Publication of pediatric critical care RCTs: A methodologic review of journals
CCCF ePoster library. Liu A. 11/13/19; 283432; EP107
Alissa Liu
Alissa Liu
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Abstract
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ePoster
Topic: Systematic Review, Meta-Analysis, or Meta-Synthesis

Liu, Alissa1; Duffet, Mark2

1
Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; 2 Departments of Pediatrics and Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada


 

Introduction: Clinicians need high-quality evidence to inform the care of critically ill children. The journals that published randomized controlled trials (RCTs) play a crucial role in clinicians' awareness of, and access to, this evidence. While open-access journals increase clinicians' ability to access RCTs, the proliferation of journals may make it more difficult for clinicians to find trials.

Objectives: To describe the characteristics of journals publishing pediatric critical care RCTs and compare characteristics of open-access journals (and the RCTs they publish) to journals with a traditional, subscription-based publication model.

Methods: In this methodological review, we included journals that published at least one pediatric critical care RCT as of July 2019. We used PICUtrials.net, a database which uses comprehensive searches of multiple databases to identify published RCTs in pediatric critical care. Journal websites were used to confirm the publication model (open-access, subscription-based, or a hybrid of the two). We searched the National Library of Medicine (NLM), Web of Science (WOS) and Scientific Journal Rankings (SJR) to determine if each journal was indexed. We used the Impact Factor and H index to measure journal influence. 

Results: 151 journals published least 1 of the 427 RCTs. Of these journals, 40 (27%) had a pediatric focus and published 151 (35%) of the RCTs, while 23 (15%) had a critical care focus and published 167 (39%) of the RCTs. 15 journals published more than 5 RCTs each and 88 each published a single RCT. The 5 journals publishing the most RCTs collectively published 141 (33%) of the RCTs: Pediatric Critical Care Medicine (53, 12%), Critical Care Medicine (35, 8.2%), Intensive Care Medicine (30, 7.0%), New England Journal of Medicine (12, 2.8%), and Journal of Pediatrics (11, 2.6%).The 5 publishers with the most journals were Elsevier (29, 19%), Wolters Kluwer (20, 13%), Springer (16, 11%), Wiley (11, 7.3%), and Oxford University Press (10, 6.6%). With respect to access, 145 (96%), 120 (80%), and 144 (95%) journals were indexed in NML, WOS and SJR respectively. 45 (29%) journals are open access, 11 (7.3%) are subscription-based, and 93 (62%) use a hybrid model. These published 71 (17%), 25 (5.9%), and 329 (77%) of the RCTs, respectively. Open access journals have a lower impact factor (median 1.7 vs. 2.0, p <0.001, and lower H index (median 29 vs. 86, p<0.001). Trials published in open access journals were less often multicentred (8.5% vs. 21%, p=0.03) and funded (30% vs. 55%, p<0.001) and cited less often (median 0.3 vs. 2 citations per year since publication, p<0.001). Trial size (median 51 vs. 57, p=0.71) and high risk of bias (55% vs. 49%, p=0.51) were not significantly different. 

Overall, 160 (37%) of the RCTs were available without a subscription or payment. Trials available for free were larger (median 61 vs. 50 children, p=0.003). They were not different with respect to the percentage of RCTs that were multicentre (12% vs. 17%, p=0.46), funded (49% vs. 52%, p=0.61), and at high risk of bias (54% vs. 49%, p=0.27). The number of citations was also not different (median 1.6 vs. 1.9 citations per year since publication, p=0.90).

Conclusion: RCTs in pediatric critical care are published in a wide variety of journals, making it challenging for clinicians to keep abreast of the current literature in the field. There are also important differences in the trials published in open-access journals.


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