefore, in this paper, we summarize the key results and emphasize the final recommendations. Further, we provide the main points of discussion that occurred during the workshops and explain how they were addressed or resolved in the final guidelines and how they can help in future endeavors to improve funders' practices to foster RI.

Creating research ethics and integrity country report cards: Case study from Europe

Structures for and practices of research integrity (RI) and research ethics (RE) differ among countries. This study analyzed the processes and structures for RI and RE in Europe, following the framework developed at the World Conferences on Research Integrity. We present RI and RE Country Report Cards for 16 European countries, which included the information on RI and RE structures, processes and outcomes. While some of the countries are front-runners when it comes to RI and RE, with well-established and continually developing policies and structures, others are just starting their journey in RI and RE. Although RI and RE contextual divergences must be taken into account, a level of harmonization among the countries is necessary so that researchers working in the European area can similarly handle RI and RE issues and have similar expectations regardless of the organization in which they work. RI and RE Country Report Cards can be a tool to monitor, compare, and strengthen RE and integrity across countries through empowerment and inspiration by examples of good practices and developed systems.

Development of consensus on essential virtues for ethics and research integrity training using a modified Delphi approach

Most ethics and research integrity (ERI) training approaches are based on teaching moral rules, duties or responsibilities, often not sufficiently addressing virtue-based ethics. This study aimed to obtain a consensus among relevant experts on the importance of essential virtues for ERI training and their acquisitions. A modified Delphi consensus process was conducted in three rounds; 31 ERI experts participated in Round 1 and 23 in Round 2 and Round 3. Based on findings generated from qualitative data in Round 1, a structured questionnaire with 90 different statements grouped under five domains was developed for Round 2 and Round 3. After the final round, a consensus was achieved on two-thirds of statements included in this study. The experts agreed that virtues are based on learned and reflected attitudes and that the appropriate direction to acquire research virtues is through continuing education using case studies and discussions based on real-life scenarios. Furthermore, the consensus was obtained on 35 scientific virtues that should be stimulated in ERI training, prioritizing honesty, integrity, accountability, criticism and fairness as the most essential scientific virtues for good research practice. These results should be considered in developing or adjusting the ERI training program and materials.

Methods proposed for monitoring the implementation of evidence-based research: a cross-sectional study

OBJECTIVES

Evidence-based research (EBR) is the systematic and transparent use of prior research to inform a new study so that it answers questions that matter in a valid, efficient, and accessible manner. This study surveyed experts about existing (e.g., citation analysis) and new methods for monitoring EBR and collected ideas about implementing these methods.

STUDY DESIGN AND SETTING

We conducted a cross-sectional study via an online survey between November 2022 and March 2023. Participants were experts from the fields of evidence synthesis and research methodology in health research. Open-ended questions were coded by recurring themes; descriptive statistics were used for quantitative questions.

RESULTS

Twenty-eight expert participants suggested that citation analysis should be supplemented with content evaluation (not just what is cited but also in which context), content expert involvement, and assessment of the quality of cited systematic reviews. They also suggested that citation analysis could be facilitated with automation tools. They emphasized that EBR monitoring should be conducted by ethics committees and funding bodies before the research starts. Challenges identified for EBR implementation monitoring were resource constraints and clarity on responsibility for EBR monitoring.

CONCLUSION

Ideas proposed in this study for monitoring the implementation of EBR can be used to refine methods and define responsibility but should be further explored in terms of feasibility and acceptability. Different methods may be needed to determine if the use of EBR is improving over time.

Conclusiveness, readability and textual characteristics of plain language summaries from medical and non-medical organizations: a cross-sectional study

This cross-sectional study compared plain language summaries (PLSs) from medical and non-medical organizations regarding conclusiveness, readability and textual characteristics. All Cochrane (medical PLSs, n = 8638) and Campbell Collaboration and International Initiative for Impact Evaluation (non-medical PLSs, n = 163) PLSs of latest versions of systematic reviews published until 10 November 2022 were analysed. PLSs were classified into three conclusiveness categories (conclusive, inconclusive and unclear) using a machine learning tool for medical PLSs and by two experts for non-medical PLSs. A higher proportion of non-medical PLSs were conclusive (17.79% vs 8.40%, P < 0.0001), they had higher readability (median number of years of education needed to read the text with ease 15.23 (interquartile range (IQR) 14.35 to 15.96) vs 15.51 (IQR 14.31 to 16.77), P = 0.010), used more words (median 603 (IQR 539.50 to 658.50) vs 345 (IQR 202 to 476), P < 0.001). Language analysis showed that medical PLSs scored higher for disgust and fear, and non-medical PLSs scored higher for positive emotions. The reason for the observed differences between medical and non-medical fields may be attributed to the differences in publication methodologies or disciplinary differences. This approach to analysing PLSs is crucial for enhancing the overall quality of PLSs and knowledge translation to the general public.

Author instructions in biomedical journals infrequently address systematic review reporting and methodology: a cross-sectional study

OBJECTIVES

We aimed to analyze how instructions for authors in journals indexed in MEDLINE address systematic review (SR) reporting and methodology.

STUDY DESIGN AND SETTING

We analyzed instructions for authors in 20% of MEDLINE-indexed journals listed in the online catalog of the National Library of Medicine on July 27, 2021. We extracted data only from the instructions published in English. We extracted data on the existence of instructions for reporting and methodology of SRs.

RESULTS

Instructions from 1,237 journals mentioned SRs in 45% (n = 560) of the cases. Systematic review (SR) registration was mentioned in 104/1,237 (8%) of instructions. Guidelines for reporting SR protocols were found in 155/1,237 (13%) of instructions. Guidelines for reporting SRs were explicitly mentioned in 461/1,237 (37%), whereas the EQUATOR (Enhancing the Quality and Transparency of Health Research) network was referred to in 474/1,237 (38%) of instructions. Less than 2% (n = 20) of instructions mentioned risk of bias and meta-analyses; less than 1% mentioned certainty of evidence assessment, methodological expectations, updating of SRs, overviews of SRs, or scoping reviews.

CONCLUSION

Journals indexed in MEDLINE rarely provide instructions for authors regarding SR reporting and methodology. Such instructions could potentially raise authors' awareness and improve how SRs are prepared and reported.

The definition of research misconduct should be stated in the abstract when reporting research on research misconduct

Research integrity is the cornerstone for a reliable and trustworthy science. Research misconduct is classically defined as fabrication, falsification, or plagiarism. To be considered as such, the action must have been committed with the intent to mislead or deceive. There are many other research misbehaviors such as duplication, fake-peer review or lack of disclosure of conflicts of interest, that are often included in the definition of research misconduct in codes, policies, and professional documents. The definition of research misconduct varies among countries and institutions, the seriousness and intentionality of the action. This variability is also present in research articles on the prevalence of research misconduct because it is common for each author to use a different definition, creating confusion for readers. We argue that the definition of research misconduct used in a study should be stated already in the abstract, particularly because not all publications are in open access, so that readers can fully understand what the study found concerning research misconduct without needing to have access to the full article.

Research misconduct as a challenge for academic institutions and scientific journals

Research misconduct refers to a set of unethical practices in research and publication and is the main reason for retraction of articles published in the academic literature. Research misconduct has negative consequences and has generated public scepticism about research, which has led to increasing distrust in science. In this context, a joint effort by the scientific community, academic institutions, scientific journals and research funders is needed to identify and prevent research misconduct. In this paper, we will evaluate what has already been done and what is needed to do to better address research misconduct. The focus of this paper will be on the actions taken by academic institutions, as the first line of defence, and scientific journals, as the gatekeepers of science. However, scientific journals and academic institutions are only a part of a much larger and multistakeholder effort needed to address the challenges scientific research is facing.

Factors influencing the promotion and implementation of research integrity in research performing and research funding organizations: A scoping review

Promoting and implementing research integrity is considered the joint responsibility and effort of multiple stakeholders in the research community. We conducted a scoping review and analyzed 236 research articles and gray literature publications from biomedical sciences, social sciences, natural sciences (including engineering), and humanities that dealt with the factors that may positively or negatively impact the promotion and implementation of research integrity. Critical appraisal of evidence was performed for studies describing interventions aimed at research integrity promotion in order to provide insight into the effectiveness of these interventions. The results of this scoping review provide a comprehensive taxonomy of factors with positive or negative impact and their relatedness to individual researchers, research performing and funding organizations, and the system of science. Moreover, the results show that efforts for fostering and promoting research integrity should be implemented at all three levels (researcher, institution, system) simultaneously to deliver greater adherence and implementation of research integrity practices. Although various educational interventions aiming at research integrity promotion exist, we were not able to conclude on the effectiveness of explored interventions due to the methodological quality issues in the studies.

Evaluating health claim assessment skills of parents with preschool children: A cross-sectional study using Informed Health Choices Claim Evaluation Tool

Background

Health literacy is a global problem and is particularly relevant when making health care decisions about small children. We analysed how parents of preschool children assess health claims and explored the predictors of their assessment skill.

Methods

We conducted a survey with questions from the Claim Evaluation Tools (CET) database, part of the Informed Health Choices (IHC) project, in ten paediatric primary care practices of the Split-Dalmatia County Health Center, Split, Croatia, from 1 February to 31 March 2023. Eligible participants were parents accompanying preschool-aged children for check-ups. We also collected data on parents' and children's demographic and health characteristics (including the presence of any chronic illness in the child), visits to paediatric emergency service, hospitalisations, vaccination status, the presence of chronic illness of parents or relatives, and whether parents had to made treatment decisions for themselves and/or their family member.

Results

Overall, 402 parents of preschool children (median age 35 years (interquartile range (IQR) = 31.0-38.3)) had a median IHC CET test score of 10.0 (IQR = 8.0-11.0) out of 12 questions. The multiple regression analysis showed that female gender, higher level of education, being employed, and having a history of a visit to paediatric emergency service were significant predictors of the test score, explaining 21.9% of the variance.

Conclusions

Parents of preschool children have a very good ability for critical assessment of health-related statements in a complex health care system and an environment of generally unsatisfactory health literacy. Further studies should explore how parents understand health claims in different geographical, socio-economic and cultural setting, and explore educational interventions to increase critical thinking abilities and informed decision-making, especially among fathers, unemployed parents and those with lower levels of education.

Assessing the quality and completeness of reporting in health systems guidance for pandemics using the AGREE-HS tool

Background

During health emergencies, leading healthcare organisations, such as the World Health Organization (WHO), the European Centre for Disease Control and Prevention (ECDC), and the United States Centers for Disease Control and Prevention (CDC), provide guidance for public health response. Previous studies have evaluated clinical practice guidelines (CPGs) produced in response to epidemics or pandemics, yet few have focused on public health guidelines and recommendations. To address this gap, we assessed health systems guidance (HSG) produced by the WHO, the ECDC, and the CDC for the 2009 H1N1 and COVID-19 pandemics.

Methods

We extracted HSG for the H1N1 and COVID-19 pandemics from the organisations' dedicated repositories and websites. After screening the retrieved documents for eligibility, five assessors evaluated them using the Appraisal of Guidelines Research & Evaluation - Health Systems (AGREE-HS) tool to assess the completeness and transparency of reporting according to the five AGREE-HS domains: "Topic", "Participants", "Methods", "Recommendations", and "Implementability".

Results

Following the screening process, we included 108 HSG in the analysis. We observed statistically significant differences between the H1N1 and COVID-19 pandemics, with HSG issued during COVID-19 receiving higher AGREE-HS scores. The HSG produced by the CDC had significantly lower overall scores and single-domain scores compared to the WHO and ECDC. However, all HSG scored relatively low, under the median of 40 total points (range = 10-70), indicating incomplete reporting. The HSG produced by all three organisations received a median score <4 (range = 1-7) for the "Participants", "Methods", and "Implementability" domains.

Conclusions

There is still significant progress to be made in the quality and completeness of reporting in HSG issued during pandemics, especially regarding methodological approaches and the composition of the guidance development team. Due to their significant impact and importance for healthcare systems globally, HSG issued during future healthcare crises should adhere to best reporting practices to increase uptake by stakeholders and ensure public trust in healthcare organisations.

Tool to assess recognition and understanding of elements in Summary of Findings Table for health evidence synthesis: a cross-sectional study

of Findings (SoF) tables concisely present the main findings of evidence synthesis of health evidence, but how users navigate it to understand and interpret the presented information is not clear. We quantified the interaction of medical students with an SoF table while answering a knowledge quiz. Read&Learn tool was used to measure the number of target and non-target table cells visited for each question and the time spent on these cells. Students positively identified target elements for quiz questions and answered simpler questions, but struggled with critical thinking and understanding study outcomes. The question on outcomes with the largest improvement post-intervention had the fewest correct answers, the longest interaction with table cells and the most opened cells before answering. Students spent a median of 72% of the time reading target table cells. A heatmap of the interactions showed that they were mostly answer-oriented. Further development of the tool and metrics is needed to use the tool and the metrics to study the cognitive processes during the assessment of health evidence.

Completeness of intervention description in invasive cardiology trials: an observational study of ClinicalTrials.gov registry and corresponding publications

Introduction

Non-pharmacological invasive interventions in cardiology are complex and often inadequately reported. Template for Intervention Description and Replication (TIDieR) checklist and guide were developed to aid reporting and assessment of non-pharmacological interventions. The aim of our study was to assess the completeness of describing invasive cardiology interventions in clinical trials at the level of trial registration and corresponding journal article publication.

Methodology

We searched for clinical trials in invasive cardiology registered in Clinicaltrials.gov and corresponding journal publications. We used the 10-item TIDieR checklist for registries and 12-item checklist for journal publications.

Results

Out of 7,017 registry items retrieved by our search, 301 items were included in the analysis. The search for corresponding published articles yielded 192 journal publications. The majority of trials were funded by the industry and were medical device trials. The median number of reported TIDieR items was 4.5 (95% CI 4.49-4.51) out of 10, and while the corresponding journal articles reported 6.5 (95% CI 6.0-6.5) out of 12 TIDieR items.

Conclusion

Registration and reporting of invasive cardiology trials is often incomplete and adequate detailed description of the interventions is not provided. TIDieR checklist is an important tool which should be used to ensure rigorous reporting of non-pharmacological interventions in cardiology.

Reporting characteristics of nonsurgical periodontal therapy trials registered in ClinicalTrials.gov: an observational study

Aim: To evaluate the completeness of the description of nonsurgical periodontal therapy interventions in clinical trials registered in ClinicalTrials.gov and correspondence of registered information for trial participants and outcome measures with published articles. Materials & methods: We retrieved data from ClinicalTrials.gov and corresponding publications. The completeness of intervention reporting was assessed using the Template for Intervention Description and Replication (TIDieR) checklist for oral hygiene instructions (OHI), professional mechanical plaque removal (PMPR), and subgingival instrumentation, antiseptics and antibiotics. The completeness of registration of trial protocol information was assessed according to the WHO Trial Registration DataSet for participant information (enrollment, sample size calculation, age, gender, condition) and primary/secondary outcome measures. Results: 79 included trials involved OHI (n = 38 trials, 48.1%), PMPR (n = 19, 24.1%), antiseptics (n = 11, 12.7%), or antibiotics (n = 11, 12.7%). There was a great variety in the terms used to describe these interventions. Most of the analyzed trials (93.7%) were completed and did not provide any data on study phase (74.7%). The description of intervention in the registry in ClinicalTrials.gov was inadequate for all analyzed interventions, with description inconsistencies in matching publications. There were also discrepancies in registered and published outcomes: for 39 trials with published results, 18 had different registered and reported primary outcomes, and 29 different registered and reported secondary outcomes. Conclusion: The completeness of the description of nonsurgical therapy of periodontitis in clinical trials is unsatisfactory, reducing the quality of translation of the new evidence and procedures into clinical practice. Significant discrepancy in registered and reported trial outcomes calls into question the validity of reported results and relevance for practice.

Linguistic analysis of plain language summaries and corresponding scientific summaries of Cochrane systematic reviews about oncology interventions

BACKGROUND

Cochrane plain language summaries (PLSs) are an important format to present high-quality healthcare evidence to patients with cancer and their families. They should be written in a way everyone can understand, since they serve as a tool in decision-making and present a bridge to overcome the gap between the healthcare users and professionals.

OBJECTIVE

The aim of the study was to assess the language characteristics of PLSs of Cochrane systematic reviews of oncology interventions in comparison with corresponding Cochrane scientific abstracts (SAs).

METHODS

In this cross-sectional study, we included all Cochrane PLSs and SAs of systematic reviews of oncology interventions available in the Cochrane Database of Systematic Reviews. We assessed text readability, measured using the Simple Measure of Gobbledygook (SMOG) index, and the prevalence of words related to different language tones (clout, authenticity, emotions and analytical tones). Two independent assessors categorized the conclusiveness of the efficacy of interventions into nine categories.

RESULTS

The overall median SMOG index for 275 PLSs was 13.0 (95% confidence interval [CI] 12.8-13.3). Readability scores did not differ across Cochrane Review Groups. SAs had a higher readability index than the corresponding PLSs (median = 16.6, 95% CI = 16.4-16.8). Regarding linguistic characteristics, PLSs were shorter than SAs, with less use of analytical tone, but more use of a positive emotional tone and authenticity. Overall, the 'Unclear' category of conclusiveness was the most common among all PLSs. Also, PLSs with 'No evidence' conclusions were the shortest and had the lowest SMOG index.

CONCLUSION

PLSs of Cochrane systematic reviews of oncological interventions have low readability and most give unclear conclusions about the efficacy of interventions. PLSs should be simplified so that patients and their families can benefit from appropriate health information on evidence synthesis. Further research is needed into reasons for unclear language to describe evidence from oncology trials.

Student Moral Foundations in the Context of Research Misbehavior: An Experimental Study

The study aimed to examine whether the use of words related to different moral foundations can predict the perceived severity of research misconduct. We gave two groups of participants, undergraduate medical students, the same hypothetical scenarios of research misconduct cases containing words related to different aspects of morality, and asked them to assess how inappropriate the described behavior was. Students ranked the described behaviors differently by the inappropriateness of the behavior, but the group wording was not a significant predictor of appropriateness. The reasons for the ranking were not related to any standardized procedures for research integrity but were related to the moral assessment of the students, which was assessed using qualitative approach. The results of this study implicate that personal moral views are an important part in research integrity training.

Delphi survey on the most promising areas and methods to improve systematic reviews' production and updating

BACKGROUND

Systematic reviews (SRs) are invaluable evidence syntheses, widely used in biomedicine and other scientific areas. Tremendous resources are being spent on the production and updating of SRs. There is a continuous need to automatize the process and use the workforce and resources to make it faster and more efficient.

METHODS

Information gathered by previous EVBRES research was used to construct a questionnaire for round 1 which was partly quantitative, partly qualitative. Fifty five experienced SR authors were invited to participate in a Delphi study (DS) designed to identify the most promising areas and methods to improve the efficient production and updating of SRs. Topic questions focused on which areas of SRs are most time/effort/resource intensive and should be prioritized in further research. Data were analysed using NVivo 12 plus, Microsoft Excel 2013 and SPSS. Thematic analysis findings were used on the topics on which agreement was not reached in round 1 in order to prepare the questionnaire for round 2.

RESULTS

Sixty percent (33/55) of the invited participants completed round 1; 44% (24/55) completed round 2. Participants reported average of 13.3 years of experience in conducting SRs (SD 6.8). More than two thirds of the respondents agreed/strongly agreed the following topics should be prioritized: extracting data, literature searching, screening abstracts, obtaining and screening full texts, updating SRs, finding previous SRs, translating non-English studies, synthesizing data, project management, writing the protocol, constructing the search strategy and critically appraising. Participants have not considered following areas as priority: snowballing, GRADE-ing, writing SR, deduplication, formulating SR question, performing meta-analysis.

CONCLUSIONS

Data extraction was prioritized by the majority of participants as an area that needs more research/methods development. Quality of available language translating tools has dramatically increased over the years (Google translate, DeepL). The promising new tool for snowballing emerged (Citation Chaser). Automation cannot substitute human judgement where complex decisions are needed (GRADE-ing).

TRIAL REGISTRATION

Study protocol was registered at https://osf.io/bp2hu/ .

Researchers on research integrity: a survey of European and American researchers

BACKGROUND

Reports of questionable or detrimental research practices (QRPs) call into question the reliability of scientific evidence and the trustworthiness of research. A critical component of the research ecosystem is the organization within which research takes place. We conducted a survey to explore the attitudes and beliefs of European and American researchers about the organisations in which they work, their own research practices and their attitudes towards research integrity and research integrity policies.

METHODS

We administered an online survey (International Research Integrity Survey (IRIS)) to 2,300 active researchers based in the US and 45,000 in Europe (including UK, Norway, Iceland and Switzerland).  We employed a stratified probability sample of the authors of research articles published between 2016 and 2020 included in Clarivate's Web of Science citation database. Coverage includes researchers in the humanities, social sciences, natural sciences and medical sciences, who hold at least a master's level degree.

RESULTS

In comparison to researchers in the US, European researchers admit to more QRPs and are less confident in maintaining high research integrity (RI) standards. In the US and Europe, many researchers judge their organization to fall short of best RI practice. All researchers recognize the benefits of RI, reliable knowledge and the trust of colleagues and the public, and there is support for RI training particularly among Europeans.

CONCLUSION

To create and maintain a culture of integrity in scientific research, a collective commitment from researchers, their institutions and funders is needed. Researchers rely on many channels of communication about research integrity and thus the involvement of many different participants in the research system is required to make improvements. Policies must be developed to reinforce best practice rather than being seen as an irrelevance to the real business of research.

The Embassy of Good Science - a community driven initiative to promote ethics and integrity in research

The Embassy of Good Science ( https://www.embassy.science) aims to improve research integrity and research ethics by offering an online, open, 'go-to' platform, which brings together information on research integrity and research ethics and makes that information accessible, understandable, and appealing. It effectively organizes and describes research integrity and research ethics guidelines, educational materials, cases, and scenarios. The Embassy is wiki-based, allowing users to add -- when logged in with their ORCID researcher id -- new information, and update and refine existing information. The platform also makes the research integrity and research ethics community visible and more accessible in pages dedicated to relevant initiatives, news and events. Therefore, the Embassy enables researchers to find useful guidance, rules and tools to conduct research responsibly. The platform empowers researchers through increased knowledge and awareness, and through the support of the research integrity and research ethics community. In this article we will discuss the background of this new platform, the way in which it is organized, and how users can contribute.

Diplomatic response to global health challenges in recognizing patient needs: A qualitative interview study

Background

Global health diplomacy is the applied practice of foreign affairs to further national goals that focus on health issues requiring international cooperation and collective action. We aimed to determine how international diplomats and health policy-related professionals in the EU understand the concept of health diplomacy, which impacts both diplomatic relations as well as patients' rights.

Methods

In a qualitative interview study, we used a heterogeneous stratified purposeful sampling to reach participants from different countries and different practitioners from the Pyramid of Health Diplomacy: core, multi-stakeholder, and informal. Reflexive thematic analysis was used to identify the main themes.

Findings

We contacted 131 practitioners of GHD, of which 37 responded, and nine agreed to be interviewed. From 11 interview questions, four main themes emerged from the analysis of the individual interview. The participants reported limited knowledge about the definition of GHD but also that they engaged in daily activities and decisions of inter-governmental bodies. They were not aware of existing special education and training for health attachés and made suggestions for improving the field and practice of GHD. They were not fully familiar with the European Charter of Patients' Rights. There was a consensus from all participants that patient rights need to improve as a fundamental right. They stressed the fact that the hospital lockdown and the right access to healthcare were impaired during the COVID pandemic.

Interpretation

The role of health diplomacy in linking public health and foreign affairs is key to respecting patients' rights. Health over other interests is becoming an increasingly critical element in foreign policy. Establishing a clear career path for health attachés is necessary to foster effective global health agreements and coordination across countries.