Publication Bias: Its Role in Medical Literature & the Ethical Implications Público
Roome, Kerryn (Spring 2021)
Abstract
Publication bias, also called positive-outcome bias and dissemination bias, has been a long standing and prominent problem in the scientific community. Publication occurs for several reasons, but this thesis aims to analyze the ethical implications of such bias in medical literature through the lens of several different moral theories – feminist ethics, the ethics of care, utilitarianism, and Kantian ethics. This thesis also explores the ethical obligations all stakeholders have in publishing in an ethically sound manner as well as identifying the powers at play in a competitive and high stakes environment. Additionally, since this specifically has not been quantitatively measured or assessed, this thesis quantifies the status of publication bias in today’s medical society as well as determines the changes that have occurred over a 30-year time period. Every original, hypothesis-driven research article in the top 3 and bottom 3 medical journals, ranked by impact factor, are coded and assessed in the years 1998, 2008, and 2018. This sampling technique shows trends in publication bias and provides insight into the status of publication bias. It was found that non-significant studies were more likely to be published if they were experimental studies rather than observational studies. Additionally, a significant change over time was found within high impact journals and observational studies.
Table of Contents
I. An Introduction 1
Publication Bias: What is it and why is it a problem? 2
Structure 7
II. Ethical Obligations and the Powers at Play 9
III. Feminist & Virtue Ethics 21
Feminism Overview 22
Bias, Objectivity, and Empiric Research 23
Virtue Ethics 26
The Nature of Flourishing 30
IV. A Utilitarian Approach 32
V. A Kantian Approach 39
VI. Counter-arguments 46
VII. Methods 49
Specific research questions 50
Data sources and selection of journals and years of publication (process and rationale) 51
Criteria used to select articles for the final analysis 53
Specific information extracted from each article that met inclusion criteria 54
Second Coder 56
Second Coder Results 57
Data analysis 58
VIII. Results 59
Study sample (Table 1) 60
Association between journal, journal group, and study type (Table 2) 61
Journal Title 61
Journal Group: High vs. Low Impact Factors 62
Study Type 62
Changes over time (Table 3) 63
By Impact Factor 63
By Study Type 63
IX. Discussion 65
Interpretation of Findings 66
Notable Observations 68
Limitations 69
X. Conclusion & Reflections 71
Recent Events 74
References 77
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