Health journal coverage of climate change and health: a bibliometric study.

OBJECTIVES: To find what proportion of a broad set of health journals have published on climate change and health, how many articles they have published, and when they first published on the subject. DESIGN: Bibliometric study. SETTING AND PARTICIPANTS: We conducted electronic searches in Ovid MEDLINE ALL for articles about climate change and human health published from 1860 to 31 December 2022 in 330 health journals. There were no limits by language or publication type. Results were independently screened by two raters for article eligibility. RESULTS: After screening there were 2932 eligible articles published across 253 of the 330 journals between 1947 and 2022; most (2795/2932; 95%) were published in English. A few journals published articles in the early 90s, but there has been a rapid increase since about 2006. We were unable to categorise the types of publication but estimate that fewer than half are research papers. While articles were published in journals in 39 countries, two-thirds (1929/2932; 66%) were published in a journal published in the UK or the USA. Almost a quarter (77/330; 23%) of the journals published no eligible articles, and almost three-quarters (241/330; 73%) published five articles or fewer. The publication of joint editorials in over 200 journals in 2021 and 2022 boosted the number of journals publishing something on climate change and health. A third of the (112/330; 34%) journals in our sample published at least one of the joint editorials, and almost a third of those (32/112; 29%) were publishing on climate change and health for the first time. CONCLUSIONS: Health journals are rapidly increasing the amount they publish on climate change and health, but despite climate change being the major threat to global health many journals had until recently published little or nothing. A joint editorial published in multiple journals increased coverage, and for many journals it was the first thing they published on climate change and health.

Systematic review search strategies are poorly reported and not reproducible: a cross-sectional metaresearch study.

OBJECTIVES: To determine the reproducibility of biomedical systematic review search strategies. STUDY DESIGN AND SETTING: A cross-sectional reproducibility study was conducted on a random sample of 100 systematic reviews indexed in MEDLINE in November 2021. The primary outcome measure is the percentage of systematic reviews for which all database searches can be reproduced, operationalized as fulfilling six key Preferred Reporting Items for Systematic reviews and Meta-Analyses literature search extension (PRISMA-S) reporting guideline items and having all database searches reproduced within 10% of the number of original results. Key reporting guideline items included database name, multi-database searching, full search strategies, limits and restrictions, date(s) of searches, and total records. RESULTS: The 100 systematic review articles contained 453 database searches. Only 22 (4.9%) database searches reported all six PRISMA-S items. Forty-seven (10.4%) database searches could be reproduced within 10% of the number of results from the original search; six searches differed by more than 1,000% between the originally reported number of results and the reproduction. Only one systematic review article provided the necessary search details to be fully reproducible. CONCLUSION: Systematic review search reporting is poor. To correct this will require a multifaceted response from authors, peer reviewers, journal editors, and database providers.

Reminding Peer Reviewers of Reporting Guideline Items to Improve Completeness in Published Articles: Primary Results of 2 Randomized Trials.

Importance: Numerous studies have shown that adherence to reporting guidelines is suboptimal. Objective: To evaluate whether asking peer reviewers to check if specific reporting guideline items were adequately reported would improve adherence to reporting guidelines in published articles. Design, Setting, and Participants: Two parallel-group, superiority randomized trials were performed using manuscripts submitted to 7 biomedical journals (5 from the BMJ Publishing Group and 2 from the Public Library of Science) as the unit of randomization, with peer reviewers allocated to the intervention or control group. Interventions: The first trial (CONSORT-PR) focused on manuscripts that presented randomized clinical trial (RCT) results and reported following the Consolidated Standards of Reporting Trials (CONSORT) guideline, and the second trial (SPIRIT-PR) focused on manuscripts that presented RCT protocols and reported following the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guideline. The CONSORT-PR trial included manuscripts that described RCT primary results (submitted July 2019 to July 2021). The SPIRIT-PR trial included manuscripts that contained RCT protocols (submitted June 2020 to May 2021). Manuscripts in both trials were randomized (1:1) to the intervention or control group; the control group received usual journal practice. In the intervention group of both trials, peer reviewers received an email from the journal that asked them to check whether the 10 most important and poorly reported CONSORT (for CONSORT-PR) or SPIRIT (for SPIRIT-PR) items were adequately reported in the manuscript. Peer reviewers and authors were not informed of the purpose of the study, and outcome assessors were blinded. Main Outcomes and Measures: The difference in the mean proportion of adequately reported 10 CONSORT or SPIRIT items between the intervention and control groups in published articles. Results: In the CONSORT-PR trial, 510 manuscripts were randomized. Of those, 243 were published (122 in the intervention group and 121 in the control group). A mean proportion of 69.3% (95% CI, 66.0%-72.7%) of the 10 CONSORT items were adequately reported in the intervention group and 66.6% (95% CI, 62.5%-70.7%) in the control group (mean difference, 2.7%; 95% CI, -2.6% to 8.0%). In the SPIRIT-PR trial, of the 244 randomized manuscripts, 178 were published (90 in the intervention group and 88 in the control group). A mean proportion of 46.1% (95% CI, 41.8%-50.4%) of the 10 SPIRIT items were adequately reported in the intervention group and 45.6% (95% CI, 41.7% to 49.4%) in the control group (mean difference, 0.5%; 95% CI, -5.2% to 6.3%). Conclusions and Relevance: These 2 randomized trials found that it was not useful to implement the tested intervention to increase reporting completeness in published articles. Other interventions should be assessed and considered in the future. Trial Registration: ClinicalTrials.gov Identifiers: NCT05820971 (CONSORT-PR) and NCT05820984 (SPIRIT-PR).

Analysis of peer reviewers' response to invitations by gender and geographical region: cohort study of manuscripts reviewed at 21 biomedical journals before and during covid-19 pandemic.

OBJECTIVES: To describe gender and geographical inequalities in invitations to review and the response to these invitations and to assess whether inequalities increased during the covid-19 pandemic. DESIGN: Retrospective cohort study. SETTING: 19 specialist medical journals and two large general medical journals from BMJ Publishing Group. POPULATION: Reviewers invited to review manuscripts submitted between 1 January 2018 and 31 May 2021. The cohort was followed up to 28 February 2022. MAIN OUTCOME MEASURES: Reviewer's agreement to review. RESULTS: A total of 257 025 reviewers were invited (38.6% (88 454/228 869) women), and 90 467 (35.2%) agreed to review. Invited reviewers were mainly (217 682; 84.7%) affiliated with high income countries: Europe (122 414; 47.6%), North America (66 931; 26.0%), Africa (25 735; 10.0%), Asia (22 693; 8.8%), Oceania (16 175; 6.3%), and South America (3076; 1.2%). Independent factors associated with agreement to review were gender (odds ratio 0.89, 95% confidence interval 0.87 to 0.92, for women compared with men), geographical affiliation (2.89, 2.73 to 3.06, for Asia; 3.32, 2.94 to 3.75 for South America; 1.35, 1.27 to 1.43, for Oceania; and 0.35, 0.33 to 0.37, for Africa compared with Europe), and country income (0.47, 0.45 to 0.49, for upper middle income; 5.12, 4.67 to 5.61, for lower middle income; and 4.66, 3.79 to 5.73, for low income compared with high income country). Agreement was also independently associated with editor's gender (0.96, 0.93 to 0.99, for women compared with men), last author's geographical affiliation (0.80, 0.78 to 0.83, for Asia; 0.89, 0.85 to 0.94, for Oceania compared with Europe), impact factor (1.78, 1.27 to 2.50, for >10 compared with <5), and type of peer review process (0.52, 0.35 to 0.77, for open compared with anonymised). During the first and second phases of the pandemic, agreement was lower than in the pre-pandemic period (P<0.001). The interaction between time periods and covid-19 related topic and reviewer's gender was non-significant. However, significant interaction was found between time periods and covid-19 related topic and reviewer's geographical affiliation. CONCLUSIONS: To reduce bias and improve diversity, editors need to identify and implement effective strategies and continually evaluate progress against these to ensure that more women and researchers from upper middle income and low income countries are involved in review.

Evaluation of editors' abilities to predict the citation potential of research manuscripts submitted to The BMJ: a cohort study.

OBJECTIVE: To evaluate the ability of The BMJ editors to predict the number of times submitted research manuscripts will be cited. DESIGN: Cohort study. SETTING: Manuscripts submitted to The BMJ, reviewed, and subsequently scheduled for discussion at a prepublication meeting between 27 August 2015 and 29 December 2016. PARTICIPANTS: 10 BMJ research team editors. MAIN OUTCOME MEASURES: Reviewed manuscripts were rated independently by attending editors for citation potential in the year of first publication plus the next year: no citations, below average (<10 citations), average (10-17 citations), or high (>17 citations). Predicted citations were subsequently compared with actual citations extracted from Web of Science (WOS). RESULTS: Of 534 manuscripts reviewed, 505 were published as full length articles (219 in The BMJ) by end of 2019 and indexed in WOS, 22 were unpublished, and one abstract was withdrawn. Among the 505 manuscripts, the median (IQR [range]) number of citations in the year of publication plus the following year was 9 (4-17 [0-150]); 277 (55%) manuscripts were cited <10 times, 105 (21%) were cited 10-17 times, and 123 (24%) cited >17 times. Manuscripts accepted by The BMJ were cited more highly (median 12 (IQR 7-24) citations) than those rejected (median 7 (3-12) citations). For all 10 editors, predicted ratings tended to increase in line with actual citations, but with considerable variation within categories; nine failed to identify the correct citation category for >50% (range 31%-52%) of manuscripts, and κ ranged between 0.01 to 0.19 for agreement between predicted and actual categories. Editors more often rated papers that achieved high actual citation counts as having low citation potential than the reverse. Collectively, the mean percentage of editors predicting the correct citation category was 43%, and for 160 (32%) manuscripts at least 50% of editors predicted the right category. CONCLUSIONS: Editors weren't good at estimating the citation potential of manuscripts individually or as a group; there is no wisdom of the crowd when it comes to BMJ editors.

Peer Reviewed Evaluation of Registered End-Points of Randomised Trials (the PRE-REPORT study): a stepped wedge, cluster-randomised trial.

OBJECTIVE: To test whether providing relevant clinical trial registry information to peer reviewers evaluating trial manuscripts decreases discrepancies between registered and published trial outcomes. DESIGN: Stepped wedge, cluster-randomised trial, with clusters comprised of eligible manuscripts submitted to each participating journal between 1 November 2018 and 31 October 2019. SETTING: Thirteen medical journals. PARTICIPANTS: Manuscripts were eligible for inclusion if they were submitted to a participating journal during the study period, presented results from the primary analysis of a clinical trial, and were peer reviewed. INTERVENTIONS: During the control phase, there were no changes to pre-existing peer review practices. After journals crossed over into the intervention phase, peer reviewers received a data sheet describing whether trials were registered, the initial registration and enrolment dates, and the registered primary outcome(s) when enrolment began. MAIN OUTCOME MEASURE: The presence of a clearly defined, prospectively registered primary outcome consistent with the primary outcome in the published trial manuscript, as determined by two independent outcome assessors. RESULTS: We included 419 manuscripts (243 control and 176 intervention). Participating journals published 43% of control-phase manuscripts and 39% of intervention-phase manuscripts (model-estimated percentage difference between intervention and control trials = -10%, 95% CI -25% to 4%). Among the 173 accepted trials, published primary outcomes were consistent with clearly defined, prospectively registered primary outcomes in 40 of 105 (38%) control-phase trials and 27 of 68 (40%) intervention-phase trials. A linear mixed model did not show evidence of a statistically significant primary outcome effect from the intervention (estimated difference between intervention and control=-6% (90% CI -27% to 15%); one-sided p value=0.68). CONCLUSIONS: These results do not support use of the tested intervention as implemented here to increase agreement between prospectively registered and published trial outcomes. Other approaches are needed to improve the quality of outcome reporting of clinical trials. TRIAL REGISTRATION NUMBER: ISRCTN41225307.

Coronary revascularisation outcome questionnaire: validation study of the Serbian version.

PURPOSE: To translate, culturally adapt and validate the Coronary Revascularisation Outcome Questionnaire (CROQ), a disease-specific tool for measuring health-related quality of life (HRQoL) in patients with ischaemic heart disease (IHD), into Serbian language (CROQ-S). METHODS: Validation study was performed at the Clinic for Cardiac Surgery and Clinic for Cardiology, University Clinical Centre of Serbia. We included a convenience sample of 600 patients with IHD divided into four groups. Acceptability, reliability and validity of the CROQ-S were assessed. RESULTS: CROQ-S was acceptable to patients as demonstrated by less than 1% of missing data for each single item. Cronbach's Alpha was higher than the criterion of 0.70 for all scales in each version except the Cognitive Functioning scale which only met this criterion in the CABG pre-revascularisation version. Mean values of item-total correlations were greater than 0.30 for all scales except the Cognitive Functioning scale in both the pre-revascularisation groups. Compared to the original version, exploratory factor analysis in our study showed more factors; however, the majority of items had a factor loading greater than 0.3 on the right scale. Correlations of CROQ-S scales with the 36-Item Short Form Health Survey and Seattle Angina Questionnaire showed the expected pattern whereby scales measuring similar constructs were most highly correlated. CONCLUSION: CROQ-S is an acceptable, reliable and valid disease-specific instrument for measuring HRQoL in this sample of Serbian speaking patients with IHD both before and after coronary revascularisation. However, the Cognitive Functioning scale did not meet all the psychometric criteria and further validation of its responsiveness is required.

Improving peer review of systematic reviews by involving librarians and information specialists: protocol for a randomized controlled trial.

BACKGROUND: Problems continue to exist with the reporting quality and risk of bias in search methods and strategies in systematic reviews and related review types. Peer reviewers who are not familiar with what is required to transparently and fully report a search may not be prepared to review the search components of systematic reviews, nor may they know what is likely to introduce bias into a search. Librarians and information specialists, who have expertise in searching, may offer specialized knowledge that would help improve systematic review search reporting and lessen risk of bias, but they are underutilized as methodological peer reviewers. METHODS: This study will evaluate the effect of adding librarians and information specialists as methodological peer reviewers on the quality of search reporting and risk of bias in systematic review searches. The study will be a pragmatic randomized controlled trial using 150 systematic review manuscripts submitted to BMJ and BMJ Open as the unit of randomization. Manuscripts that report on completed systematic reviews and related review types and have been sent for peer review are eligible. For each manuscript randomized to the intervention, a librarian/information specialist will be invited as an additional peer reviewer using standard practices for each journal. First revision manuscripts will be assessed in duplicate for reporting quality and risk of bias, using adherence to 4 items from PRISMA-S and assessors' judgements on 4 signaling questions from ROBIS Domain 2, respectively. Identifying information from the manuscripts will be removed prior to assessment. DISCUSSION: The primary outcomes for this study are quality of reporting as indicated by differences in the proportion of adequately reported searches in first revision manuscripts between intervention and control groups and risk of bias as indicated by differences in the proportions of first revision manuscripts with high, low, and unclear bias. If the intervention demonstrates an effect on search reporting or bias, this may indicate a need for journal editors to work with librarians and information specialists as methodological peer reviewers. TRIAL REGISTRATION: Open Science Framework. Registered on June 17, 2021, at https://doi.org/10.17605/OSF.IO/W4CK2 .

Female authorship of covid-19 research in manuscripts submitted to 11 biomedical journals: cross sectional study.

OBJECTIVE: To describe prominent authorship positions held by women and the overall percentage of women co-authoring manuscripts submitted during the covid-19 pandemic compared with the previous two years. DESIGN: Cross sectional study. SETTING: Nine specialist and two large general medical journals. POPULATION: Authors of research manuscripts submitted between 1 January 2018 and 31 May 2021. MAIN OUTCOME MEASURES: Primary outcome: first author's gender. SECONDARY OUTCOMES: last and corresponding authors' gender; number (percentage) of women on authorship byline in "pre-pandemic" period (1 January 2018 to 31 December 2019) and in "covid-19" and "non-covid-19" manuscripts during pandemic. RESULTS: A total of 63 259 manuscripts were included. The number of female first, last, and corresponding authors respectively were 1313 (37.1%), 996 (27.9%), and 1119 (31.1%) for covid-19 manuscripts (lowest values in Jan-May 2020: 230 (29.4%), 165 (21.1%), and 185 (22.9%)), compared with 8583 (44.9%), 6118 (31.2%), and 7273 (37.3%) for pandemic non-covid-19 manuscripts and 12 724 (46.0%), 8923 (31.4%), and 10 981 (38.9%) for pre-pandemic manuscripts. The adjusted odds ratio of having a female first author in covid-19 manuscripts was <1.00 in all groups (P<0.001) compared with pre-pandemic (lowest in Jan-May 2020: 0.55, 98.75% confidence interval 0.43 to 0.70). The adjusted odds ratio of having a woman as last or corresponding author was significantly lower for covid-19 manuscripts in all time periods (except for the two most recent periods for last author) compared with pre-pandemic (lowest values in Jan-May 2020: 0.74 (0.57 to 0.97) for last and 0.61 (0.49 to 0.77) for corresponding author). The odds ratios for pandemic non-covid-19 manuscripts were not significantly different compared with pre-pandemic manuscripts. The median percentage of female authors on the byline was lower for covid-19 manuscripts (28.6% in Jan-May 2020) compared with pre-pandemic (36.4%) and non-covid-19 pandemic manuscripts (33.3% in Jan-May 2020). Gender disparities in all prominent authorship positions and the proportion of women authors on the byline narrowed in the most recent period (Feb-May 2021) compared with the early pandemic period (Jan-May 2020) and were very similar to values observed for pre-pandemic manuscripts. CONCLUSIONS: Women have been underrepresented as co-authors and in prominent authorship positions in covid-19 research, and this gender disparity needs to be corrected by those involved in academic promotion and awarding of research grants. Women attained some prominent authorship positions equally or more frequently than before the pandemic on non-covid-19 related manuscripts submitted at some time points during the pandemic.

Consistency of causal claims in observational studies: a review of papers published in a general medical journal.

OBJECTIVE: To evaluate the consistency of causal statements in observational studies published in The BMJ. DESIGN: Review of observational studies published in a general medical journal. DATA SOURCE: Cohort and other longitudinal studies describing an exposure-outcome relationship published in The BMJ in 2018. We also had access to the submitted papers and reviewer reports. MAIN OUTCOME MEASURES: Proportion of published research papers with 'inconsistent' use of causal language. Papers where language was consistently causal or non-causal were classified as 'consistently causal' or 'consistently not causal', respectively. For the 'inconsistent' papers, we then compared the published and submitted version. RESULTS: Of 151 published research papers, 60 described eligible studies. Of these 60, we classified the causal language used as 'consistently causal' (48%), 'inconsistent' (20%) and 'consistently not causal'(32%). Eleven out of 12 (92%) of the 'inconsistent' papers were already inconsistent on submission. The inconsistencies found in both submitted and published versions were mainly due to mismatches between objectives and conclusions. One section might be carefully phrased in terms of association while the other presented causal language. When identifying only an association, some authors jumped to recommending acting on the findings as if motivated by the evidence presented. CONCLUSION: Further guidance is necessary for authors on what constitutes a causal statement and how to justify or discuss assumptions involved. Based on screening these papers, we provide a list of expressions beyond the obvious 'cause' word which may inspire a useful more comprehensive compendium on causal language.

A randomized trial of an editorial intervention to reduce spin in the abstract's conclusion of manuscripts showed no significant effect.

OBJECTIVE: To estimate the effect of an intervention compared to the usual peer-review process on reducing spin in the abstract's conclusion of biomedical study reports. STUDY DESIGN AND SETTING: We conducted a two-arm, parallel-group RCT in a sample of primary research manuscripts submitted to BMJ Open. The authors received short instructions alongside the peer reviewers' comments in the intervention group. We assessed the presence of spin (primary outcome), types of spin, and wording change in the revised abstract's conclusion. Outcome assessors were blinded to the intervention assignment. RESULTS: Of the 184 manuscripts randomized, 108 (54 intervention, 54 control) were selected for revision and could be evaluated for the presence of spin. The proportion of manuscripts with spin was 6% lower (95% CI: 24% lower to 13% higher) in the intervention group (57%, 31/54) than in the control group (63%, 34/54). The wording of the revised abstract's conclusion was changed in 34/54 (63%) manuscripts in the intervention group and 26/54 (48%) in the control group. The four prespecified types of spin involved (i) selective reporting (12 in the intervention group vs. 8 in the control group), (ii) including information not supported by evidence (9 vs. 9), and (iii) interpretation not consistent with the study results (14 vs. 18), and (iv) unjustified recommendations for practice (5 vs. 11). CONCLUSION: These short instructions to authors did not have a statistically significant effect on reducing spin in revised abstract conclusions, and based on the confidence interval, the existence of a large effect can be excluded. Other interventions to reduce spin in reports of original research should be evaluated. STUDY REGISTRATION: osf.io/xnuyt.

Awareness, usage and perceptions of authorship guidelines: an international survey of biomedical authors.

OBJECTIVES: To investigate authors' awareness and use of authorship guidelines, and to assess their perceptions of the fairness of authorship decisions. DESIGN: A cross-sectional online survey. SETTING AND PARTICIPANTS: Corresponding authors of research papers submitted in 2014 to 18 BMJ journals. RESULTS: 3859/12 646 (31%) researchers responded. They worked in 93 countries and varied in research experience. Of these, 1326 (34%) reported their institution had an authorship policy providing criteria for authorship; 2871 (74%) were 'very familiar' with the International Committee of Medical Journal Editors' authorship criteria and 3358 (87%) reported that guidelines were beneficial when preparing manuscripts. Furthermore, 2609 (68%) reported that their use was 'sometimes' or 'frequently' encouraged in their research setting. However, 2859 respondents (74%) reported that they had been involved in a study at least once where someone was added as an author who had not contributed substantially (honorary authorship), and 1305 (34%) where someone was not listed as an author but had contributed substantially (ghost authorship). Only 740 (19%) reported that they had never experienced either honorary or ghost authorship; 1115 (29%) reported that they had experienced both at least once. There was no clear pattern in experience of authorship misappropriation by continent. For their last coauthored article, 2187 (57%) reported that explicit authorship criteria had been used to determine eligibility, and 3088 (80%) felt that the decision made was fair. When institutions frequently encouraged use of authorship guidelines, authorship eligibility was more likely to be discussed early (817 of 1410, 58%) and perceived as fairer (1273 of 1410, 90%) compared with infrequent encouragement (974 of 2449, 40%, and 1891 of 2449, 74%). CONCLUSIONS: Despite a high level of awareness of authorship guidelines and criteria, these are not so widely used; more explicit encouragement of their use by institutions may result in more favourable use of guidelines by authors.

Effect of an editorial intervention to improve the completeness of reporting of randomised trials: a randomised controlled trial.

OBJECTIVE: To evaluate the impact of an editorial intervention to improve completeness of reporting of reports of randomised trials. DESIGN: Randomised controlled trial (RCT). SETTING: BMJ Open's quality improvement programme. PARTICIPANTS: 24 manuscripts describing RCTs. INTERVENTIONS: We used an R Shiny application to randomise manuscripts (1:1 allocation ratio, blocks of 4) to the intervention (n=12) or control (n=12) group. The intervention was performed by a researcher with expertise in the content of the Consolidated Standards of Reporting Trials (CONSORT) and consisted of an evaluation of completeness of reporting of eight core CONSORT items using the submitted checklist to locate information, and the production of a report containing specific requests for authors based on the reporting issues found, provided alongside the peer review reports. The control group underwent the usual peer review. OUTCOMES: The primary outcome is the number of adequately reported items (0-8 scale) in the revised manuscript after the first round of peer review. The main analysis was intention-to-treat (n=24), and we imputed the scores of lost to follow-up manuscripts (rejected after peer review and not resubmitted). The secondary outcome is the proportion of manuscripts where each item was adequately reported. Two blinded reviewers assessed the outcomes independently and in duplicate and solved disagreements by consensus. We also recorded the amount of time to perform the intervention. RESULTS: Manuscripts in the intervention group (mean: 7.01; SD: 1.47) were more completely reported than those in the control group (mean: 5.68; SD: 1.43) (mean difference 1.43, 95% CI 0.31 to 2.58). We observed the main differences in items 6a (outcomes), 9 (allocation concealment mechanism), 11a (blinding) and 17a (outcomes and estimation). The mean time to perform the intervention was 87 (SD 42) min. CONCLUSIONS: We demonstrated the benefit of involving a reporting guideline expert in the editorial process. Improving the completeness of RCTs is essential to enhance their usability. TRIAL REGISTRATION NUMBER: NCT03751878.

Impact of a short version of the CONSORT checklist for peer reviewers to improve the reporting of randomised controlled trials published in biomedical journals: study protocol for a randomised controlled trial.

INTRODUCTION: Transparent and accurate reporting is essential for readers to adequately interpret the results of a study. Journals can play a vital role in improving the reporting of published randomised controlled trials (RCTs). We describe an RCT to evaluate our hypothesis that asking peer reviewers to check whether the most important and poorly reported CONsolidated Standards of Reporting Trials (CONSORT) items are adequately reported will result in higher adherence to CONSORT guidelines in published RCTs. METHODS AND ANALYSIS: Manuscripts presenting the primary results of RCTs submitted to participating journals will be randomised to either the intervention group (peer reviewers will receive a reminder and short explanation of the 10 most important and poorly reported CONSORT items; they will be asked to check if these items are reported in the submitted manuscript) or a control group (usual journal practice). The primary outcome will be the mean proportion of the 10 items that are adequately reported in the published articles. Peer reviewers and manuscript authors will not be informed of the study hypothesis, design or intervention. Outcomes will be assessed in duplicate from published articles by two data extractors (at least one blinded to the intervention). We will enrol eligible manuscripts until a minimum of 83 articles per group (166 in total) are published. ETHICS AND DISSEMINATION: This pragmatic RCT was approved by the Medical Sciences Interdivisional Research Ethics Committee of the University of Oxford (R62779/RE001). If this intervention is effective, it could be implemented by all medical journals without requiring large additional resources at journal level. Findings will be disseminated through presentations in relevant conferences and peer-reviewed publications. This trial is registered on the Open Science Framework (https://osf.io/c4hn8).

A survey exploring biomedical editors' perceptions of editorial interventions to improve adherence to reporting guidelines.

Background: Improving the completeness of reporting of biomedical research is essential for improving its usability. For this reason, hundreds of reporting guidelines have been created in the last few decades but adherence to these remains suboptimal. This survey aims to inform future evaluations of interventions to improve adherence to reporting guidelines. In particular, it gathers editors' perceptions of a range of interventions at various stages in the editorial process.   Methods: We surveyed biomedical journal editors that were knowledgeable about this topic. The questionnaire included open and closed questions that explored (i) the current practice of their journals, (ii) their perceptions of the ease of implementation and the potential effectiveness of different interventions, (iii) the barriers and facilitators associated with these interventions, and (iv) suggestions for future interventions and incentives. Results: Of the 99 editors invited, 24 (24%) completed the survey. Involving trained editors or administrative staff was deemed the potentially most effective intervention but, at the same time, it was considered moderately difficult to implement due to logistic and resource issues. Participants believed that checking adherence to guidelines goes beyond the role of peer reviewers and could decrease the overall quality of reviews. Journals incentivising adherence, and publishers and medical institutions encouraging journals to adopt strategies to boost adherence were two recurrent themes. Conclusions: Further evaluation of interventions are required. These evaluations could take into account the points raised in this survey.

Working 9 to 5, not the way to make an academic living: observational analysis of manuscript and peer review submissions over time.

OBJECTIVE: To determine whether researchers are submitting manuscripts and peer reviews to BMJ journals out of hours and whether this has changed over time. DESIGN: Observational study of research manuscripts and peer reviews submitted between 2012 and 2019 for which an author's address could be geocoded. SETTING: Online BMJ submission systems for two large general medical journals. MAIN OUTCOME MEASURES: Manuscript and peer review submissions on weekends, on national holidays, and by hour of day (to determine early mornings and late nights). Logistic regression was used to estimate the probability of manuscript and peer review submissions on weekends or holidays. RESULTS: The analyses included more than 49 000 manuscript submissions and 76 000 peer reviews. Little change over time was seen in the average probability of manuscript or peer review submissions occurring on weekends or holidays. The levels of out of hours work were high, with average probabilities of 0.14 to 0.18 for work on the weekends and 0.08 to 0.13 for work on holidays compared with days in the same week. Clear and consistent differences were seen between countries. Chinese researchers most often worked at weekends and at midnight, whereas researchers in Scandinavian countries were among the most likely to submit during the week and the middle of the day. CONCLUSION: The differences between countries that are persistent over time show that a "culture of overwork" is a literal thing, not just a figure of speech.

Frequency and format of clinical trial results dissemination to patients: a survey of authors of trials indexed in PubMed.

OBJECTIVE: Dissemination of research findings is central to research integrity and promoting discussion of new knowledge and its potential for translation into practice and policy. We investigated the frequency and format of dissemination to trial participants and patient groups. DESIGN: Survey of authors of clinical trials indexed in PubMed in 2014-2015. RESULTS: Questionnaire emailed to 19 321 authors; 3127 responses received (16%). Of these 3127 trials, 2690 had human participants and 1818 enrolled individual patients. Among the 1818, 498 authors (27%) reported having disseminated results to participants, 238 (13%) planned to do so, 600 (33%) did not plan to, 176 (10%) were unsure and 306 (17%) indicated 'other' or did not answer. Of the 498 authors who had disseminated, 198 (40%) shared academic reports, 252 (51%) shared lay reports, 111 (22%) shared both and 164 (33%) provided individualised study results. Of the 1818 trials, 577 authors (32%) shared/planned to share results with patients outside their trial by direct contact with charities/patient groups, 401 (22%) via patient communities, 845 (46%) via presentations at conferences with patient representation, 494 (27%) via mainstream media and 708 (39%) by online lay summaries. Relatively few of the 1818 authors reported dissemination was suggested by institutional bodies: 314 (17%) of funders reportedly suggested dissemination to trial participants, 252 (14%) to patient groups; 333 (18%) of ethical review boards reportedly suggested dissemination to trial participants, 148 (8%) to patient groups. Authors described many barriers to dissemination. CONCLUSION: Fewer than half the respondents had disseminated to participants (or planned to) and only half of those who had disseminated shared lay reports. Motivation to disseminate results to participants appears to arise within research teams rather than being incentivised by institutional bodies. Multiple factors need to be considered and various steps taken to facilitate wide dissemination of research to participants.