|Year : 2021 | Volume
| Issue : 2 | Page : 102-107
Publication outcomes after conference abstract submissions in a Singapore anesthesiology academic clinical program
Ha Thi Thu Truong1, Raymond Wee Lip Goy2, Rehena Sultana3, Darren Liang Khai Koh4, Prit Anand Singh5, Yew Nam Siow6, Chai Rick Soh7, Ban Leong Sng2
1 Anaesthesiology and Perioperative Sciences Academic Clinical Programme, Singapore General Hospital, Singapore
2 Women's Anaesthesia, KK Women's and Children's Hospital, Singapore
3 Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore
4 Department of Anaesthesiology, Singapore General Hospital, Singapore
5 Department of Anaesthesia and Surgical Intensive Care, Changi General Hospital, Singapore
6 Paediatric Anaesthesia, KK Women's and Children's Hospital, Singapore
7 Department of Anaesthesiology, Division of Anaesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore
|Date of Submission||07-Jan-2021|
|Date of Decision||09-Feb-2021|
|Date of Acceptance||28-Feb-2021|
|Date of Web Publication||16-Apr-2021|
Dr. Ha Thi Thu Truong
ANAES ACP Office, Level 5, SingHealth Tower, 10 Hospital Boulevard, 168582
Source of Support: None, Conflict of Interest: None
Background: We conducted a survey among anesthesiologists in a Singapore Anesthesiology Academic Clinical Program to investigate the rate of successful publications following conference abstract submissions, the reasons for not submitting manuscripts, and unsuccessful publications. Materials and Methods: Anonymous online survey enquired about respondents' publication records, the number of abstracts submitted and accepted, the number of manuscripts written and their status in the past 3 years, the reasons for not submitting manuscripts following abstract submission, unsuccessful publications, and the types of published articles. Statistical analyses included the descriptive statistics and comparisons between two subgroups of clinician (Senior Resident/Associate Consultant [SRAC], Consultant [C]). Results: There were 68 responses to the survey. A total of 175 local and international conferences abstract submissions were accepted from May 2016 to May 2019. Of these, 67 (38.3%) were written into full-length manuscripts and 64 (36.5%) were published. The top reasons for the lack of manuscripts were “the low likelihood to be accepted for the publication due to methodological reasons,” “no intention to write the abstracts to manuscripts,” and “lack of time to prepare manuscripts.” The most common categories of published articles were case report/case series, retrospective, and prospective studies. The SRAC group (n = 41) reported higher number of retrospective studies than the C group (n = 27): 14 versus 3 studies, P = 0.045. Clinical research and medical education were the main successful publication domains. Conclusion: A minority of 36.5% (N = 65) of the abstracts submitted to conferences were published. This study identified potential areas where support can be given to anesthesiologists to improve publication success.
Keywords: Academic medicine, anesthesiology, medical education, publication
|How to cite this article:|
Thu Truong HT, Lip Goy RW, Sultana R, Khai Koh DL, Singh PA, Siow YN, Soh CR, Sng BL. Publication outcomes after conference abstract submissions in a Singapore anesthesiology academic clinical program. Bali J Anaesthesiol 2021;5:102-7
|How to cite this URL:|
Thu Truong HT, Lip Goy RW, Sultana R, Khai Koh DL, Singh PA, Siow YN, Soh CR, Sng BL. Publication outcomes after conference abstract submissions in a Singapore anesthesiology academic clinical program. Bali J Anaesthesiol [serial online] 2021 [cited 2021 Jun 23];5:102-7. Available from: https://www.bjoaonline.com/text.asp?2021/5/2/102/313898
| Introduction|| |
The SingHealth Anesthesiology and Perioperative Sciences Academic Clinical Program (ANAES ACP) provides a framework to advance Anesthesiology academic medicine initiatives at the SingHealth Duke-NUS Academic Medical Centre. The ANAES ACP supports academic medicine at the Singapore General Hospital, KK Women's and Children's Hospital, Changi General Hospital and Sengkang Health. Postgraduate education in the ANAES ACP is provided by the SingHealth Anesthesiology Residency Program (SHARP). This is a 5-year program with 3 years of junior residency and 2 years of senior residency (SR). There are over 100 anesthesiologists and 60 residents in the ACP.
Funding is available to support faculty and residents for training and career development at conferences that often require abstract submission with a poster or an oral presentation. Participation in these academic activities allows clinicians to know current research trends and active engagement in best clinical practices at national and international levels.
A good abstract is an excellent tool to provide the target audience with a brief preview of a study that is informative and concise. Selected abstracts for the presentation at scientific meetings are usually published in conference proceedings and could be followed by subsequent publications in peer-reviewed journal. The transference of knowledge and findings from presentations at scientific meetings attended by a small group of audiences, to a wider range of audiences worldwide through peer-reviewed journal could enhance the impact of the presented work clinically and academically. Despite the merits of publications, only 44.5% of 30,000 abstracts presented at scientific meetings materialized into published articles. There were several barriers to full-length published articles derived from abstracts: The lack of time to prepare a manuscript, the lack of support from co-authors and the low likelihood of journal acceptance due to methodological limitations of study.,,
In the academic medicine context, publications in peer-reviewed scientific journals serve both as a means to contribute to scientific knowledge and clinician key performance indicator. This study aimed to determine the rate of publications derived from the abstracts presented at scientific meetings, by anesthesiologists and senior residents. This study also investigated the reasons for the lack of manuscripts derived from accepted abstracts of studies and unsuccessful publications. Information obtained from this study can then be used to understand and enhance academic medicine development in the ACP.
| Materials and Methods|| |
This study was approved by our Ethics Committee – the SingHealth Centralized Institutional Review Board, reference 2018/3227. Anonymized online survey was conducted online on SurveyMonkey™ platform to facilitate participation across different institutions. The survey was conducted from May to August 2019. An invitation E-mail explained the study objectives and contained the survey link which was sent to all the eligible participants. Reminder E-mails were sent weekly until the study ended.
The survey was developed in reference to several recent studies on this topic.,,, The drafted questionnaire was read and fine-tuned for clarity and validity by the investigators. The 15-question survey was designed to be concise to enhance the response rate. The first six questions solicited information such as participant's age, current designation (Senior Resident [SR], Associate Consultant, Consultant Year 1 and 2, Consultant Year 3 and above), Clinician Scientist (CS) career track intention (Yes/No), and publication track record. The question on CS career track was specifically asked as CS is given protected time for research and thus tracked for research key performance indicators such as the number of publications and awarded grants. Their answers could be potential outliers in comparison to clinicians who were not in the CS track. Questions 7–10 asked for the number of abstracts submitted and accepted; the number of full-length manuscripts written following these abstracts and the publication status of these manuscripts. Survey participants were asked to choose all applicable reasons for the lack of manuscripts and unsuccessful publications in questions 11 and 12. The next two questions 13 and 14 inquired about the types of successful publication in terms of study type (prospective, retrospective, case report, and others) and research field (clinical, translational, education, quality improvement, patient safety, clinical innovation, and others). We also explored what could be done to help with the publication preparation process in question 15, allowing a free text answer.
We identified potentially suitable survey respondents using the anesthesiology faculty and residency databases who were subjected to promotional publication requirements. Eligibility criteria were full time employed SingHealth Anesthesiologists designated Associate Consultant (3) to Consultant (C), or SHARP senior residents (SR) who are not leaving employment and not on long leave. The designation criterion of the respondents is associated with organizational promotion guidelines, i.e., a clinician must author several peer-reviewed journal articles in order to be promoted from AC to C for example.
Statistical analyses were performed using SAS (version 9.4, 2017, SAS Institute Inc., Cary, North Carolina, U.S.) Descriptive analysis was conducted for the two subgroups of survey participants (Senior Residents and Associate Consultant, [SRAC] group) versus (Consultant, C group). The comparison of demographic characteristics, publication track record, and abstract outcomes was done using the Fisher/t-tests, as the sample size was small and the mean and median values were close to one another in all the counts. P < 0.05 was considered statistically significant.
| Results|| |
Using the faculty databases in April 2019, we identified 105 clinicians who were potentially eligible for this study and the study period was May to August 2019. Upon further examining, 13 clinicians were removed from the eligible list due to the following reasons: on maternity leave (n = 4), newly promoted to Senior Consultant (n = 4), in the process of separation from the employed institution (n = 3), and on 1-year training leave (n = 2). After the first round of study participation invitation E-mail, four clinicians opted out of the invitation list. There were 88 remaining eligible clinicians. Of these, 68 completed the survey (77.3%) [Figure 1]. The response rates by group were 85.4% among the SRAC and 67.5% among the C group.
A total of 182 scientific abstracts were submitted in the past 3 years of this survey. Of these, 175 were accepted and presented at various scientific conferences and meetings (96.1%). The respondents reported 67 manuscripts written up from these abstracts (38.2%). During the same period, the respondents reported 64 publications (36.5%).
The demographic characteristics and publication track record of the respondents are in [Table 1]. The mean age of the study participants was 34.9 years. Overall, 32 respondents reported having met the publication criteria for promotion (48.5%). The survey participants published a total of 110 articles as the first author and 109 articles as an author in other author sequences in total. There was no difference in the number of published articles between the two groups [Table 1].
|Table 1: Demographic and publication records of the survey respondents (n=68)|
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[Table 2] shows information on the reported scientific conference abstracts submitted, accepted and the number of resulting manuscripts in the past 3 years. The SRAC group reported a higher mean (standard deviation [SD]) number of abstracts submitted in the past 3 years at 3.2 (2.1), compared to C group at 1.9 (2.0), P = 0.009. Similarly, the mean (SD) number of abstracts accepted was higher in the SRAC group 3.1 (2.1), compared to the C group 1.8 (1.95), P = 0.01. Regarding the number of abstracts written into full-length manuscript, the SRAC group reported a higher mean (SD) number of abstracts per clinician at 1.2 (1.4), compared to C group 0.6 (1.1), P = 0.03. Of the 175 abstracts that were accepted, 67 were written into full-length manuscripts (38.3%) and 64 (36.5%) were published. The mean number of manuscripts published was higher in the SRAC group 1.3 (2.2) compared to the C group 0.3 (0.5), P = 0.007 [Table 2].
|Table 2: Three-year abstract submission figures and publication outcomes|
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The survey investigated the reasons for the lack of manuscripts derived from accepted abstracts of studies and unsuccessful publication [Table 3]. The most common reason chosen for the lack of full-length manuscript was “There was no intention to write the abstract to a manuscript” (n = 25), followed by “The study has a low likelihood of being accepted for publication, due to methodological reasons (e.g., weak study design, small sample size, etc.)” (n = 23). The respondents reported “The manuscript has a low likelihood of being accepted for publication due to various reasons, e.g., weak study design, small sample size, the results were not statistically significant, etc.” as the most common reason for the unpublished manuscripts (n = 16).
|Table 3: Top reasons for the lack of manuscripts written and unsuccessful publications|
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Of the successfully published articles, 29 respondents reported Case reports/ Case series, followed by Retrospective study and Prospective study design, n = 17 each. Clinical research (n = 35) and medical education research (n = 4) publications were published. The survey participants also contributed suggestions on useful measures to help them in publication endeavors, including skills training and publication strategy guidance [Table 4].
|Table 4: Suggestions to improve publication quality and quantity in the Academic Clinical Program|
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| Discussion|| |
This study found a successful publication rate at 36.5% of manuscripts from conference abstracts among anesthesiologists in a single Singapore Academic Medical Centre. There are several challenges during the manuscript writing and submission process including: (1) the lack of intention to report scientific results in an article after submission of conference abstract was most commonly reported, (2) some studies were perceived to be poorly designed and (3) the lack of time and experience in publication strategy hindered some anesthesiologists in their publication success. The SRAC group reported a higher number of abstract submission and publications than the C group.
Previous studies evaluated the eventual publication outcomes from scientific conference meetings across different disciplines showed a wide range of success: 57% in anatomy, 40.1% in hip arthroscopy, 30.6% in cardiovascular, 26.8% in obstetric anesthesia and perinatology. In anesthesiology, this study publication rate of 36.5% was higher than those reported by National Turkish Society of Anesthesiology, the Indian Society of Anesthesiologists' Conference and the American Society of Anesthesiologists Annual meeting at 4.7%, 5% and 22% respectively, about the same as the Congress of the American Society of Anesthesiologists (33.8%) and lower than the Turkey Society of Anesthesiology and Reanimation National Congresses (42.3%).,,
Possible explanations for the differences in the reporting publication rates could be meeting-specific factors (the size of the meeting, geographical level, and abstract acceptance rate), specialty-specific factor (general or sub-specialty meeting), and the methodology in reporting (tracking of publications and abstract-to-publication timeframe). These studies tracked publication success through different methods, such as searching Medline or directly on PubMed using keywords composed of authors' names or conference abstract titles. These searches can be done manually or computerized using Boolean operation.,, This study used self-reported data from the cohort of eligible Anesthesiologists in our Academic Medical Centre.
The frequently cited obstacles to publication were the lack of time to prepare for publication, the lack of intention to publish, low priority, lack of support from co-author, incomplete or on-going study, poor study design, and negative or unimportant result.,, However, this study found a less reported barrier to publication: clinicians' self-reported lack of experience in preparing a manuscript and submission strategy. This study population had relatively more junior specialists and senior residents still in training.
Lack of time is the most common reason cited by clinicians.,,,, Manuscript preparation and submission is often lengthy and time-consuming. When the final manuscript is submitted, it could take from 3 months up to 18 months for revisions till final publication.,, The heavy clinical workload of senior residents in training and junior specialists could be a significant barrier to publications due to competing interest in achieving clinical competency and clinical workload.
Only a small minority had the intention to follow the CS track (2.94%) and would be more motivated to build a publication track record and credible portfolio for future grant funding application. Most clinicians are more likely to view publication as a minor part of the requirements to fulfil for career promotion. There are other competing academic activities such as administrative, clinical quality and safety and education work.
Weak study design and poor methodology were common reasons for the lack of manuscript and unsuccessful publications in this study (30.9%). This is of concern as poorly designed studies are less likely to reach the publication stage. Six correspondents mentioned that the abstracts used preliminary results and the studies were on-going (8.8%). We did not investigate the types of on-going studies. This rate was much lower than the rate of 31% reported by Sprague et al. 2003. Hence, a follow-up study could be useful to investigate if these preliminary results with added data could lead to publications in future. Only one respondent reported delay of manuscript writing due to slow correspondence with other co-authors (1.47%). This was lower than the rate of authorship issues that other studies reported at 4.76%, 9%, and 17%. Thus, it has been recommended for the authors to agree on the deliverables and authorship issues before the manuscript writing process.,,
To overcome such barriers to publications, the problem of lack of time could be addressed early by having dedicated time for manuscript writing and establishing a deadline. Clinicians should assess their ability to see through the studies to completion. Quantitative help or support is essential to ensure that study design is properly planned. Dedicated mentorship will be helpful especially for relatively inexperienced clinicians to reduce the overall time for the publication. Avoiding presenting preliminary results to lower the risk of potentially inaccurate conclusion, proper and thorough literature review to ensure that the study contains new and useful information and ensuring adequate resources and funding to ensure studies could be completed are other strategies to improve publication success.
The limitations of this study include that we did not investigate whether the conference presentations and projects were externally funded. We did not assess the average publication lag time, the quality of journals that the manuscripts were published and whether there was any conflict between the co-authors of the abstracts. There could be a long lag-time for an abstract to reach a full-length article publication phase. The study time frame of 3-years could be too short for an accurate evaluation of publication success. We did not investigate the quality of the published articles (whether indexed or nonindexed journals and impact factor). The results were self-reported and might be subjected to recall bias.
This study employed short questionnaire with multiple-choice questions, but could limit the true extent and depth of the responses. A follow-up qualitative study in the forms of focus group discussions and one-to-one interview would be strategic. We can then explore in-depth the participants' personal perception of the barriers and providing more robust suggestions to overcome obstacles to publication.
| Conclusion|| |
This study showed that the publication rate from conference abstracts from Anesthesiologists in a single Singapore Academic Medical Centre was 36.5%. Lack of time, the lack of intention and motivation in publication, perceived flaws in the methodology of study and the lack of experience in manuscript preparation and publication strategy were found as possible reasons to improve. Efforts are needed in mentoring clinicians in guiding through the preparation and revision process.
The authors would like to thank all the Anesthesiologists from the Anesthesiology and Perioperative Sciences Academic Clinical Program (ANAES ACP) and senior residents in the SingHealth Residency Program (SHARP) for taking part in this study. The authors would like to acknowledge the SHARP team and Ms Christine Neoh Gaik Yie, ANAES ACP for their support.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4]