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Abstracts of Randomized Controlled Trials Presented at the Society for Pediatric Research Meeting
An Example of Publication Bias
Terry P. Klassen, MD;
Natasha Wiebe, MMath;
Kelly Russell, BSc;
Kelly Stevens, BSc;
Lisa Hartling, MSc;
William R. Craig, MD;
David Moher, MSc
Arch Pediatr Adolesc Med. 2002;156:474-479.
Background Publication bias toward studies that favor new therapies has been known
to occur for the past 40 years, yet its implications are not well studied
in child health. The increased interest in meta-analyses has highlighted the
need to identify the totality of evidence when addressing treatment questions.
Objectives To measure the percentage of randomized controlled trials (RCTs) presented
at a major pediatric scientific meeting that were subsequently published as
full-length articles, to investigate factors associated with publication,
and to describe the variables that change from abstract to manuscript form.
Design The scientific proceedings from the Society for Pediatric Research were
hand searched for RCTs (1992-1995). Subsequent publication was ascertained
through a search of various electronic databases. Quality of abstracts and
manuscripts was measured, and data were extracted using a structured form.
Results A total of 264 (59.1%) of 447 abstracts were subsequently published.
Almost 64% of RCTs that were subsequently published favored new therapy compared
with 43.5% of studies that were never published (P<.001).
Mean effect size for published vs unpublished RCTs was 0.74 vs 0.05 (P<.001). Median sample size was larger in published
(n = 45) vs unpublished (n = 34) RCTs (P = .02).
Quality was significantly lower for abstracts vs published RCTs (P<.001). For 5% of abstracts that were subsequently published, the
conclusion regarding treatment efficacy changed.
Conclusions Publication bias is a serious threat to assessing the effectiveness
of interventions in child health, as little more than half of RCTs presented
at a major scientific meeting are subsequently published. There is a need
to institute an international registry of RCTs in children so that the totality
of evidence can be accessed when assessing treatment effectiveness.
From the Department of Pediatrics, University of Alberta, and the Alberta
Research Centre for Child Health Evidence, Edmonton (Drs Klassen and Craig
and Mss Wiebe, Russell, Stevens, and Hartling); and the Thomas C. Chalmers
Centre for Systematic Reviews, Children's Hospital of Eastern Ontario, University
of Ottawa (Mr Moher).
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