Sub-Saharan African randomised trial, the barriers and enablers to publishing the results: a survey of principal investigators
1
Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
2
Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
3
Health systems research unit, South African Medical Research Council, Cape Town, South Africa
4
School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Timely reporting of randomised controlled trials(RCTs) is an essential part of evidence-based practice and policy, and an ethical obligation 1-3. Non-publication and delayed publication contribute to publication bias, but barriers faced by Africa-based principal investigators (PIs) are not well described.
METHODS:
We conducted a cross-sectional survey of African-based PIs who have conducted RCTs in Africa, whom we traced via the World Health Organization's primary trial registries. Outcomes included awareness of publication bias and obligation to publish, perceived magnitude of publication bias, experience of publication bias, and proposed ways to mitigate it.
RESULTS:
6056 invitations were sent, and 409 PIs consented to proceed. 62.7% were aware that all RCTs should be published, and indicated that the median publication bias in their region was 71%. For at least one completed RCT, 24% of PIs had non-published results because of journal rejections (31%), time constraints (29%), non-significant/non-positive results (13.4%), methodological concerns (13.4%), low confidence to write (12%). 27% had delayed publishing because of time constraints (47%), journal rejections (37%), for which the median journal submission ranged from 2 to 3.
CONCLUSIONS:
Publication bias appears to be driven by time pressures, repeated journal rejection and limited writing support. Mitigation strategies are needed to help PIs meet the scientific and ethical requirements, i.e. RCT results must be published.
Timely reporting of randomised controlled trials(RCTs) is an essential part of evidence-based practice and policy, and an ethical obligation 1-3. Non-publication and delayed publication contribute to publication bias, but barriers faced by Africa-based principal investigators (PIs) are not well described.
METHODS:
We conducted a cross-sectional survey of African-based PIs who have conducted RCTs in Africa, whom we traced via the World Health Organization's primary trial registries. Outcomes included awareness of publication bias and obligation to publish, perceived magnitude of publication bias, experience of publication bias, and proposed ways to mitigate it.
RESULTS:
6056 invitations were sent, and 409 PIs consented to proceed. 62.7% were aware that all RCTs should be published, and indicated that the median publication bias in their region was 71%. For at least one completed RCT, 24% of PIs had non-published results because of journal rejections (31%), time constraints (29%), non-significant/non-positive results (13.4%), methodological concerns (13.4%), low confidence to write (12%). 27% had delayed publishing because of time constraints (47%), journal rejections (37%), for which the median journal submission ranged from 2 to 3.
CONCLUSIONS:
Publication bias appears to be driven by time pressures, repeated journal rejection and limited writing support. Mitigation strategies are needed to help PIs meet the scientific and ethical requirements, i.e. RCT results must be published.
| eISSN: | 2654-1459 |
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