Why are medical and health-related studies not being published? A systematic review of reasons given by investigators

On the value of meta-research for early career researchers: A commentary

Meta-research, also known as "research on research" is a field of study that investigates the methods, reporting, reproducibility, evaluation, and incentives along the research continuum. Meta-research literacy is imperative to ensure high quality, transparent and reproducible primary data or meta-research products. In this commentary, we propose that early career researchers should be trained in meta-research as a foundation to develop a deeper understanding of the research process and ability to appraise the research literature and design high-quality original studies, irrespective of their chosen field of study. We discuss the importance of meta-research and open science from the perspective of an early career trainee, highlighting essential areas for growth and obstacles one may encounter.

Temporal Trends in Severe Brain Injury and Associated Outcomes in Very Preterm Infants

INTRODUCTION

Severe brain injury (SBI), including severe intraventricular haemorrhage (sIVH) and cystic periventricular leukomalacia, poses significant challenges for preterm infants, yet recent data and trends are limited.

METHODS

Analyses were conducted using the Australian and New Zealand Neonatal Network data on preterm infants born <32 weeks' gestation admitted at Monash Children's Hospital, Australia, from January 2014 to April 2021. The occurrence and trends of SBI and sIVH among preterm infants, along with the rates and trends of death and neurodevelopmental impairment (NDI) in SBI infants were assessed.

RESULTS

Of 1,609 preterm infants, 6.7% had SBI, and 5.6% exhibited sIVH. A total of 37.6% of infants with SBI did not survive to discharge, with 92% of these deaths occurring following redirection of clinical care. Cerebral palsy was diagnosed in 65.2% of SBI survivors, while 86.4% of SBI survivors experienced NDI. No statistically significant differences were observed in the temporal trends of SBI (adjusted OR [95% CI] 1.08 [0.97-1.20]; p = 0.13) or sIVH (adjusted OR [95% CI] 1.09 [0.97-1.21]; p = 0.11). Similarly, there was no statistically significant difference noted in the temporal trend of the composite outcome, which included death or NDI among infants with SBI (adjusted OR [95% CI] 0.90 [0.53-1.53]; p = 0.71).

CONCLUSION

Neither the rates of SBI nor its associated composite outcome of death or NDI improved over time. A notable proportion of preterm infants with SBI faced redirection of care and subsequent mortality, while most survivors exhibited adverse neurodevelopmental challenges. The development of better therapeutic interventions is imperative to improve outcomes for these vulnerable infants.

Positive Outcome Bias in the Influential Otolaryngology Clinical Trial Literature

OBJECTIVE

To assess for the presence of positive outcome bias in the otolaryngology clinical trial literature. Specifically, we investigate the prevalence of clinical trials with positive findings (CTP) and clinical trials with negative findings (CTN), as well as their quality of evidence and subsequent impact.

STUDY DESIGN

Retrospective analysis.

SETTING

Clinical Trials in the Influential Otolaryngology Literature.

METHODS

We reviewed all clinical trials published in 4 major otolaryngology journals between 2000 and 2020. We constructed several multivariable regression models to investigate the relationship of finding direction with randomization status and citation count. Subsequently, we incorporated an interaction term between year and the primary covariate of each model to assess the temporal trajectory of these relationships. All models accounted for sample size, journal, subspecialty, and the affiliated program prestige.

RESULTS

Of the 1367 trials analyzed, 1143 (84%) were CTPs, a rate that persisted throughout the study period (aOR 1.00, 95% CI 0.98-1.03). CTPs were significantly less likely to be randomized compared to CTNs (aOR 0.25, 0.17-0.37), a relationship that persisted over time (aOR 1.05, 0.99-1.03). CTPs received significantly more citations compared to CTNs (aIRR 1.41, 1.25-1.60), a disparity that also persisted over time (aIRR 0.99, 0.97-1.01).

CONCLUSION

The otolaryngology clinical trial literature has been heavily dominated by positive findings. CTPs were more frequently cited and published even with a lower level of evidence compared to CTNs. This bias may influence the objectivity of evidence used to guide clinical practice and warrants attention when reviewing findings and changing practices.

Methodological quality of systematic reviews on sepsis treatments: A cross-sectional study

OBJECTIVE

Systematic reviews (SRs) offer updated evidence to support decision-making on sepsis treatments. However, the rigour of SRs may vary, and methodological flaws may limit their validity in guiding clinical practice. This cross-sectional study appraised the methodological quality of SRs on sepsis treatments.

METHODS

We searched MEDLINE, EMBASE, and Cochrane Database for eligible SRs on randomised controlled trials on sepsis treatments with at least one meta-analysis published between 2018 and 2023. We extracted SRs' bibliographical characteristics with a pre-designed form and appraised their methodological quality using AMSTAR (A MeaSurement Tool to Assess systematic Reviews) 2. We applied logistic regressions to explore associations between bibliographical characteristics and methodological quality ratings.

RESULTS

Among the 102 SRs, two (2.0%) had high overall quality, while respectively four (3.9%), seven (6.9%) and 89 (87.3%) were of moderate, low, and critically low quality. Performance in several critical methodological domains was poor, with only 32 (31.4%) considering the risk of bias in primary studies in result interpretation, 22 (21.6%) explaining excluded primary studies, and 16 (15.7%) applying comprehensive searching strategies. SRs published in higher impact factor journals (adjusted odds ratio: 1.19; 95% confidence interval: 1.05 to 1.36) was associated with higher methodological quality.

CONCLUSIONS

The methodological quality of recent SRs on sepsis treatments is unsatisfactory. Future reviewers should address the above critical methodological aspects. More resources should also be allocated to support continuous training in critical appraisal among healthcare professionals and other evidence users.

How do children's hospitals address health inequalities: a grey literature scoping review

OBJECTIVES

Health inequalities are systematic differences in health between people, which are avoidable and unfair. Globally, more political strategies are required to address health inequalities, which have increased since the global SARS-CoV-2/COVID-19 pandemic, with a disproportionate impact on children. This scoping review aimed to identify and collate information on how hospitals around the world that deliver care to children have addressed health inequalities.

DESIGN

Scoping review focused solely on grey literature.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Following Joanna Briggs Institute guidelines, a four-step approach to identifying literature was adopted.

DATA SOURCES

Overton, OpenGrey, OpenMD, Trip Database, DuckDuckGo, Google, targeted websites and children's hospital websites were searched on March 2023 for items published since 2010.

DATA EXTRACTION AND SYNTHESIS

Retrieved items were screened against clear inclusion and exclusion criteria before data were extracted by two independent reviewers using a data extraction tool. Studies were tabulated by a hospital. A meta-analysis was not conducted due to the varied nature of studies and approaches.

RESULTS

Our study identified 26 approaches to reduction of health inequalities, from 17 children's hospitals. Approaches were categorised based on their size and scope. Seven approaches were defined as macro, including hospital-wide inequality strategies. Ten approaches were classed as meso, including the establishment of new departments and research centres. Micro approaches (n=9) included one-off projects or interventions offered to specific groups/services. Almost half of the reported approaches did not discuss the evaluation of impact.

CONCLUSIONS

Children's hospitals provide a suitable location to conduct public health interventions. This scoping review provides examples of approaches on three scales delivered at hospitals across high-income countries. Hospitals with the most comprehensive and extensive range of approaches employ dedicated staff within the hospital and community. This review indicates the value of recruitment of both public health-trained staff and culturally similar staff to deliver community-based interventions.

Discontinuation and nonpublication of nasopharyngeal carcinoma clinical trials

OBJECTIVES

To determine the extent of research waste in the field of nasopharyngeal carcinoma (NPC).

MATERIALS AND METHODS

In this cross-sectional study, we explored the rates, causes and predictors of discontinuation and nonpublication of NPC clinical trials. The sample was derived using the ClinicalTrials.gov advanced search function. Adjusted logistic regression was used to ascertain the effect of trial characteristics on completion and publication status. If a trial discontinuation explanation or publication status could not be determined through the systematic search, the corresponding author was emailed.

RESULTS

Ultimately, 311 NPC clinical trials were included (255 [82.0 %] completed and 56 [18.0 %] discontinued trials). The most common reason for trial discontinuation was poor accrual (50 %, 23/46). Industry funding (adjusted OR, 3.12; P = 0.003) and recurrent/metastatic setting (adjusted OR, 11.95; P = 0.003) were significantly associated with increased likelihood of trial discontinuation. Of the 207 completed trials included in the publication query, 141 (68.1 %) were published in peer-reviewed journals, 10 (4.8 %) had results only available on ClinicalTrials.gov, and 56 (27.1 %) remained unpublished 3 or more years after trial completion. Radiation with or without pharmacologic interventions significantly increased the potential of publication (adjusted OR, 3.20; P = 0.048). Among published trials, the median time to publication was 28.47 months (interquartile range, 15.27-44.98 months).

CONCLUSION

We identified the difficulties inherent in NPC clinical trials from completion to publication. This represents considerable research waste in NPC, thus raising ethical concerns about the concealment of clinical data and futile patient participation and attendant risks.

Unpublished clinical trials of common rheumatic diseases

OBJECTIVES

Randomized controlled trials (RCTs) provide high-quality evidence for treatment efficacy, but many RCTs remain unpublished. The objective of this study was to describe the proportion of unpublished RCTs in five rheumatic diseases and to identify factors associated with publication.

METHODS

Registered RCTs for five rheumatic diseases (SLE, vasculitis, spondyloarthritis, SS and PsA) with over 30 months since study completion were identified using ClinicalTrials.gov. Index publications were identified by NCT ID numbers and structured text searches of publication databases. The results of unpublished studies were identified in abstracts and press releases; reasons for non-publication were assessed by surveying corresponding authors.

RESULTS

Out of 203 studies that met eligibility criteria, 17.2% remained unpublished, representing data from 4281 trial participants. Higher proportions of published trials were phase 3 RCTs (57.1% vs 28.6% unpublished, P < 0.05) or had a positive primary outcome measure (64.9% vs 25.7% unpublished, P < 0.001). In a multivariable Cox proportional hazards model, a positive outcome was independently associated with publication (hazard ratio 1.55; 95% CI: 1.09, 2.22). Corresponding authors of 10 unpublished trials cited ongoing preparation of the manuscript (50.0%), sponsor/funder issues (40.0%) and unimportant/negative result (20.0%) as reasons for lack of publication.

CONCLUSIONS

Nearly one in five RCTs in rheumatology remain unpublished 2 years after trial completion, and publication is associated with positive primary outcome measures. Efforts to encourage universal publication of rheumatology RCTs and reanalysis of previously unpublished trials should be undertaken.

Rapid, accurate publication and dissemination of clinical trial results: benefits and challenges

Large-scale clinical trials are essential in cardiology and require rapid, accurate publication, and dissemination. Whereas conference presentations, press releases, and social media disseminate information quickly and often receive considerable coverage by mainstream and healthcare media, they lack detail, may emphasize selected data, and can be open to misinterpretation. Preprint servers speed access to research manuscripts while awaiting acceptance for publication by a journal, but these articles are not formally peer-reviewed and sometimes overstate the findings. Publication of trial results in a major journal is very demanding but the use of existing checklists can help accelerate the process. In case of rejection, procedures such as easing formatting requirements and possibly carrying over peer-review to other journals could speed resubmission. Secondary publications can help maximize benefits from clinical trials; publications of secondary endpoints and subgroup analyses further define treatment effects and the patient populations most likely to benefit. These rely on data access, and although data sharing is becoming more common, many challenges remain. Beyond publication in medical journals, there is a need for wider knowledge dissemination to maximize impact on clinical practice. This might be facilitated through plain language summary publications. Social media, websites, mainstream news outlets, and other publications, although not peer-reviewed, are important sources of medical information for both the public and for clinicians. This underscores the importance of ensuring that the information is understandable, accessible, balanced, and trustworthy. This report is based on discussions held on December 2021, at the 18th Global Cardiovascular Clinical Trialists meeting, involving a panel of editors of some of the top medical journals, as well as members of the lay press, industry, and clinical trialists.

Evidence of publication bias in multiple sclerosis clinical trials: a comparative analysis of published and unpublished studies registered in ClinicalTrials.gov

BACKGROUND

Complete and timely publication of clinical trials ensures that patients and the medical community are fully informed when making treatment decisions. The aim of this study is to assess the publication of phase III and IV clinical trials on multiple sclerosis (MS) drugs that have been carried out between 2010 and 2019 and to identify the factors associated with their publication in peer-reviewed journals.

METHODS

An advanced search in ClinicalTrials.gov was performed and consecutive searches in PubMed, EMBASE and Google Scholar were conducted looking for the associated publications of all completed trials. Study design characteristics, results and other relevant information were extracted. Data was analysed following a case-control design. Clinical trials with associated publications in peer-reviewed journals were the cases and unpublished trials were the controls. A multivariate logistic regression analysis was performed to identify factors associated with trial publication.

RESULTS

One hundred and fifty clinical trials were included in the analysis. Ninety-six of them (64.0%) were published in peer-reviewed journals. In the multivariate analysis, factors associated with trial publication were a favourable primary outcome (OR 12.49, 95% CI 1.28 to 122.29) and reaching the originally estimated sample size (OR 41.97, 95% CI 1.96 to 900.48), while those associated with a lower odds of publication were having 20% or more patients lost to follow-up (OR 0.03, 95% CI 0.01 to 0.52) and evaluating drugs intended to improve treatment tolerability (OR 0.01, 95% CI 0.00 to 0.74).

CONCLUSIONS

Phase III and IV clinical trials on MS drugs are prone to under-reporting and publication bias. Efforts must be made to promote a complete and accurate dissemination of data in MS clinical research.

Factors relating to nonpublication and publication bias in clinical trials in Canada: A qualitative interview study

AIMS

This study aims to understand factors contributing to nonpublication and publication bias in clinical trials in Canada.

METHODS

Qualitative interviews were conducted between March 2019 and April 2021 with 34 participants from the Canadian provinces of Alberta, British Columbia and Ontario, including 17 clinical trial investigators, 1 clinical research coordinator, 3 research administrators, 3 research ethics board members and 10 clinical trial participants. We conducted a thematic analysis involving coding of interview transcripts and memo-writing to identify key themes.

RESULTS

Several factors contribute to nonpublication and publication bias in clinical trial research. A core theme was that reporting practices are shaped by incentives within the research system taht favour publication of positive over negative trials. Investigators are discouraged from reporting by experiences or perceptions of difficulty in publishing negative findings but rewarded for publishing positive findings in various ways. Trial investigators more strongly associated positive clinical trials than negative trials with opportunities for industry and nonindustry funding and with academic promotion, bonuses and recognition. Research institutions and ethics boards tended to lack well-resourced, proactive policies and practices to ensure trial findings are reported in registries or journals.

CONCLUSION

Clinical trial reporting practices in Canada are shaped by incentives favouring reporting of positive over negative trials, such as funding opportunities and academic promotion, bonuses and recognition. Research institutions could help change incentives by adopting performance metrics that emphasize full reporting of results in journals or registries.

Publication rate and research topics of studies in pediatric kidney transplantation

BACKGROUND

The quality of medical care for pediatric kidney transplant recipients depends on sound evidence from published clinical trials.

METHODS

We examined the publication rate, time to publication, and factors associated with publication of studies in pediatric kidney transplantation registered on ClinicalTrials.gov from 1999 to 2020.

RESULTS

We identified 136 studies with an overall enrollment of 36255 study participants, of which only 58.8% have been published yet. Unpublished studies included data from 14 350 participants. The median time to publication was 25 months (range, 0-117) with a significantly shorter time to publication in more recent years. The most frequently investigated research topic was immunosuppressants (49.3%), followed by perioperative management (11.0%) and infectiology (10.3%). The percentage of published studies was highest for the topic steroid withdrawal (87.5%), followed by infectiology (78.6%), and nutrition, sports and quality of life (71.4%). Studies, which were co-funded by industry, showed a significantly higher 5-year publication rate (p = 0.019).

CONCLUSIONS

In conclusion, nearly half of all studies in pediatric kidney transplantation remain unpublished. Non-publication of studies might lead to a publication bias with a negative impact on clinical decision-making.

Gray Literature in Evaluating Effectiveness in Digital Health and Health and Welfare Technology: A Source Worth Considering

Background

The need to assess the effectiveness and value of interventions involving digital health and health and welfare technologies is becoming increasingly important due to the rapidly growing development of these technologies and their areas of application. Systematic reviews of scientific literature are a mainstay of such assessment, but publications outside the realm of traditional scientific bibliographic databases—known as gray literature—are often not included. This is a disadvantage, particularly apparent in the health and welfare technology (HWT) domain.

Objective

The aim of this article is to investigate the significance of gray literature in digital health and HWT when reviewing literature. As an example, the impact of including gray literature to the result of two systematic reviews in HWT is examined.

Methods

In this paper, we identify, discuss, and suggest methods for including gray literature sources when evaluating effectiveness and appropriateness for different review types related to HWT. The analysis also includes established sources, search strategies, documentation, and reporting of searches, as well as bias and credibility assessment. The differences in comparison to scientific bibliographic databases are elucidated. We describe the results, challenges, and benefits of including gray literature in 2 examples of systematic reviews of HWT.

Results

In the 2 systematic reviews described in this paper, most included studies came from context-specific gray literature sources. Gray literature contributed to the overall result of the reviews and corresponded well with the reviews’ aims. The assessed risk of bias of the included studies derived from gray literature was similar to the included studies from other types of sources. However, because of less standardized publication formats, assessing and extracting data from gray literature studies were more time-consuming and compiling statistical results was not possible. The search process for gray literature required more time and the reproducibility of gray literature searches were less certain due to more unstable publication platforms.

Conclusions

Gray literature is particularly relevant for digital health and HWT but searches need to be conducted systematically and reported transparently. This way gray literature can broaden the range of studies, highlight context specificity, and decrease the publication bias of reviews of effectiveness of HWT. Thus, researchers conducting systematic reviews related to HWT should consider including gray literature based on a systematic approach.

Publication rate of abstracts presented at the Australian Orthopaedic Association Annual Scientific Meeting

BACKGROUND

Presentations at scientific conferences are an important method of research dissemination, with abstracts often used to inform clinical practice. Abstract to publication ratio is a commonly used tool for determining meeting quality. The aim of this study was to determine the publication rate for abstracts presented at the Australian Orthopaedic Association Annual Scientific Meeting (AOA ASM) between 2012 and 2015 inclusive and identify reasons for non-publication.

METHODS

MEDLINE, PubMed and Google Scholar were searched to determine whether each abstract presented at AOA ASMs between 2012 and 2015 was associated with a full text publication in a peer-reviewed journal. Where a publication could not be located, the presenter was contacted to confirm the reason for non-publication.

RESULTS

A total of 1130 abstracts were submitted (951 oral and 179 posters), and 573 resulted in full-text peer-reviewed publications (51%). The majority of publications (73%) were published within 2 years of presentation. There was no difference in likelihood of publication for oral presentations compared to posters, nor in the rate of publication across the 4 years of meetings. Common reasons for non-publication were lack of time (32%), publication considered low priority (27%) and journal rejections (22%).

CONCLUSION

The overall publication rate for abstracts presented at the AOA ASM is 51%, which is an increase from the 1998 ASM (31%). This publication rate is higher than many similar Australian meetings and on par with other international orthopaedic and subspecialty meetings. Future research should investigate potential publication bias and methods to minimise barriers to publication.

Association of Accuracy, Conclusions, and Reporting Completeness With Acceptance by Radiology Conferences and Journals

BACKGROUND

Preferential publication of studies with positive findings can lead to overestimation of diagnostic test accuracy (i.e. publication bias). Understanding the contribution of the editorial process to publication bias could inform interventions to optimize the evidence guiding clinical decisions.

PURPOSE/HYPOTHESIS

To evaluate whether accuracy estimates, abstract conclusion positivity, and completeness of abstract reporting are associated with acceptance to radiology conferences and journals.

STUDY TYPE

Meta-research.

POPULATION

Abstracts submitted to radiology conferences (European Society of Gastrointestinal and Abdominal Radiology (ESGAR) and International Society for Magnetic Resonance in Medicine (ISMRM)) from 2008 to 2018 and manuscripts submitted to radiology journals (Radiology, Journal of Magnetic Resonance Imaging [JMRI]) from 2017 to 2018. Primary clinical studies evaluating sensitivity and specificity of a diagnostic imaging test in humans with available editorial decisions were included.

ASSESSMENT

Primary variables (Youden's index [YI > 0.8 vs. <0.8], abstract conclusion positivity [positive vs. neutral/negative], number of reported items on the Standards for Reporting of Diagnostic Accuracy Studies [STARD] for Abstract guideline) and confounding variables (prospective vs. retrospective/unreported, sample size, study duration, interobserver agreement assessment, subspecialty, modality) were extracted.

STATISTICAL TESTS

Multivariable logistic regression to obtain adjusted odds ratio (OR) as a measure of the association between the primary variables and acceptance by radiology conferences and journals; 95% confidence intervals (CIs) and P-values were obtained; the threshold for statistical significance was P < 0.05.

RESULTS

A total of 1000 conference abstracts (500 ESGAR and 500 ISMRM) and 1000 journal manuscripts (505 Radiology and 495 JMRI) were included. Conference abstract acceptance was not significantly associated with YI (adjusted OR = 0.97 for YI > 0.8; CI = 0.70-1.35), conclusion positivity (OR = 1.21 for positive conclusions; CI = 0.75-1.90) or STARD for Abstracts adherence (OR = 0.96 per unit increase in reported items; CI = 0.82-1.18). Manuscripts with positive abstract conclusions were less likely to be accepted by radiology journals (OR = 0.45; CI = 0.24-0.86), while YI (OR = 0.85; CI = 0.56-1.29) and STARD for Abstracts adherence (OR = 1.06; CI = 0.87-1.30) showed no significant association. Positive conclusions were present in 86.7% of submitted conference abstracts and 90.2% of journal manuscripts.

DATA CONCLUSION

Diagnostic test accuracy studies with positive findings were not preferentially accepted by the evaluated radiology conferences or journals.

EVIDENCE LEVEL

3 TECHNICAL EFFICACY: Stage 2.

Writing Rounds: An Innovation to Increase Physician Scientific Dissemination

INTRODUCTION

Many high-quality studies presented at conferences never reach the peer-reviewed literature, most likely because physician authors do not take the next step to fully write up the studies and submit them to a journal. We evaluated a curriculum designed to equip authors with the practical skills to submit research projects to peer-reviewed publication.

METHODS

We designed a mixed asynchronous-synchronous longitudinal curriculum, occurring across 4 months via a virtual platform. To evaluate the curriculum, we tracked process and production outcomes and conducted semistructured interviews with participants following participation.

RESULTS

Across two cohorts in 2019, nine participant authors completed the curriculum. Seven participants submitted their studies for publication; two were accepted. In interviews with eight participants, participant authors described the value of the program, expressing intention to participate again and to recommend it to colleagues.

CONCLUSION

Through a coach-directed writing group, participant authors developed the skills and confidence needed to prepare and submit scientific manuscripts for peer review. Curriculum maintenance and enhancement is ongoing. We plan to scale up this innovation in support of other university departments and medical disciplines, developing an implementation guide to describe needed elements, including technological platforms, qualities of the coach, author recruitment, and group conduct.

POSITIVE RESULTS BIAS AND IMPACT FACTOR IN RETINA CLINICAL TRIALS 2016 to 2019

PURPOSE

To assess for a positive results bias in recently published randomized controlled trials in the field of vitreoretinal disease.

METHODS

A bibliometric analysis was conducted examining randomized controlled trials published in the field of retina between January 1, 2016, and December 31, 2019. Studies were classified as positive result or negative result based on the statistical significance of their primary outcome. Publication date and sample size were documented. These variables were compared against Journal Citation Reports Impact Factor in the year of publication.

RESULTS

Two hundred and eighty-eight randomized controlled trials from 64 unique journals were included and analyzed. One hundred and eighty-five (64.2%) studies were classified as positive result, and 103 (35.8%) studies were classified as negative result. There was no association between impact factor and positive result. Studies classified as positive result had larger sample sizes, and higher sample size was associated with higher impact factor.

CONCLUSION

These results do not support the presence of a recent positive results bias in retina randomized controlled trials. This is reassuring, although several factors could be contributing to this finding including studies that were conducted but never submitted and selective reporting of outcomes. Thus, it will be important to remain cognizant of potential publication biases moving forward.

A rapid review exploring nurse-led memory clinics

AIMS

To systematically explore the structures, functions, outcomes, roles and nursing credentials of memory clinics where nurses autonomously lead diagnosis and postdiagnostic care.

DESIGN

A systematic rapid review was conducted.

DATA SOURCES

MEDLINE (Ovid), CINAHL Full-Text (EBSCO) and EMBASE were systematically searched in December 2019 with no timeframe limitations imposed.

REVIEW METHODS

The modified PRISMA checklist was used as a guide to facilitate the review. Articles identified were screened and assessed for inclusion criteria, and screening of reference lists of included studies was also completed.

RESULTS

Six articles, published between 2011-2019, including two case studies, two descriptive reports, one qualitative study and one programme evaluation were included in the review. Nurse-led memory clinics were situated in community centres, on university campuses, hospitals and in general practitioners' offices. The services offered included assessment, diagnosis and treatment/postdiagnostic care. Nurse credentials included advanced practice nurses and a community psychiatric nurse who was a non-medical prescriber. Overall, there was low quantity and quality of evidence to evaluate outcomes.

Delays in reporting and publishing trial results during pandemics: cross sectional analysis of 2009 H1N1, 2014 Ebola, and 2016 Zika clinical trials

BACKGROUND

Pandemic events often trigger a surge of clinical trial activity aimed at rapidly evaluating therapeutic or preventative interventions. Ensuring rapid public access to the complete and unbiased trial record is particularly critical for pandemic research given the urgent associated public health needs. The World Health Organization (WHO) established standards requiring posting of results to a registry within 12 months of trial completion and publication in a peer reviewed journal within 24 months of completion, though compliance with these requirements among pandemic trials is unknown.

METHODS

This cross-sectional analysis characterizes availability of results in trial registries and publications among registered trials performed during the 2009 H1N1 influenza, 2014 Ebola, and 2016 Zika pandemics. We searched trial registries to identify clinical trials testing interventions related to these pandemics, and determined the time elapsed between trial completion and availability of results in the registry. We also performed a comprehensive search of MEDLINE via PubMed, Google Scholar, and EMBASE to identify corresponding peer reviewed publications. The primary outcome was the compliance with either of the WHO's established standards for sharing clinical trial results. Secondary outcomes included compliance with both standards, and assessing the time elapsed between trial completion and public availability of results.

RESULTS

Three hundred thirty-three trials met eligibility criteria, including 261 H1N1 influenza trials, 60 Ebola trials, and 12 Zika trials. Of these, 139 (42%) either had results available in the trial registry within 12 months of study completion or had results available in a peer-reviewed publication within 24 months. Five trials (2%) met both standards. No results were available in either a registry or publication for 59 trials (18%). Among trials with registered results, a median of 42 months (IQR 16-76 months) elapsed between trial completion and results posting. For published trials, the median elapsed time between completion and publication was 21 months (IQR 9-34 months). Results were available within 24 months of study completion in either the trial registry or a peer reviewed publication for 166 trials (50%).

CONCLUSIONS

Very few trials performed during prior pandemic events met established standards for the timely public dissemination of trial results.

Web-based survey among animal researchers on publication practices and incentives for increasing publication rates

OBJECTIVES

Publication bias, non-publication, and selective reporting of animal studies limit progress toward the 3Rs (Replacement, Reduction, and Refinement) that guide ethical animal testing, waste public resources, and result in redundant research, which collectively undermine the public's trust in scientific reliability. In this study, we aimed to 1) validate findings from a previous follow-up study by our team that examined the publication rates of animal studies from protocol to publication and 2) identify incentives for improving publication rates in animal research.

METHODS

The researchers responsible for the animal proposals (n = 210) from our previous study were contacted as participants for a Web-based survey between October 2019 and April 2020. Question types varied between free text questions, answer options based on a 5-point Likert scale and closed yes/no questions.

RESULTS

In total, 78 researchers responsible for 101 of 210 animal study proposals participated, yielding a response rate of 48.1%. Results showed that the publication rate increased from 67% in our follow-up study to 70%. According to a 5-point Likert scale (from 1 = "not relevant" to 5 = "extremely relevant"), the most widely accepted suggestions for increasing publication rates were "Publication costs for open access journals are fully covered by funders or universities" (mean 4.02, SD 1.01), "Performance-based allocation of intramural funds for results reporting of animal research not supporting the initial hypothesis (including preprints and repositories)" (mean 3.37, SD 1.05), and "Researchers receive more information from scientific journals that also publish non-significant results" (mean 3.30, SD 1.02).

CONCLUSION

While the extent of publication and publication practices have been thoroughly investigated for clinical trials, less data is available for animal research to date. Therefore, the study contributes in complementing the picture of publication practice in animal research. Suggestions from our survey may help improve the publication rates of animal studies.

Publication rates of hematology/oncology abstracts presented at major pharmacy association meetings

INTRODUCTION

Professional conferences are where research findings are initially presented. Studies suggest many research ideas presented at conferences are never published. Previous studies have demonstrated that the full publication rate of abstracts presented at pharmacy meetings is approximately 20%. The objective of this study was to determine the full publication rate of hematology/oncology abstracts presented at major pharmacy organization annual meetings.

METHODS

A systematic search of PubMed and Google Scholar was performed. Publication status was evaluated for hematology/oncology abstracts presented at annual meetings for the following organizations: American College of Clinical Pharmacy Annual Meeting, American Society of Health-System Pharmacists Midyear Clinical Meeting, Hematology/Oncology Pharmacy Association Annual Meeting, and International Society of Oncology Pharmacy Practitioners Annual Meeting. Data collected included the meeting of abstract presentation, number of authors, abstract study type, country of origin, journal of publication, and type of publication. Abstracts presented as trainee research were excluded.

RESULTS

Of 451 oncology abstracts evaluated, the most common topic categories included pharmacotherapy (n = 244; 54.1%), clinical pharmacy practice (n = 84; 18.6%), and operational/compounding (n = 69; 15.3%). The overall publication rate was 17.5% (n = 79). Abstracts were published as full manuscripts over a spread of 48 different journals. Factors associated with full publication included abstracts with more than 5 authors (OR 3.86, 95% CI 2.32-6.43; p < 0.0001) and abstracts presented at oncology-focused pharmacy meetings (OR 2.92, 95% CI 1.49-5.72; p = 0.0018).

CONCLUSION

This study showed an overall publication rate of 17.5% for abstracts presented at pharmacy meetings, consistent with prior studies.

Publication rates of research projects of an internal funding program of a university medical center in Germany: A retrospective study (2004-2013)

Objectives

Non-publication and publication bias are topics of considerable importance to the scientific community. These issues may limit progress toward the 3R principle for animal research, promote waste of public resources, and generate biased interpretations of clinical outcomes. To investigate current publishing practices and to gain some understanding of the extent to which research results are reported, we examined publication rates of research projects that were approved within an internal funding program of the Faculty of Medicine at a university medical center in Germany, which is exemplary for comparable research funding programs for the promotion of young researchers in Germany and Europe.

Methods

We analyzed the complete set (n = 363) of research projects that were supported by an internal funding program between 2004 and 2013. We divided the projects into four different proposal types that included those that required an ethics vote, those that included an animal proposal, those that included both requirements, and those that included neither requirement.

Results

We found that 65% of the internally funded research projects resulted in at least one peer-reviewed publication; this increased to 73% if other research contributions were considered, including abstracts, book and congress contributions, scientific posters, and presentations. There were no significant differences with respect to publication rates based on (a) the clinic/institute of the applicant, (b) project duration, (c) scope of funding or (d) proposal type.

Conclusion

To the best of our knowledge, this is the first study to explore publication rates associated with early-career medical research funding. As >70% of the projects ultimately generated some form of publication, the program was overall effective toward this goal; however, non-publication of research results is still prevalent. Further research will explore the reasons underlying non-publication. We hope to use these findings to develop strategies that encourage publication of research results.

Publication and related bias in quantitative health services and delivery research: a multimethod study

Background

Bias in the publication and reporting of research findings (referred to as publication and related bias here) poses a major threat in evidence synthesis and evidence-based decision-making. Although this bias has been well documented in clinical research, little is known about its occurrence and magnitude in health services and delivery research.

Objectives

To obtain empirical evidence on publication and related bias in quantitative health services and delivery research; to examine current practice in detecting/mitigating this bias in health services and delivery research systematic reviews; and to explore stakeholders’ perception and experiences concerning such bias.

Methods

The project included five distinct but interrelated work packages. Work package 1 was a systematic review of empirical and methodological studies. Work package 2 involved a survey (meta-epidemiological study) of randomly selected systematic reviews of health services and delivery research topics (n = 200) to evaluate current practice in the assessment of publication and outcome reporting bias during evidence synthesis. Work package 3 included four case studies to explore the applicability of statistical methods for detecting such bias in health services and delivery research. In work package 4 we followed up four cohorts of health services and delivery research studies (total n = 300) to ascertain their publication status, and examined whether publication status was associated with statistical significance or perceived ‘positivity’ of study findings. Work package 5 involved key informant interviews with diverse health services and delivery research stakeholders (n = 24), and a focus group discussion with patient and service user representatives (n = 8).

Results

We identified only four studies that set out to investigate publication and related bias in health services and delivery research in work package 1. Three of these studies focused on health informatics research and one concerned health economics. All four studies reported evidence of the existence of this bias, but had methodological weaknesses. We also identified three health services and delivery research systematic reviews in which findings were compared between published and grey/unpublished literature. These reviews found that the quality and volume of evidence and effect estimates sometimes differed significantly between published and unpublished literature. Work package 2 showed low prevalence of considering/assessing publication (43%) and outcome reporting (17%) bias in health services and delivery research systematic reviews. The prevalence was lower among reviews of associations than among reviews of interventions. The case studies in work package 3 highlighted limitations in current methods for detecting these biases due to heterogeneity and potential confounders. Follow-up of health services and delivery research cohorts in work package 4 showed positive association between publication status and having statistically significant or positive findings. Diverse views concerning publication and related bias and insights into how features of health services and delivery research might influence its occurrence were uncovered through the interviews with health services and delivery research stakeholders and focus group discussion conducted in work package 5.

Conclusions

This study provided prima facie evidence on publication and related bias in quantitative health services and delivery research. This bias does appear to exist, but its prevalence and impact may vary depending on study characteristics, such as study design, and motivation for conducting the evaluation. Emphasis on methodological novelty and focus beyond summative assessments may mitigate/lessen the risk of such bias in health services and delivery research. Methodological and epistemological diversity in health services and delivery research and changing landscape in research publication need to be considered when interpreting the evidence. Collection of further empirical evidence and exploration of optimal health services and delivery research practice are required.

Study registration

This study is registered as PROSPERO CRD42016052333 and CRD42016052366.

Funding

This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 33. See the NIHR Journals Library website for further project information.

Publication and related biases in health services research: a systematic review of empirical evidence

Background

Publication and related biases (including publication bias, time-lag bias, outcome reporting bias and p-hacking) have been well documented in clinical research, but relatively little is known about their presence and extent in health services research (HSR). This paper aims to systematically review evidence concerning publication and related bias in quantitative HSR.

Methods

Databases including MEDLINE, EMBASE, HMIC, CINAHL, Web of Science, Health Systems Evidence, Cochrane EPOC Review Group and several websites were searched to July 2018. Information was obtained from: (1) Methodological studies that set out to investigate publication and related biases in HSR; (2) Systematic reviews of HSR topics which examined such biases as part of the review process. Relevant information was extracted from included studies by one reviewer and checked by another. Studies were appraised according to commonly accepted scientific principles due to lack of suitable checklists. Data were synthesised narratively.

Results

After screening 6155 citations, four methodological studies investigating publication bias in HSR and 184 systematic reviews of HSR topics (including three comparing published with unpublished evidence) were examined. Evidence suggestive of publication bias was reported in some of the methodological studies, but evidence presented was very weak, limited in both quality and scope. Reliable data on outcome reporting bias and p-hacking were scant. HSR systematic reviews in which published literature was compared with unpublished evidence found significant differences in the estimated intervention effects or association in some but not all cases.

Conclusions

Methodological research on publication and related biases in HSR is sparse. Evidence from available literature suggests that such biases may exist in HSR but their scale and impact are difficult to estimate for various reasons discussed in this paper.

Systematic review registration

PROSPERO 2016 CRD42016052333.

Ethical arguments concerning human-animal chimera research: a systematic review

Background

The burgeoning field of biomedical research involving the mixture of human and animal materials has attracted significant ethical controversy. Due to the many dimensions of potential ethical conflict involved in this type of research, and the wide variety of research projects under discussion, it is difficult to obtain an overview of the ethical debate. This paper attempts to remedy this by providing a systematic review of ethical reasons in academic publications on human-animal chimera research.

Methods

We conducted a systematic review of the ethical literature concerning human-animal chimeras based on the research question: “What ethical reasons have been given for or against conducting human-animal chimera research, and how have these reasons been treated in the ongoing debate?” Our search extends until the end of the year 2017, including MEDLINE, Embase, PhilPapers and EthxWeb databases, restricted to peer-reviewed journal publications in English. Papers containing ethical reasons were analyzed, and the reasons were coded according to whether they were endorsed, mentioned or rejected.

Results

Four hundred thirty-one articles were retrieved by our search, and 88 were ultimately included and analyzed. Within these articles, we found 464 passages containing reasons for and against conducting human-animal chimera research. We classified these reasons into five categories and, within these, identified 12 broad and 31 narrow reason types.

15% of the retrieved passages contained reasons in favor of conducting chimera research (Category P), while 85% of the passages contained reasons against it. The reasons against conducting chimera research fell into four further categories: reasons concerning the creation of a chimera (Category A), its treatment (Category B), reasons referring to metaphysical or social issues resulting from its existence (Category C) and to potential downstream effects of chimera research (Category D). A significant proportion of identified passages (46%) fell under Category C.

Conclusions

We hope that our results, in revealing the conceptual and argumentative structure of the debate and highlighting some its most notable tendencies and prominent positions, will facilitate continued discussion and provide a basis for the development of relevant policy and legislation.

Assessment of Consistency Between Peer-Reviewed Publications and Clinical Trial Registries

Importance

Clinical trial registries are intended to increase clinical research transparency by nonselectively identifying and documenting clinical trial designs and outcomes. Inconsistencies in reported data undermine the utility of such registries and have previously been noted in general medical literature.

Objective

To assess whether inconsistencies in reported data exist between ophthalmic literature and clinical trial registries.

Design, Setting, and Participants

In this retrospective, cross-sectional study, interventional clinical trials published from January 1, 2014, to December 31, 2014, in the American Journal of Ophthalmology, JAMA Ophthalmology, and Ophthalmology were reviewed. Observational, retrospective, uncontrolled, and post hoc reports were excluded, yielding a sample size of 106 articles. Data collection was performed from January through September 2016. Data review and adjudication continued through January 2017.

Main Outcomes and Measures

If possible, articles were matched to registry entries listed in the ClinicalTrials.gov database or in 1 of 16 international registries indexed by the World Health Organization International Clinical Trials Registry Platform version 3.2 search engine. Each article-registry pair was assessed for inconsistencies in design, results, and funding (each of which was further divided into subcategories) by 2 reviewers and adjudicated by a third.

Results

Of 106 trials that met the study criteria, matching registry entries were found for 68 (64.2%), whereas no matching registry entries were found for 38 (35.8%). Inconsistencies were identified in study design, study results, and funding sources, including specific interventions in 8 (11.8%), primary outcome measure (POM) designs in 32 (47.1%), and POM results in 48 (70.6%). In addition, numerous data pieces were unreported, including analysis methods in 52 (76.5%) and POM results in 38 (55.9%).

Conclusions and Relevance

Clinical trial registries were underused in this sample of ophthalmology clinical trials. For studies with registry data, inconsistency rates between published and registered data were similar to those previously reported for general medical literature. In most cases, inconsistencies involved missing data, but explicit discrepancies in methods and/or data were also found. Transparency and credibility of published trials may be improved by closer attention to their registration and reporting.

Should research misconduct be criminalized?

For more than 25 years, research misconduct (research fraud) is defined as fabrication, falsification, or plagiarism (FFP)—although other research misbehaviors have been also added in codes of conduct and legislations. A critical issue in deciding whether research misconduct should be subject to criminal law is its definition, because not all behaviors labeled as research misconduct qualifies as serious crime. But assuming that all FFP is fraud and all non-FFP not is far from obvious. In addition, new research misbehaviors have recently been described, such as prolific authorship, and fake peer review, or boosted such as duplication of images. The scientific community has been largely successful in keeping criminal law away from the cases of research misconduct. Alleged cases of research misconduct are usually looked into by committees of scientists usually from the same institution or university of the suspected offender in a process that often lacks transparency. Few countries have or plan to introduce independent bodies to address research misconduct; so for the coming years, most universities and research institutions will continue handling alleged research misconduct cases with their own procedures. A global operationalization of research misconduct with clear boundaries and clear criteria would be helpful. There is room for improvement in reaching global clarity on what research misconduct is, how allegations should be handled, and which sanctions are appropriate.

Outcomes of nurse practitioner-led care in patients with cardiovascular disease: A systematic review and meta-analysis

Aim

To assess randomized controlled trials evaluating the impact of nurse practitioner‐led cardiovascular care.

Background

Systematic review of nurse practitioner–led care in patients with cardiovascular disease has not been completed.

Design

Systematic review and meta‐analysis.

Data sources

The Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, CINAHL, Web of Science, Scopus and ProQuest were systematically searched for studies published between January 2007 ‐ June 2017.

Review Methods

Cochrane methodology was used for risk of bias, data extraction and meta‐analysis. The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation approach.

Results

Out of 605 articles, five articles met the inclusion criteria. There was no statistical difference between nurse practitioner‐led care and usual care for 30‐day readmissions, health‐related quality of life and length of stay. A 12% reduction in Framingham risk score was identified.

Conclusion

There are a few randomized control trials assessing nurse practitioner‐led cardiovascular care.

Impact

Low to moderate quality evidence was identified with no statistically significant associated outcomes of care. Nurse practitioner roles need to be supported to conduct and publish high‐quality research.

Effectiveness of Food Handler Training and Education Interventions: A Systematic Review and Meta-Analysis

Improper food handling among those working in retail and food service settings is a frequent contributor to foodborne illness outbreaks. Food safety training and education interventions are important strategies to improve the behaviors and behavioral precursors (e.g., knowledge and attitudes) of food handlers in these settings. We conducted a comprehensive systematic review to identify, characterize, and synthesize global studies in this area to determine the overall effectiveness of these interventions. The review focused on experimental studies with an independent control group. Review methods included structured search strategy, relevance screening of identified abstracts, characterization of relevant articles, risk of bias assessment, data extraction, meta-analysis of intervention effectiveness for four outcome categories (attitudes, knowledge, behavior, and food premise inspection scores), and a quality of evidence assessment. We identified 18 relevant randomized controlled trials (RCTs) and 29 nonrandomized trials. Among RCTs, 25 (64%) unique outcomes were rated as high risk of bias, primarily owing to concerns about outcome measurement methods, while 45 (98%) nonrandomized trial outcomes were rated as serious risk of bias, primarily because of concerns about confounding bias. High confidence was identified for the effect of training and education interventions to improve food handler knowledge outcomes in eight RCT studies (standardized mean difference = 0.92; 95% confidence interval: 0.03, 1.81; I² = 86%). For all other outcomes, no significant effect was identified. In contrast, nonrandomized trials identified a statistically significant positive intervention effect for all outcome types, but confidence in these findings was very low due to possible confounding and other biases. Results indicate that food safety training and education interventions are effective to improve food handler knowledge, but more evidence is needed on strategies to improve behavior change.

Publishing Without Perishing: A Guide to the Successful Reporting of Clinical Data

Many researchers find writing a scientific manuscript a highly discouraging task. This problem may be partly responsible for the fact that approximately half of completed clinical studies worldwide remain unreported or unpublished. Therefore, we aimed to create a user-friendly guide with helpful recommendations, which are complementary to the many existing reporting guidelines for quantitative clinical data. This article has been prepared with clearly defined subheadings, to facilitate quick identification of any specific sections/topics. We encourage the use of the IMRaD model (ie, Introduction, Methods, Results, and Discussion), providing guidance on the key information required, as well as the dos and don’ts. We also comment briefly on feedback and rejection, proposing the I AM approach (Ignore, Address, and Move on).

Publication in a medical student journal predicts short- and long-term academic success: a matched-cohort study

BACKGROUND

Medical student journals play a critical role in promoting academic research and publishing amongst medical students, but their impact on students' future academic achievements has not been examined. We aimed to evaluate the short- and long-term effects of publication in the New Zealand Medical Student Journal (NZMSJ) through examining rates of post-graduation publication, completion of higher academic degrees, and pursuing an academic career.

METHODS

Student-authored original research publications in the NZMSJ during the period 2004-2011 were retrospectively identified. Gender-, university- and graduation year-matched controls were identified from publicly available databases in a 2:1 ratio (two controls for each student authors). Date of graduation, current clinical scope of practice, completion of higher academic degrees, and attainment of an academic position for both groups were obtained from Google searches, New Zealand graduate databases, online lists of registered doctors in New Zealand and Australia, and author affiliation information from published articles. Pre- and post-graduation PubMed®-indexed publications were identified using standardised search criteria.

RESULTS

Fifty publications authored by 49 unique students were identified. The median follow-up period after graduation was 7.0 years (range 2-12 years). Compared with controls, student-authors were significantly more likely to publish in PubMed®-indexed journals (OR 3.09, p = 0.001), obtain a PhD (OR 9.21, p = 0.004) or any higher degree (OR 2.63, p = 0.007), and attain academic positions (OR 2.90, p = 0.047) following graduation.

CONCLUSION

Publication in a medical student journal is associated with future academic achievement and contributes to develop a clinical academic workforce. Future work should aim to explore motivators and barriers associated with these findings.

Cross-sectional analysis on publication status and age representation of clinical studies addressing mechanical ventilation and ventilator-induced lung injury in infants and children

OBJECTIVES

We determined the number and time-to-public availability of study results of published and unpublished clinical studies in paediatric mechanical ventilation (MV) and ventilator-induced lung injury (VILI), which were registered as completed on ClinicalTrials.gov. Furthermore, we explored the pattern of represented research study subtopics and the corresponding study populations.

SETTING

Literature search based on ClinicalTrials.gov, PubMed and Google Scholar from 9 July 2017 to 27 September 2017.

PRIMARY AND SECONDARY OUTCOME MEASURES

Assessment, if studies included in our analysis had been published. Assessment of primary research focus, patient enrolment and age representation of the analysed studies.

RESULTS

We identified n=109 registered and completed clinical studies on paediatric MV and VILI (enrolment: 22 233 participants). 71% were published, including data from 18 647 subjects. 29% of studies were unpublished, containing data from 3586 subjects. Median time-to-public availability of study results was 22 (IQR, 12.8-41.5) months. The most important study subtopics were biophysical and technical aspects of MV (32 studies), administration of drugs to mitigate VILI through various mechanisms (40 studies) and diagnostic procedures (16 studies). n=66/109 (61%) studies exclusively focused on children below 1 year of age and n=2/109 (2%) exclusively on children between 1 and 14 years.

CONCLUSIONS

One-third of clinical studies in paediatric MV and VILI registered as completed on ClinicalTrials.gov remained unpublished and contained data on 3586 study participants. The overall median time-to-public availability of study results was longer than the deadline of 12 months mandated by the Food and Drug Administration Amendment Act of 2007. Important and clinically relevant research study subtopics were represented in the research questions investigated in paediatric MV and VILI. The study population was skewed towards children younger than 1 year which indicates, that there is a substantial need for clinical VILI research in older children.

Conversion of Skeletal Society of Radiology annual meeting abstracts to publications in 2010-2015

Background

Material presented at conferences is meant to provide exposure to ongoing research that could affect medical decision making based on future outcomes. It is important then to evaluate the rates of publication from conference presentations as a measure of academic quality as such research has undergone peer review and journal acceptance. The purpose of this study is to evaluate the fate of abstracts presented at the Skeletal Society of Radiology Annual Meetings from 2010-2015.

Materials and Methods

Conference abstracts were searched using Google, Google Scholar, and PubMed (which includes Medline) to locate the corresponding published reports. The data recorded for published studies included date published online, in print, or both; the journal in which it was published; and the 5-year journal impact factor. When an abstract was not confirmed as published, authors were contacted by email to verify its publication status or, if not published, the reason for nonpublication.

Results

A total of 162 abstracts were published out of 320 presented (50.6%) at the SSR conferences from 2010 to 2015 with 59.9% (85/142) of publications occurring within two years of the conference date (not counting abstracts published prior to conference). Mean time to publication was 19 months and is calculated by excluding the 20 (12.3%) abstracts that were published prior to the conference date. The median time to publication is 13 months (25th-75th percentile: 6.25-21.75). The top two journals publishing research studies from this conference were Skeletal Radiology and The American Journal of Roentgenology. These journals accepted 72 of the 162 (44.4%) studies for publication. Of the 14 authors who responded with 17 reasons for not publishing, the most common reasons were lack of time (7-41.2%), results not important enough (4-23.5%), publication not an aim (3-17.6%), and lack of resources (3-17.6%).

Discussion

At least half of the abstracts presented at the annual meeting for the Society of Skeletal Radiology are accepted for publication in a peer-reviewed journal. The majority (59.9%) of these publications were achieved within two years of the conference presentation. The rate at which presentations are published and the journals that accept the abstracts can potentially be used to compare the importance and quality of information at conferences.

An observational analysis of discontinuation and non-publication of osteoarthritis trials

OBJECTIVE

Discontinuation and nonpublication are causes for concern in highly funded research areas of prevalent medical conditions. The aim of our study is to evaluate the rate of discontinuation and nonpublication in osteoarthritis randomized controlled clinical trials.

DESIGN

We used the ClinicalTrials.gov advanced search using the keyword "osteoarthritis" for phase 3 or phase 4 clinical trials in adults. Two investigators then independently screened the search results by registered title, condition, study design, and completion date. We then performed a systematic search to determine the publication status of the study.

RESULTS

Our final analysis included 273 studies. Our analysis of these studies included 243 (89%) completed and 30 (11%) discontinued trials. A total of 121,307 (92%) and 10,368 (8%) patients participated in completed and discontinued trials, respectively. Following our searches of PubMed, Embase, and Google Scholar, we identified 67 of the 243 (27.6%) studies as completed but having not reached publication in manuscript form.

CONCLUSIONS

If discontinuation and non-publication rates in osteoarthritis trials continue to be sub-optimal, already scarce research resources will continue to be wasted. One possible explanation for the witnessed nonpublication that warrants further investigation is the issue of publication bias or selective reporting bias, two known problems that decrease research productivity and ethics.

Publication status of completed registered studies in paediatric appendicitis: a cross-sectional analysis

OBJECTIVE

Appendicitis is considered the most frequent surgical emergency in children. While the management of paediatric appendicitis is evolving, the precise amount of unpublished completed trials, potentially introducing bias into meta-analyses, is unknown. Controversial issues include the appropriate choice of surgical procedures, criteria for diagnosis of appendicitis, the role of antibiotic treatment and pain management. Selective reporting may introduce bias into evidence-based clinical decision-making, and the current, precise extent of unpublished results in paediatric appendicitis is unknown. We therefore assessed the publication status of completed clinical studies involving children registered on ClinicalTrials.gov.

DESIGN

Cross sectional analysis. STrengthening the Reporting of OBservational studies in Epidemiology criteria were applied for design and analysis.

SETTING AND PARTICIPANTS

ClinicalTrials.gov was queried for completed studies which were matched to publications on ClinicalTrials.gov, PubMed or Google Scholar. If no publication could be identified, principal investigators were contacted.

INTERVENTIONS/EXPOSURE

Observational analysis.

PRIMARY AND SECONDARY OUTCOME MEASURES

The proportion of published and unpublished studies was calculated. Subgroup analysis included studies on surgical procedures, diagnosis, antibiotic treatment and pain management.

RESULTS

Out of n=52 completed clinical studies involving children with appendicitis, n=33 (63%) were published and n=19 (37%) were unpublished. Eighty-three per cent (n=43/52) of clinical trials assessed the above-listed controversial issues. Diagnostic studies were most rigorously published (91% of trials reported), data on surgical procedures, antibiotic and pain management were less transparent. Sixty-six per cent of interventional studies and 60% of randomised studies were published. Median time-to-publication, for example, the delay between completion of the trial until public availability of the results was 24 (IQR 12-36), range 2-92 months.

CONCLUSION

Despite the importance of appendicitis in clinical practice for the paediatric surgeon, there remains scientific uncertainty due to unpublished clinical trial results with room for improvement in the future. These data are helpful in framing the shifting paradigms in paediatric appendicitis because it adds transparency to the debate.

Is publication bias present in gastroenterological research? An analysis of abstracts presented at an annual congress

Background

Publication bias is the tendency of investigators, reviewers, and editors to submit or accept manuscripts for publication based on their direction or strength of findings. In this study, we investigated if publication bias was present in gastroenterological research by evaluating abstracts at Americas Hepato-Pancreato-Biliary Congresses from 2011 to 2013.

Methods

We searched Google, Google Scholar, and PubMed to locate the published reports of research described in these abstracts. If a publication was not found, a second investigator searched to verify nonpublication. If abstract publication status remained undetermined, authors were contacted regarding reasons for nonpublication. For articles reaching publication, the P value, study design, time to publication, citation count, and journals in which the published report appeared were recorded.

Results

Our study found that of 569 abstracts presented, 297 (52.2%) reported a P value. Of these, 254 (85.5%) contained P values supporting statistical significance. The abstracts reporting a statistically significant outcome were twice as likely to reach publication than abstracts with no significant findings (OR 2.10, 95% CI [1.06–4.14]). Overall, 243 (42.7%) abstracts reached publication. The mean time to publication was 14 months and a median time of nine months.

Conclusion

In conclusion, we found evidence for publication bias in gastroenterological research. Abstracts with significant P values had a higher probability of reaching publication. More than half of abstracts presented from 2011 to 2013 failed to reach publication. Readers should take these findings into consideration when reviewing medical literature.

Publication rates of podium and poster abstract presentations at the 2010 and 2011 society of gynecologic oncology conferences

Objective

This study aimed to determine the publication rate of oral and poster abstracts presented at the 2010 and 2011 Society of Gynecologic Oncology (SGO) conferences as well as the journals that most commonly published these studies, their 5-year impact factor, the time to publication, and the reasons for nonpublication.

Methods

Abstracts presented at the 2010-2011 SGO conferences were included in this study. We searched Google, Google Scholar, and PubMed to locate published reports of these abstracts. If an abstract's full-text manuscript could not be located, an author of the conference abstract was contacted via email to inquire whether the research was published. If the research was unpublished, the authors were asked to provide the reason for nonpublication. The time to publication, journal, and journal impact factor were noted for abstracts that reached full-text publication.

Results

A total of 725 abstracts were identified, of which 386 (53%) reached publication in a peer-reviewed journal. Oral presentations were published at a higher rate than poster presentations. Most (70%) reached publication within 2 years of abstract presentation. Abstracts were published in 89 journals, but most (39%) were published in Gynecologic Oncology. The mean time to publication was 15.7 months, with a mean 5-year impact factor of 4.956.

Conclusions

A 53% publication rate indicates that the SGO conference selection process favors research likely to be published and, thus, presumably of high quality. The overall publication rate is higher than that reported for many other biomedical conferences.

Conversion of Plastic Surgery meeting abstract presentations to full manuscripts: a brazilian perspective

Objective

to assess the conversion rate of Plastic Surgery meeting abstract presentations to full manuscript publications and examine factors associated with this conversion.

Methods

we assessed the abstracts presented at the 47th and 48th Brazilian Congresses of Plastic Surgery by cross-referencing with multiple databases. We analyzed the Abstracts' characteristics associated with full manuscript publications.

Results

of the 200 abstracts presented, 50 abstracts were subsequently published in full, giving the conference a conversion rate of 25%. The mean time to publish was 15.00±13.75 months. In total, there were 4.93±1.63 authors per abstract and 67.8±163 subjects per abstract; 43.5% of the abstracts were of retrospective studies; 69% comprised the plastic surgery topics head and neck, and chest and trunk, and 88.5% had no statistical analysis. Overall, 80% of the manuscripts were published in plastic surgery journals, 76% had no impact factor and 52% had no citations. Bivariate and multivariate analyses revealed the presence of statistical analysis to be the most significant (p<0.05) predictive factor of conversion of abstracts into full manuscripts.

Conclusion

the conversion rate found from this bibliometric research appeared a bit lower than the conversion trend of international plastic surgery meetings, and statistical analysis was a determinant of conversion success.

Conditional equivalence testing: An alternative remedy for publication bias

We introduce a publication policy that incorporates "conditional equivalence testing" (CET), a two-stage testing scheme in which standard NHST is followed conditionally by testing for equivalence. The idea of CET is carefully considered as it has the potential to address recent concerns about reproducibility and the limited publication of null results. In this paper we detail the implementation of CET, investigate similarities with a Bayesian testing scheme, and outline the basis for how a scientific journal could proceed to reduce publication bias while remaining relevant.

Full-text publication of abstract-presented work in sport and exercise psychology

Objectives

Meetings promote information sharing, but do not enable full dissemination of details. A systematic search was conducted for abstracts presented at the 2010 and 2011 Association of Applied Sport Psychology Annual Conferences to determine the full-text dissemination rate of work presented in abstract form and investigate factors influencing this rate.

Methods

Systematic searches were sequentially conducted to determine whether the abstract-presented work had been published in full-text format in the 5 years following presentation. If a potential full-text publication was identified, information from the conference abstract (eg, results, number of participants in the sample(s), measurement tools used and so on) was compared with the full text to ensure the two entities represented the same body of work. Abstract factors of interest were assessed using logistic regression.

Results

Ninety-four out of 423 presented abstracts (22.2%) were published in full text. Odds of full-text publication increased if the abstract was from an international institution, presented in certain conference sections or presented as a lecture.

Conclusion

Those attending professional conferences should be cautious when translating data presented at conferences into their applied work because of the low rate of peer-reviewed and full-text publication of the information.

Reporting bias in imaging: higher accuracy is linked to faster publication

OBJECTIVES

The objective of this study was to evaluate whether higher reported accuracy estimates are associated with shorter time to publication among imaging diagnostic accuracy studies.

METHODS

We included primary imaging diagnostic accuracy studies, included in meta-analyses from systematic reviews published in 2015. For each primary study, we extracted accuracy estimates, participant recruitment periods and publication dates. Our primary outcome was the association between Youden's index (sensitivity + specificity - 1, a single measure of diagnostic accuracy) and time to publication.

RESULTS

We included 55 systematic reviews and 781 primary studies. Study completion dates were missing for 238 (30%) studies. The median time from completion to publication in the remaining 543 studies was 20 months (IQR 14-29). Youden's index was negatively correlated with time from completion to publication (rho = -0.11, p = 0.009). This association remained significant in multivariable Cox regression analyses after adjusting for seven study characteristics: hazard ratio of publication was 1.09 (95% CI 1.03-1.16, p = 0.004) per unit increase for logit-transformed estimates of Youden's index. When dichotomizing Youden's index by a median split, time from completion to publication was 20 months (IQR 13-33) for studies with a Youden's index below the median, and 19 months (14-27) for studies with a Youden's index above the median (p = 0.104).

CONCLUSION

Imaging diagnostic accuracy studies with higher accuracy estimates were weakly associated with a shorter time to publication.

KEY POINTS

• Higher accuracy estimates are weakly associated with shorter time to publication. • Lag in time to publication remained significant in multivariate Cox regression analyses. • No correlation between accuracy and time from submission to publication was identified.

Hearing loss, lead (Pb) exposure, and noise: a sound approach to ototoxicity exploration

To determine the state of the research on ototoxic properties of Pb, evaluate possible synergistic effects with concurrent noise exposure, and identify opportunities to improve future research, we performed a review of the peer-reviewed literature to identify studies examining auditory damage due to Pb over the past 50 years. Thirty-eight studies (14 animal and 24 human) were reviewed. Of these, 24 suggested potential ototoxicity due to Pb exposure, while 14 found no evidence of ototoxicity. More animal studies are needed, especially those investigating Pb exposure levels that are occupationally and environmentally relevant to humans. Further investigations into potential interactions of Pb in the auditory system with other hazards and compounds that elicit ototoxicity are also needed in animal models. To better assess the effects of Pb exposure on the human auditory system and the possibility of a synergism with noise, future epidemiological studies need to carefully consider and address four main areas of uncertainty: (1) hearing examination and quantification of hearing loss, (2) Pb exposure evaluation, (3) noise exposure evaluation, and (4) the personal characteristics of those exposed. Two potentially confounding factors, protective factors and mixtures of ototoxicants, also warrant further exploration.

Publication Rates in Podium and Poster Presentations at the 2012-2014 American Association of Hip and Knee Surgeons Annual Meetings

BACKGROUND

Subspecialty conferences are an important forum for disseminating the latest research relevant to clinical practice. The purpose of this study was to identify publication rates in podium and poster abstracts for the American Association of Hip and Knee Surgeons (AAHKS) Annual Meeting and to identify the most common journals of publication and the reasons for nonpublication.

METHODS

Six hundred ten accepted abstracts (182 podium presentations, 428 posters) from the 2012-2014 AAHKS meetings were searched using Google, Google Scholar, and PubMed. If an abstract could not be found after efforts by multiple searchers, the first author was emailed to determine where the research was published or why it was not published. For articles that were published, the journal, time to publication, and journal impact factor were noted.

RESULTS

The overall rate of publication was 71% (436/610). Podium presentations (164/182, 90%) were published at a higher rate than posters (271/428, 63%). The most common journal of publication was the Journal of Arthroplasty (218/436, 50%), followed by Clinical Orthopaedics and Related Research (77/436, 18%) and The Journal of Bone and Joint Surgery (40/436, 9%). Average time to publication was 14.5 months (range, -4 to 44 months) from the date of the conference in which it was presented.

CONCLUSION

Presentations at the AAHKS annual meeting have an impressive rate of publication. The research presented at the meeting is impactful and high quality, warranting consideration for future publication.