Abstract
Policy has been developed to promote the conduct of high-quality pediatric randomized controlled trials (RCTs). Whether these strategies have influenced publication trends in high-impact journals is unknown. We aim to evaluate characteristics, citation patterns, and publication trends of pediatric RCTs published in general medical journals (GMJs) compared with adult RCTs over a 13-year period. Studies were identified using Medline, and impact metrics were collected from Web of Science and Scopus. All RCTs published from 2005–2018 in 7 GMJs with the highest impact factors were identified for analysis. A random sample of matched pediatric and adult RCTs were assessed for publication characteristics, academic and non-academic citation. Citations were counted from publication until June 2019. Among 4146 RCTs, 2794 (67.3%) enrolled adults, 591 (14.2%) enrolled children, and 761 RCTs (18.3%) enrolled adult and pediatric patients. Adult RCTs published in GMJs grew by 5.1 publications per year (95% CI: 3.3–6.9), while the number of pediatric RCTs did not show significant change (−0.4 RCTs/year, 95% CI: −1.4–0.6). Adult RCTs were cited more than pediatric RCTs (median(IQR): 29.9 (68.5–462.8) citations/year vs. 13.2 (6.8–24.9) citations/year; p < 0.001); however, social media attention was similar (median(IQR) Altmetric Attention Score: 37 (13.75–133.8) vs. 26 (6.2–107.5); p = 0.25). Despite policies which may facilitate conduct of pediatric RCTs, the publishing gap in high-impact GMJs is widening.
Highlights
Randomized controlled trials (RCTs) are regarded as the “gold standard” in interventional research design [1]
Previous studies from over a decade ago have noted this paucity of pediatric randomized controlled trials (RCTs) in published literature, in general medical journals [6,7,8]
We previously reported that the publication of pediatric RCTs in general medical journals (GMJs) did not increase from to 2004, whereas the publication of adult RCTs increased substantially over the same period [8]
Summary
Randomized controlled trials (RCTs) are regarded as the “gold standard” in interventional research design [1]. General medical journals (GMJs) are important sources of information for family physicians, generalists and subspecialists These journals publish high-quality research which is widely read, cited, and disseminated; as of 2019, the top five GMJs all have journal impact factors higher than any pediatric journal [9]. In high-impact GMJs, recent studies have documented a paucity in the publication of RCTs conducted in low- and middle-income countries as well as RCTs addressing diseases of poverty [10,11], diseases which disproportionately affect children [12]. This suggests that high-impact GMJs may underreport trials relating to diseases of childhood
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