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Peer Review Congress
July 15, 1998

Positive-Outcome Bias and Other Limitations in the Outcome of Research Abstracts Submitted to a Scientific Meeting

Author Affiliations

From the Division of Emergency Medicine (Drs Weber, Callaham, and Young), University of California, San Francisco; the Division of Emergency Medicine, University of Florida Health Center, Jacksonville (Dr Wears); the Department of Emergency Medicine, University of North Carolina, Chapel Hill (Dr Barton); and the Department of Emergency Medicine, Highland Hospital, Alameda County Medical Center, Oakland, Calif (Dr Young). Dr Young is now with Sacred Heart Medical Center, Eugene, Ore.

JAMA. 1998;280(3):254-257. doi:10.1001/jama.280.3.254

Context.— Studies with positive results are more likely to be published in biomedical journals than are studies with negative results. However, many studies submitted for consideration at scientific meetings are never published in full; bias in this setting is poorly studied.

Objective.— To identify features associated with the fate of research abstracts submitted to a scientific meeting.

Design and Setting.— Prospective observational cohort, with 5-year follow-up of all research submitted for consideration to the major annual 1991 US research meeting in the specialty of emergency medicine.

Participants.— All research abstracts submitted for consideration at the meeting for possible presentation.

Main Outcome Measures.— Characteristics associated with acceptance for presentation at the meeting and subsequent publication as a full manuscript.

Results.— A total of 492 research abstracts were submitted from programs in emergency medicine and other specialies affiliated with 103 US medical schools. A total of 179 (36%) were accepted for presentation and 214 (43%) were published in 44 journals. Of the 179 abstracts accepted for presentation, 111 studies were published. Scientific quality of abstracts or prestige of the journal in which the study was eventually published did not predict either of these outcomes. The best predictors (by logistic regression) of meeting acceptance were a subjective "originality" factor (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.13-3.89) and positive results (OR, 1.99; 95% CI, 1.07-3.84), and, for publication, meeting acceptance (OR, 2.49; 95% CI, 1.49-4.35) and large sample size (OR, 2.26; 95% CI, 1.23-4.31). Forty-nine percent (241) of abstracts did not report on blinding, and 24% (118) did not report on randomization. Acceptance and publication were both more likely for positive outcomes (P=.03). Funnel plots showed the classic distribution of positive-outcome ("publication") bias at each of the submission, acceptance, and publication phases. Meeting acceptance predicted publication with a sensitivity of only 51%, specificity of 71%, positive predictive value of 57%, and negative predictive value of 66%.

Conclusions.— Positive-outcome bias was evident when studies were submitted for consideration and was amplified in the selection of abstracts for both presentation and publication, neither of which was strongly related to study design or quality.