Reporting Bias in Imaging Diagnostic Test Accuracy Studies: Are Studies With Positive Conclusions or Titles Submitted and Published Faster?

AJR Am J Roentgenol. 2021 Jan;216(1):225-232. doi: 10.2214/AJR.19.22744. Epub 2020 Nov 10.


Objective: The purpose of this study is to evaluate whether imaging diagnostic test accuracy (DTA) studies with positive conclusions or titles have a shorter time to publication than those with nonpositive (i.e., negative or neutral) conclusions or titles.

Materials and methods: We included primary imaging DTA studies from systematic reviews published in 2015. The conclusion and title of each study were extracted, and their positivity was classified independently in duplicate. The time from study completion to publication was extracted and calculated. A Cox regression model was used to evaluate associations of conclusion and title positivity with time to publication, with adjustment made for potentially confounding variables.

Results: A total of 774 imaging DTA studies were included; time from study completion to publication could be calculated for 516 studies. The median time from completion to publication was 18 months (interquartile range, 13-26 months) for the 413 studies with positive conclusions, 23 months (interquartile range, 16-33 months) for the 63 studies with neutral conclusions, and 25 months (interquartile range, 15-38 months) for the 40 studies with negative conclusions. A positive conclusion was associated with a shorter time from study completion to publication compared with a non-positive conclusion (hazard ratio, 1.31; 95% CI, 1.02-1.68). Of all included studies, 39 (5%) had positive titles, 731 (94%) had neutral titles, and 4 (< 1%) had negative titles. Positive titles were not significantly associated with a shorter time to study publication (hazard ratio, 1.12; 95% CI, 0.75-1.69).

Conclusion: Positive conclusions (but not titles) were associated with a shorter time from study completion to publication. This finding may contribute to an overrepresentation of positive results in the imaging DTA literature.

Keywords: diagnostic imaging; diagnostic tests; epidemiology; publication bias; research design; routine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bibliometrics*
  • Diagnostic Imaging*
  • Humans
  • Proportional Hazards Models
  • Publication Bias*
  • Sensitivity and Specificity
  • Time Factors