Publishing Identifiable Patient Photographs in Scientific Journals: Scoping Review of Policies and Practices

Background

Publishing identifiable patient data in scientific journals may jeopardize patient privacy and confidentiality if best ethical practices are not followed. Current journal practices show considerable diversity in the publication of identifiable patient photographs, and different stakeholders may have different opinions of and practices in publishing patient photographs.

Objective

This scoping review aimed to identify existing evidence and map knowledge gaps in medical research on the policies and practices of publishing identifiable photographs in scientific articles.

Methods

We performed a comprehensive search of the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, CINAHL with Full Text, Database of Abstracts of Reviews of Effects, Ovid MEDLINE, and Scopus. The Open Science Framework, PROSPERO, BASE, Google Scholar, OpenGrey, ClinicalTrials.gov, the Campbell Collaboration Library, and Science.gov were also searched.

Results

After screening the initial 15,949 titles and abstracts, 98 (0.61%) publications were assessed for eligibility at the full-text level, and 30 (0.19%) publications were included in this review. The studies were published between 1994 and 2020; most had a cross-sectional design and were published in journals covering different medical disciplines. We identified 3 main topics. The first included ethical aspects of the use of facial photographs in publications. In different clinical settings, the consent process was not conducted properly, and health professionals did not recognize the importance of obtaining written patient consent for taking and using patient medical photographs. They often considered verbal consent sufficient or even used the photographs without consent. The second topic included studies that investigated the practices and use of medical photography in publishing. Both patients and doctors asked for confidential storage and maintenance of medical photographs. Patients preferred to be photographed by their physicians using an institutional camera and preferred nonidentifiable medical photographs not only for publication but also in general. Conventional methods of deidentification of facial photographs concealing the eye area were recognized as unsuccessful in protecting patient privacy. The third topic emerged from studies investigating medical photography in journal articles. These studies showed great diversity in publishing practices regarding consent for publication of medical photographs. Journal policies regarding the consent process and consent forms were insufficient, and existing ethical professional guidelines were not fully implemented in actual practices. Patients’ photographs from open-access medical journals were found on public web-based platforms.

Conclusions

This scoping review showed a diversity of practices in publishing identifiable patient photographs and an unsatisfactory level of knowledge of this issue among different stakeholders despite existing standards. Emerging issues include the availability of patients’ photographs from open-access journals or preprints in the digital environment. There is a need to improve standards and processes to obtain proper consent to fully protect the privacy of patients in published articles.

Stakeholders' Experiences of Research Integrity Support in Universities: A Qualitative Study in Three European Countries

Fostering research integrity (RI) increasingly focuses on normative guidance and supportive measures within institutions. To be successful, the implementation of support should be informed by stakeholders' experiences of RI support. This study aims to explore experiences of RI support in Dutch, Spanish and Croatian universities. In total, 59 stakeholders (Netherlands n = 25, Spain n = 17, Croatia n = 17) participated in 16 focus groups in three European countries. Global themes on RI support experiences were identified by thematic analysis. Themes identified were: 'RI governance and institutional implementation', 'RI roles and structures', 'RI education and supervision', and 'Infrastructure, technology and tools supporting daily practice'. Experiences of support differed between countries in relation to: the efforts to translate norms into practice; the extent to which RI oversight was a responsibility of RE structures, or separate RI structures; and the availability of support close to research practice, such as training, responsible supervision, and adequate tools and infrastructure. The study reinforces the importance of a whole institutional approach to RI, embedded within local jurisdictions, rules, and practices. A whole institutional approach puts the emphasis of responsibility on institutions rather than individual researchers. When such an approach is lacking, some stakeholders look for intervention by authorities, such as funders, outside of the university.

Web-Based Educational Intervention to Improve Knowledge of Systematic Reviews Among Health Science Professionals: Randomized Controlled Trial

Background

Lack of knowledge of systematic reviews (SRs) could prevent individual health care professionals from using SRs as a source of information in their clinical practice or discourage them from participating in such research.

Objective

In this randomized controlled trial, we evaluated the effect of a short web-based educational intervention on short-term knowledge of SRs.

Methods

Eligible participants were 871 Master’s students of university health sciences studies in Croatia; 589 (67.6%) students who agreed to participate in the trial were randomized using a computer program into 2 groups. Intervention group A (294/589, 49.9%) received a short web-based educational intervention about SR methodology, and intervention group B (295/589, 50.1%) was presented with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist. The participants’ knowledge of SRs was assessed before and after the intervention. The participants could not be blinded because of the nature of the intervention. The primary outcome was the difference in the percentage of correct answers about SR methodology per participant between the groups after the intervention, expressed as relative risk and 95% CI.

Results

Results from 162 and 165 participants in the educational intervention and PRISMA checklist groups, respectively, were available for analysis. Most of them (educational intervention group: 130/162, 80.2%; PRISMA checklist group: 131/165, 79.4%) were employed as health care professionals in addition to being health sciences students. After the intervention, the educational intervention group had 23% (relative risk percentage) more correct answers in the postintervention questionnaire than the PRISMA checklist group (relative risk=1.23, 95% CI 1.17-1.29).

Conclusions

A short web-based educational intervention about SRs is an effective tool for short-term improvement of knowledge of SRs among health care studies students, most of whom were also employed as health care professionals. Further studies are needed to explore the long-term effects of the tested education.

Trial Registration

OSF Registries 10.17605/OSF.IO/RYMVC; https://osf.io/rymvc

Designing and implementing a research integrity promotion plan: Recommendations for research funders

Various stakeholders in science have put research integrity high on their agenda. Among them, research funders are prominently placed to foster research integrity by requiring that the organizations and individual researchers they support make an explicit commitment to research integrity. Moreover, funders need to adopt appropriate research integrity practices themselves. To facilitate this, we recommend that funders develop and implement a Research Integrity Promotion Plan (RIPP). This Consensus View offers a range of examples of how funders are already promoting research integrity, distills 6 core topics that funders should cover in a RIPP, and provides guidelines on how to develop and implement a RIPP. We believe that the 6 core topics we put forward will guide funders towards strengthening research integrity policy in their organization and guide the researchers and research organizations they fund.

Inadequate reporting quality of registered genome editing trials: an observational study

Background

To assess registration completeness and safety data of trials on human genome editing (HGE) reported in primary registries and published in journals, as HGE has safety and ethical problems, including the risk of undesirable and unpredictable outcomes. Registration transparency has not been evaluated for clinical trials using these novel and revolutionary techniques in human participants.

Methods

Observational study of trials involving engineered site-specific nucleases and long-term follow-up observations, identified from the WHO ICTRP HGE Registry in November 2020 and two comprehensive reviews published in the same year. Registration and adverse events (AEs) information were collected from public registries and matching publications. Published data were extracted in May 2021.

Results

Among 81 eligible trials, most were recruiting (51.9%) phase 1 trials (45.7%). Five trials were withdrawn. Most trials investigated CAR T cells therapies (45.7%) and used CRISPR/Cas9 (35.8%) ex vivo (88.9%). Among 12 trials with protocols both registered and published, eligibility criteria, sample size, and secondary outcome measures were consistently reported for less than a half. Three trials posted results in ClinicalTrials.gov, and one reported serious AEs.

Conclusions

Incomplete registration and published data give emphasis to the need to increase the transparency of HGE trials. Further improvements in registration requirements, including phase 1 trials, and a more controlled publication procedure, are needed to augment the implementation of this promising technology.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12874-022-01574-0.

Research priorities to reduce the impact of COVID-19 in low- and middle-income countries

Background

The COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health research that would have the potential to reduce the impact of the COVID-19 pandemic in LMICs.

Methods

The Child Health and Nutrition Research Initiative (CHNRI) method was used to identify COVID-19-related research priorities. All ISoGH members were invited to participate. Seventy-nine experts in clinical, translational, and population research contributed 192 research questions for consideration. Fifty-two experts then scored those questions based on five pre-defined criteria that were selected for this exercise: 1) feasibility and answerability; 2) potential for burden reduction; 3) potential for a paradigm shift; 4) potential for translation and implementation; and 5) impact on equity.

Results

Among the top 10 research priorities, research questions related to vaccination were prominent: health care system access barriers to equitable uptake of COVID-19 vaccination (ranked 1st), determinants of vaccine hesitancy (4th), development and evaluation of effective interventions to decrease vaccine hesitancy (5th), and vaccination impacts on vulnerable population/s (6th). Health care delivery questions also ranked highly, including: effective strategies to manage COVID-19 globally and in LMICs (2nd) and integrating health care for COVID-19 with other essential health services in LMICs (3rd). Additionally, the assessment of COVID-19 patients’ needs in rural areas of LMICs was ranked 7th, and studying the leading socioeconomic determinants and consequences of the COVID-19 pandemic in LMICs using multi-faceted approaches was ranked 8th. The remaining questions in the top 10 were: clarifying paediatric case-fatality rates (CFR) in LMICs and identifying effective strategies for community engagement against COVID-19 in different LMIC contexts.

Interpretation

Health policy and systems research to inform COVID-19 vaccine uptake and equitable access to care are urgently needed, especially for rural, vulnerable, and/or marginalised populations. This research should occur in parallel with studies that will identify approaches to minimise vaccine hesitancy and effectively integrate care for COVID-19 with other essential health services in LMICs. ISoGH calls on the funders of health research in LMICs to consider the urgency and priority of this research during the COVID-19 pandemic and support studies that could make a positive difference for the populations of LMICs.

Predictors of academic progression and desire to continue education for undergraduate and graduate nursing students: Cross-sectional study and a nested follow-up study

BACKGROUND

There is conflicting evidence on predictors of nursing degree completion. Identification of predictors of student desire to continue their education could be important in developing strategies for encouraging and supporting students to complete their university-level nursing education.

AIM

To explore the factors associated with the enrollment in the first graduate year of nursing studies, progression from the first to the third year of university undergraduate nursing study, and the desire of third-year undergraduate students to continue nursing education at the graduate level.

PARTICIPANTS AND METHODS

A cross-sectional study involving 351 first- and third-year undergraduate and first-year graduate nursing students from three cohorts of the University of Split Department of Health Studies and one generation of first- and third-year undergraduate nursing students from the Catholic University of Croatia, Zagreb. We collected sociodemographic data on the participants, their opinions about their education, and scores on nine psychological questionnaires: performance self-efficacy, academic self-efficacy, perseverance, attitudes towards science, self-respect, motivation, dispositional hope, future time perspective, and perceived personal incompetence.

RESULTS

More than half of third-year undergraduate students wanted to continue their nursing studies at the graduate level, but they did not progress to the graduate degree studies immediately after finishing their undergraduate studies. None of the assessed characteristics predicted the desire of the final undergraduate year students to continue nursing education at the graduate level. In a nested follow-up study of a cohort of undergraduate students, we observed an increase in student attitudes towards science, extrinsic and intrinsic motivation, future orientation, and a decrease in perceived personal incompetence.

CONCLUSION

Our results demonstrate that immediate progression to graduate level of nursing education, although perceived as desired, is not achieved by undergraduate nursing students. Interventions focusing on motivation, future orientation, and personal competence need to be explored as a way to promote academic progression in nursing.

Ten years later: a review of the US 2009 institute of medicine report on conflicts of interest and solutions for further reform

Conflicts of interest (COIs) in healthcare are increasingly discussed in the literature, yet these relationships continue to influence healthcare. Research has consistently shown that financial COIs shape prescribing practices, medical education and guideline recommendations. In 2009, the Institute of Medicine (IOM, now the National Academy of Medicine) published Conflicts of Interest in Medical Research, Practice, and Education-one of the most comprehensive reviews of empirical research on COIs in medicine. Ten years after publication of theIOM's report, we review the current state of COIs within medicine. We also provide specific recommendations for enhancing scientific integrity in medical research, practice, education and editorial practices.

Deidentification of facial photographs: a survey of editorial policies and practices

We analysed all journals from two Journal Citation Reports (JCR) categories: 'Dentistry, Oral Surgery and Medicine' and 'Otorhinolaryngology' published in 2018 for their policies on publishing facial photographs and actual practices of publishing these photographs in articles. We extracted the following data for each journal: JCR category, impact factor, volume, issue, instructions for authors regarding ethical issues, instructions for photograph deidentification, journals' references to standard research and publishing policies, presence and type of published clinical images, separate informed consent for the publication of patient photograph and methods of deidentification. The sample included 103 journals, which published 568 articles with 1404 clinical images. Around a half of the journals (52%) had a policy on clinical images, however, the only predictor of having a journal policy on clinical images was reference in the policy to International Committee of Medical Journal Editors Recommendations (OR=3.00, 95% CI 1.26 to 7.14, p=0.013). Identifiable patient photographs were found in 13% (79/568) of the articles, constituting 9% (128/1404) of the total sample of images. Only 16% (13/79) of articles publishing recognisable patient facial images included a statement about consent for publication of the image. From the total sample of articles, 34% (27/79) contained deidentified but recognisable patient photographs and only 22% (6/27) of them had a statement about patient consent for photograph publication. The patients' consent was more likely stated in the article in cases of recognisable facial images (OR=2.81, 95% CI 1.41 to 5.63, p=0.004). Journals publishing clinical research involving the face and neck region need to establish and enforce policies on publishing clinical images.

Reporting violations of European Charter of Patients' Rights: analysis of patient complaints in Croatia

Background

The European Charter of Patients' Rights (ECPR) presents basic patients' rights in health care. We analysed the characteristics of patients' complaints about their rights submitted through the official complaints system and to a non-governmental organization in Croatia.

Methods

The official system for patients’complaints in Croatia does not have a common pathway but offers different modes for addressing patient complaints. In this cross-sectional study, we analysed the reports about patients’ complaints from the official regional committees sent to the Ministry of Health. We also analysed the complaints received by the Croatian Association for the Protection of Patient’s Rights (CAPR) and mapped them to the ECPR.

Results

The aggregated official data from the Ministry of Health in 2017 and 2018 covered only 289 individual complaints from 10 out of 21 counties. Complaints were most frequently related to secondary and tertiary healthcare institutions and details were not provided. CAPR received a total of 440 letters, out of which 207 contained 301 complaints about violations of patients’ rights in 2017–2018. The most common complaint was the Right of Access to health care (35.3%) from the ECPR, followed by the Right to Information (29.9%) and the Right to Safety (21.7%). The fewest complaints were about the Right to Complain (1.9%), Right to Innovation (1.4%), Right to Compensation (1.4%), and Right to Preventive Measures (1.0%).

Conclusions

Reporting and dealing with patients’ complaints about violations of their patients’ rights does not appear to be effective in a system with parallel but uncoordinated complaints pathways. Mapping patient's complaints to the ECPR is a useful tool to assess the perception of patients’ rights and to plan actions to improve the complaints system for effective health care.

Responsible research and innovation training programs: implementation and evaluation of the HEIRRI project

Responsible research and innovation, or RRI, is a concept that aims to bring together society and science for a better future. There are six key elements of RRI: public engagement, gender equality, science education, open access, ethics and governance.

Higher Education Institutions and Responsible Research and Innovation (HEIRRI) project aimed to bring the concept of RRI into the educational system. Using state-of-the-art review of good practices, HEIRRI team developed 10 training programs on RRI for different higher education institution educational levels, including a summer school and a massive open online course (MOOC). We conducted pilot of the trainings and evaluated participants’ experiences. Satisfaction with HEIRRI training programs on responsible research and innovation was high, both for participants and for the trainers, and trainings raised awareness of RRI. Participants’ feedback was used to identify areas that need improvement and provided for recommendations for final versions of the HEIRRI training programs.

In order to equip researchers with skills to recognize and apply RRI values, RRI should be included in their education. HEIRRI training is suitable for a range of different disciplines, including forensic science, and is free to use and adjust for specific contexts (available from: https://rri-tools.eu/heirri-training-programmes).

Supplemental data for this article is available online at https://doi.org/10.1080/20961790.2021.1970319 .

Development and implementation of research integrity guidance documents: Explorative interviews with research integrity experts

Research integrity (RI) guidance documents often lack sufficient details on handling specific RI issues causing the lack of harmonized approaches to RI and opening the way to research misconduct and other detrimental research practices. Standard operating procedures (SOPs) are developed and implemented by organizations for ensuring the uniformity and quality of performed actions. This study aimed to explore stakeholders' opinions on SOPs for RI, factors influencing the implementation of RI guidance documents and practices, and ideas for improvements in the RI field. We conducted semi-structured interviews with stakeholders from different groups. Data were analyzed using the reflexive thematic analysis approach, and three themes were developed. The first theme addressed participants' knowledge and perceptions on SOPs for RI and their impact on RI promotion and implementation. The second theme described different factors that have a positive or negative impact on the implementation of RI and RI guidance documents and practices, while the third theme addressed needed changes and ideas for improvements in the RI field. Participants considered SOPs valuable for RI promotion. SOPs should be developed based on and consistent with more general and aspirational guidance and through the dialogue with researchers and other stakeholders, to ensure their relevancy.

Antifragility of healthcare systems in Croatia and Bosnia and Herzegovina: Learning from man-made and natural crises

Acute crises, such as a war or a pandemic, are the ultimate tests for health care systems' resilience (temporary response to stress with change and adaptation) and antifragility (permanent benefit from change in response to stress). In this Health Policy paper, we analyse and discuss how the healthcare systems of two European countries - Bosnia and Herzegovina and Croatia - adapted to war as a man-made disaster, and how they adapted to COVID-19 pandemic twenty-five years later. These countries experienced full scale wars in recent history, which significantly changed their political and healthcare systems. This experience prepared the countries for the response to the pandemic, which coincided with two earthquakes in Croatia. We argue that healthcare systems in Croatia and Bosnia and Herzegovina are not only resilient but antifragile, and that they benefited from stressors they were exposed to. The antifragility of the two systems were primarily based on human effort - the strength, adaptability and resilience of health care professionals. We will look at lessons from the wars that were applied to the pandemic and discuss newly recognized opportunities and improvements.

Ethics issues identified by applicants and ethics experts in Horizon 2020 grant proposals

Background: We assessed the ethics review of proposals selected for funding under the Marie Skłodowska-Curie Actions (MSCA) and the European Research Council (ERC) in Horizon 2020, EU’s framework programme for research and innovation, 2014-2020.

Methods: We analysed anonymized datasets for 3,054 MSCA individual fellowships (IF), 417 MSCA Innovative Training Networks (ITN), and 1,465 ERC main-listed proposals with ethics conditional clearance, over four years (2016 to 2019). The datasets included the information on ethics issues identified by applicants in their proposal and ethics issues and requirements identified by ethics experts during the ethics review.

Results: 42% of proposals received ethical clearance. For proposals with conditional ethics clearance (n=3546), most of the identified ethics issues by both applicants and ethics experts were in the ethics categories related to humans; protection of personal data; environment, health and safety; and non-EU countries. Ethics experts identified twice as many ethics issues compared to applicants across funding schemes, years, and from high- and low-research performing countries. ERC grants had the highest number of ethics requirements per proposal (median (Md)=8, interquartile range (IQR=4-14), compared to ITN (Md=6, IQR=3-13) and IF grants (Md=3, IQR=2-6). The majority of requirements had to be fulfilled after grant agreement: 99.4% for IF, 99.5% for ITN, and 26.0% for ERC. For 9% of the proposals, the requirements included the appointment of an independent ethics advisor and 1% of the proposals had to appoint an ethics advisory board.

Conclusions: Many applicants for highly competitive H2020 funding schemes lack awareness of ethics issues raised by their proposed research. There is a need for better training of researchers at all career stages about ethics issues in research, more support to researchers from research organizations to follow the funding agencies requirements, as well as further development and harmonization of the ethics appraisal process during grant assessment.

Important Topics for Fostering Research Integrity by Research Performing and Research Funding Organizations: A Delphi Consensus Study

To foster research integrity (RI), it is necessary to address the institutional and system-of-science factors that influence researchers' behavior. Consequently, research performing and research funding organizations (RPOs and RFOs) could develop comprehensive RI policies outlining the concrete steps they will take to foster RI. So far, there is no consensus on which topics are important to address in RI policies. Therefore, we conducted a three round Delphi survey study to explore which RI topics to address in institutional RI policies by seeking consensus from research policy experts and institutional leaders. A total of 68 RPO and 52 RFO experts, representing different disciplines, countries and genders, completed one, two or all rounds of the study. There was consensus among the experts on the importance of 12 RI topics for RPOs and 11 for RFOs. The topics that ranked highest for RPOs concerned education and training, supervision and mentoring, dealing with RI breaches, and supporting a responsible research process (e.g. through quality assurance). The highest ranked RFO topics concerned dealing with breaches of RI, conflicts of interest, and setting expectations on RPOs (e.g. about educating researchers about RI). Together with the research policy experts and institutional leaders, we developed a comprehensive overview of topics important for inclusion in the RI policies of RPOs and RFOs. The topics reflect preference for a preventative approach to RI, coupled with procedures for dealing with RI breaches. RPOs and RFOs should address each of these topics in order to support researchers in conducting responsible research.

Does reviewing experience reduce disagreement in proposals evaluation? Insights from Marie Skłodowska-Curie and COST Actions

We have limited understanding of why reviewers tend to strongly disagree when scoring the same research proposal. Thus far, research that explored disagreement has focused on the characteristics of the proposal or the applicants, while ignoring the characteristics of the reviewers themselves. This article aims to address this gap by exploring which reviewer characteristics most affect disagreement among reviewers. We present hypotheses regarding the effect of a reviewer’s level of experience in evaluating research proposals for a specific granting scheme, that is, scheme reviewing experience. We test our hypotheses by studying two of the most important research funding programmes in the European Union from 2014 to 2018, namely, 52,488 proposals evaluated under three funding schemes of the Horizon 2020 Marie Sklodowska-Curie Actions (MSCA), and 1,939 proposals evaluated under the European Cooperation in Science and Technology Actions. We find that reviewing experience on previous calls of a specific scheme significantly reduces disagreement, while experience of evaluating proposals in other schemes—namely, general reviewing experience, does not have any effect. Moreover, in MSCA—Individual Fellowships, we observe an inverted U relationship between the number of proposals a reviewer evaluates in a given call and disagreement, with a remarkable decrease in disagreement above 13 evaluated proposals. Our results indicate that reviewing experience in a specific scheme improves reliability, curbing unwarranted disagreement by fine-tuning reviewers’ evaluation.

Perspectives of key stakeholders on essential virtues for good scientific practice in research areas

In contrast to the principle-based approach to ethics and research integrity (ERI) training, which stresses the importance of following moral rules, the virtue-based approach focuses on developing good character traits. This study has aimed to explore what virtues mean in scientific practice and their suitable place in ERI training, using a qualitative approach. Two face-to-face focus group discussions were conducted with 21 participants. Heterogeneous purposive sampling was used to reach participants from different countries, organization types (academia, research, publishing, private sector), scientific disciplines and stages of their scientific careers. Data generated during the focus group discussions were analyzed using a reflexive thematic analysis approach, and three main themes were developed. The first theme addressed the relativity of virtue meanings because the participants differed in their definitions and understandings of the concept of virtue. The second theme referred to the acquisition of virtues through social interactions because participants saw virtues mostly as social constructs acquired through socialization and education. The third theme addressed the differences in the importance of particular virtues in research. Participants felt that particular virtues were more important than others because some of them are necessary for responsible research, and some are not.

Efficacy of reminders for increasing volunteer engagement in translating Cochrane plain language summaries: a pilot randomised controlled trial

OBJECTIVES

The aim of this study was to pilot test the effectiveness of reminders versus no intervention for increasing the number of translated Cochrane plain language summaries (PLSs) among volunteer translators.

STUDY DESIGN

Parallel-group randomised controlled trial.

SETTING

Cochrane Croatia translation project.

PARTICIPANTS

Adults who volunteered to translate Cochrane PLSs within the Cochrane Croatia translation project.

INTERVENTION

The participants were randomly allocated to intervention (receiving up to four bi-weekly email reminders to translate PLSs) or control group (no intervention).

PRIMARY OUTCOME

The number of translated PLSs within the 6-month trial period.

RESULTS

We included 80 participants. The median number of translated PLSs after 6 months was 9 in the intervention group (95% CI 2.0 to 15.0) and 4 in the control group (95% CI 2.9 to 7.0), but this was not significantly different (p=0.181, Mann-Whitney U test). There was no difference between the groups in the number of translations after 3 months, the average time-to-translation after 3 or 6 months, or the satisfaction at the end of the study period. The number of reminders received and the number of translated summaries were negatively correlated (r=-0.50; 95% CI -0.70 to -0.22).

CONCLUSIONS

Our pilot trial showed that reminders do not seem to be significantly effective in increasing the number of PLS translations. Future studies could explore whether different frequency, timing and content of reminders have an influence on an increase in the engagement among volunteer translators of evidence synthesis.

TRIAL REGISTRATION

NCT03534791.