Are You Seeing All the Science You Need, When You Need It?

Joseph B. Laudano and Gail Dutton

With approximately 30,000 journals in the PubMed journal list and roughly 2 million articles published each year, it is easy to see why PubMed is a primary source of information. While this database lists the most important journals, not all of the relevant sources are included. Some appear elsewhere. Scopus, for example, indexes some 35,0000 peer-reviewed titles (and approximately 40,000 in total), while Ulrich’s indexes more than 300,000 scholarly and popular periodicals. Many other indexes also are available, listing scientific papers in a variety of languages and regions of the world. That can make finding the most relevant articles challenging.

Indexed journals, however, have long lead times that stretch the lag between the time research is completed and the time it appears in publications. An analysis of 667,773 time-stamped articles indexed in PubMed showed widely varying delays and publication times after acceptance. The very longest is the Journal of Geographical Systems, with 792 days for acceptance followed by another 58 days for publication. That makes Nature’s 173-day acceptance time and 45-day delay for publication seem mild.

When it comes to reporting clinical trial data, median 300-day delays are normal between the time a pharmaceutical company issues a press release announcing the analyses of Phase III data for oncology trials, and publication in a peer-reviewed journal or on, according to a report in JAMA Oncology.

A feature in Nature outlines the issue. In March 2012, cell biologist Stephen Royle at the University of Warwick in the UK sent his manuscript to Nature Cell Biology at the request of an editor there who had heard his presentation. It was rejected without review. He sent it to Developmental Cell Biology, and then to the Journal of Cell Biology. The Journal returned it with many suggested revisions and a rejection letter. Royle revised the paper and sent it to Current Biology and then to EMBO Journal. InDecember, he sent it to the Journal of Cell Science where it finally was accepted amidst glowing praise from one reviewer and despite a rejection recommendation from another. The total time from the paper’s very first submission to acceptance at the Journal of Cell Biology was 317 days, with another 53 days until publication.

The COVID-19 pandemic has dramatically reduced publication timelines at many journals, especially for vaccine and infectious disease research. A study of 669 papers in 14 medical journals suggests that the time from submission to acceptance has declined an average of 49%. Notably, however, the publication times remained the same for subjects not related to the pandemic.

In contrast to journals, conference proceedings are a way to access scientific literature while it’s most current. Proceedings and conference programs are not reflected in most medical literature databases, however.

Separate databases of medical conferences are an option, but they are limited, too. According to Elsevier, Embase, for example, indexes approximately 8,100 journals and includes abstracts from 11,500 conferences  for some 3.6 million conference abstracts not indexed by Medline. BMC Proceedings indexes conferences and proceedings across multiple scientific disciplines but, as an open access service, may not include certain meetings. Scientists, therefore, are limited. They may never see what could be key evidence and that could affect the direction of their own work, including abstracts they are preparing for submission.

Limited indexing is compounded by the fact that only a small portion of abstracts are ever fully published, even a decade after presentation. Most scientific abstracts, in fact, are only available in conference proceedings. A landmark study involving 307,028 abstracts from a variety of biomedical and social sciences, published by Roberta W. Scherer et al in the Cochrane Database of Systematic Reviews, found that more than half the results from abstracts and nearly one third of randomized trial results that initially are presented as abstracts are never published. In addition, whether the manuscript was prepared in English can make a difference, too.

Their Key Message:

“Two important factors increase the probability that a study described in an abstract will subsequently be published in full, (1) the presence of ‘positive’ or statistically significant results in the abstract and (2) whether the team examining subsequent full publication were from an English-speaking country or wrote their report in English. The consequence is that systematic reviews relying on fully published research may provide inaccurate or biased findings because of an over-reliance on studies with positive results or from English-speaking countries.”

Consequently, an amazing amount of hard scientific evidence is available to the attendees of particular conferences, but not to the broader scientific and medical community, which may never learn it exists and, as Scherer and colleagues state. “….relying only on fully published research may provide inaccurate or biased findings…” – this is troubling.

For researchers preparing papers for publication, lack of access to such potentially important scientific evidence can also be problematic. Lack of awareness of new, pivotal data – because it was presented at a conference or only appeared in abstract form and thus never was published in favored indexing services – could cause an editor to reject the paper, delaying its publication by months. If subsequent evidence is presented while revisions are being made, but is similarly obscured, more delays can ensue, further slowing the publication of the author’s research.

By searching complete conference data, rather than just PubMed, you can be assured of having the most complete and current information possible, thus minimizing the risks that your paper will be rejected. For example, since January 2019, there have been a total of 239 posters or oral presentations presented at various conferences for aflibercept. Contrast this with a total of 129 papers for aflibercept  that appear in PubMed for the same period and the gap in evidence becomes truly remarkable, especially for an author preparing a review paper or a clinical trial protocol background summary. True, there may be a few encore posters or interim study analyses presented, but those would be negligible considering the gap in evidence. 

That premise is true for medical information response documents, too. A physician may have a question about the use of your new medication with specific patients – maybe hypertensive, diabetic patients, for instance, or those carrying a certain gene.

Medical Information Professionals need to prepare response documents from clinicians to answer medical inquiries, citing the most current and robust scientific evidence. PubMed may be your starting point, but unless your database is comprehensive, including the world’s scientific literature as well as abstracts from major as well as minor conferences or meetings, your response risks being incomplete. Similarly, Medical Affairs Professionals aiming to assess scientific impact of medical imperatives, using analytics such as Share of Scientific Voice™ cannot do so accurately if the data set is incomplete..     

For these reasons, Medical Affairs professionals and researchers need a robust, comprehensive source that regularly indexes the world’s rapidly growing body of medical knowledge and, not just in English, but, in any language in which the data are available.

Pharmaspectra provides that. In addition to its complete publication sources, augmenting what is available through PubMed, Pharmaspectra collects information from more than 21,000 conferences annually– making it the largest collection of scientific conference and publication data in the world. And, importantly, it makes those abstracts available (generally, 50% ahead of the event) as soon as they are released by the conference organizer. Scientists, therefore, are assured of having access to the full spectrum of evidence from throughout the world, whenever they need it.

Scherer RW, Meerpohl JJ, Pfeifer N, Schmucker C, Schwarzer G, von Elm E. Full publication of results initially presented in abstracts. Cochrane Database of Systematic Reviews 2018, Issue 11. Art. No.: MR000005