European Journal of Internal Medicine 26 (2015) 141–142

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Letter to the Editor Abstract-to-publication ratio and predictors for publication success for papers presented at the Italian Emergency Medicine Meeting: A cross-sectional study Keywords: Education Methods Research Clinical Teaching

It has been suggested that the quality of research output from a scientific meeting may be roughly estimated through the rate of presented abstracts which are subsequently published as full-text reports in international indexed journals, namely abstract-to publication rate (A:P) [1]. However, a recent review [2] pointed out a less than half A:P from Anglo-Saxon countries, raising the concern that an even lower A:P could be find out of the not English speaking world. We performed a cross-sectional study to assess the A:P for presentations from a recent Italian national emergency medicine conference and to investigate factors correlating with the publication success. All 298 abstracts from the 2008 Italian Society of Emergency Medicine were reviewed. Blinded to the authors and publication status, 2 investigators recorded: format (oral, poster), language (Italian, English), presence of academic authors, study population ≥ 100 units, study type (basic or clinical research) and design: Randomized Controlled Trial (RCT), observational cohort study, case report, or narrative report. Reviewers assigned global ratings for methodological quality by using: the Jadad Scale [3] for RCTs with ≥3 as good quality cut-off, the instructions for case reporting by Sorinola et al. [4] for case reports, the JAMA

Evidence Users' Guides to an article about diagnostic tests [5] and the JAMA Evidence Users' Guides to an article about prognosis [5] for observational cohort studies. We attributed one point to each fulfilled instruction and made the sum. The ratio between the calculated score and the maximum potentially achievable was used as Quality Ratio (QR). We defined of “good quality” any abstract with a QR N 0.5. MEDLINE was searched from January 2008 to December 2012 using the name of the abstract authors, followed by important keywords for effective searching. Associations between publication status and all others parameters were analyzed by simple logistic regression using SPPS 16 (SPSS Inc.). A p value b0.05 was considered statistically significant. The main findings of this study are shown in Table 1. Of the 298 abstracts, 43 abstracts (14%) have been published. The predictive factors for future publication were: ‘good’ methodological quality of the abstract (Odds Ratio [OR] 16.95; 95% CI 7.47–38.50); study design, in favor of RCT (OR 11.05; 95% CI 2.53–48.13); basic research (OR 7.23; 95% CI 2.68–19.49); large study population (OR 5.60; 95% CI 2.83– 11.10); oral format (OR 3.00; 95% CI 1.55 to 5.84); and presence of academic authors (OR 2.39; 95% CI, 1.23–4.63). The main negative predictors were case report design (OR 0.18; 95% CI, 0.05–0.60) and Italian language (OR 0.14; 95% CI, 0.06–0.33). The A:P may allow us to assess the current research status and to compare it with international standards, even across other specialties. Our results (showing an A:P of 14%) suggest that emergency medicine in Italy in recent years has produced research to a lower standard compared with Australia (35%) [6], US (23–47%) [7] and UK (30%) [1]. This data could be affected by many factors, as a lower threshold in accepting abstracts for national congress presentations, language uneasiness, higher barriers to publication for papers coming from a non-AngloSaxon country, but it may also reflect a poorer quality of research. Indeed, we found that only few abstracts among unpublished ones had

Table 1 Comparison between the presented abstracts that were published and those that were not published in peer-reviewed journals. Characteristic

Total abstracts n = 298 (%)

Published abstracts n = 43 (%)

Unpublished abstracts n = 255 (%)

Odds ratio (95% IC)

p

Oral presentation Basic research Clinical research: RCT Cross-sectional and cohort study Case report Narrative study Italian language Study population N 100 patients ≥1 Foreign author Polycentric study ≥ 1 Academic author Good qualitya

112 (38) 18 (6) 280 (94) 8 (3) 91 (32) 78 (28) 103 (37) 270 (91) 86 (29) 8 (3) 21 (7) 88 (29) 46 (15)

26 (60) 9 (21) 34 (79) 5 (12) 26 (60) 3 (7) 0 (0) 30 (70) 27 (63) 1 (2) 4 (9) 20 (47) 22 (64)a

86 (34) 9 (3) 246 (96) 3 (1) 65 (26) 75 (29) 103 (40) 240 (94) 59 (23) 7 (3) 17 (7) 68 (27) 24 (10)a

3.00 (1.55–5.84) 7.23 (2.68–19.49) 0.14 (0.05–0.37) 11.05 (2.53–48.13) 4.47 (2.28–8.76) 0.18 (0.05–0.60) na 0.14 (0.06–0.33) 5.60 (2.83–11.10) 0.84 (0.10–7.03) 1.43 (0.46–4.49) 2.39 (1.23–4.63) 16.95 (7.47–38.50)

0.0008⁎ 0.0000⁎ 0.0000⁎ 0.0001⁎ 0.0000⁎ 0.002⁎ na 0.0000⁎ 0.0000⁎ 0.9 0.5 0.008 0.0000⁎

⁎ p b 0.05. a Good quality research was defined in the text; if we excluded basic research and narrative studies ex (because of the impossibility and the difficulty to apply our scores to them, respectively) than we found that 22 out of 34 published abstracts (65%) vs 24 out of 143 unpublished abstracts (17%) were of good methodological quality with an OR of 9.09 (CI95% 3.97 to 20.82).

http://dx.doi.org/10.1016/j.ejim.2014.12.003 0953-6205/© 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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Letter to the Editor

high quality scores compared to the published ones. In previous studies an association between full publication and study quality was not described [8]. In conclusion, we promote the use of our methodological quality evaluation to better select abstracts in (Italian emergency) medicine meeting and to increase efforts in publishing.

for Evidence-Based Clinical Practice. 2nd ed. McGraw-Hill; 2008. p. 419–37 (p. 509–520). [6] Walby A, Kelly A, Georgakas C. Abstract to publication ratio for papers presented at scientific meetings: how does emergency medicine compare? Emerg Med 2001;13: 460–4. [7] Korn CS, Henderson SO. Publication of research abstracts presented at four emergency medicine research forums. Acad Emerg Med 2000;7:534. [8] Weber E, Callaham M, Wears RL, et al. Unpublished research from a medical specialty meeting: why investigators fail to publish. JAMA 1998;280:257.

Conflict of interests The authors state that they have no conflicts of interest. References [1] Macmillan CD, Moore AK, Cook RJ, Pedley DK. Abstract-to-publication ratio for papers presented at scientific meetings: a quality marker for UK emergency medicine research. Emerg Med J 2007;24(6):425–6. [2] Scherer PW, Langenberg P, von Elm E. Full publication of results initially presented in abstracts. Cochrane Database Syst Rev 2007;18. [3] Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials 1996;17(1):1–12. [4] Sorinola O, Olufowobi O, Coomarasamy A. Khan SK Instructions to authors for case reporting are limited: a review of a core journal list. BMC Med Educ 2004;4:4. [5] Furukawa TA, Strauss S, Bucher HC, Guyatt G, Diagnostic test and Randolph A, Cook DJ, et al. Prognosis. In: Guyatt Gordon, Rennie Drummond, Meade Maureen O, Cook Deborah J, editors. JAMA Evidence. Users' Guides to the Medical Literature: A Manual

V.G. Menditto Department of Internal Medicine, Ospedali Riuniti di Ancona, Ancona, Italy Corresponding author at: Department of Internal Medicine Ospedali Riuniti di Ancona, Via Conca n.71, 60126 Ancona, Italy. Tel.: +39 71 5964061; fax: +39 71 5963012. E-mail address: [email protected]. S. Tedesco L. Manfredi L. Postacchini G. Pomponio Clinica Medica, Università Politecnica delle Marche, Ancona, Italy 12 December 2014

Abstract-to-publication ratio and predictors for publication success for papers presented at the Italian Emergency Medicine Meeting: a cross-sectional study.

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