OA Epidemiology

All That Glitters Isn?t Gold: A Survey on Acknowledgement of Limitations in Biomedical Studies

Proceedings of the 2013 annual meeting of the Netherlands Epidemiology Society

Volume 1 Issue S1 Abstract 1


Gerben ter Riet, Department of Family Medicine, Meibergdreef 15, Room J2-117, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
Paula Chesley, Seminar für Sprachwissenschaft University of Tübingen Tübingen, Germany
Alan G. Gross, Department of Communication Studies, University of Minnesota, MN, USA
Milo A. Puhan, Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA

Acknowledgment of all serious limitations to research evidence is important for patient care and scientific progress. Formal research on how biomedical authors acknowledge limitations is scarce. We assessed the extent to which limitations are acknowledged in biomedical publications explicitly, and implicitly by investigating the use of phrases that express uncertainty, so-called hedges; to assess the association between industry support and the extent of hedging.

We analyzed reporting of limitations and use of hedges in 300 biomedical publications published in 30 high and medium -ranked journals in 2007. Hedges were assessed using linguistic software that assigned weights between 1 and 5 to each expression of uncertainty. Results: Twenty-seven percent of publications (81/300) did not mention any limitations, while 73% acknowledged a median of 3 (range 1-8) limitations. Five percent mentioned a limitation in the abstract. After controlling for confounders, publications on industry- supported studies used significantly fewer hedges than publications not so supported (p=0.028).

Reporting of limitations in biomedical publications is probably very incomplete. Transparent reporting of limitations may protect clinicians and guideline committees against overly confident beliefs and decisions and support scientific progress through better design, conduct or analysis of new studies.

Published: 06 Jun, 2013

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