Monday, May 11, 2020

Adventures in Protocol Publication

As most reading this will know, a systematic review is no small feat. But while the complete project itself can feel intimidating at times, a well-planned systematic review is broken up into enough small parts to make each part feel manageable – and a lot like an accomplishment it itself. One such step that more and more authors are choosing to take is the publication of their protocol in a peer-reviewed journal.

As Evidence Foundation fellow, I have had the unique opportunity to lead the development of a systematic review and critical appraisal of physical activity guidelines in collaboration with members of the U.S. GRADE Network. After nearly 18 months of work, I’m happy to report that the first draft of the manuscript has been written – but I was given a sweet taste of this accomplishment earlier on when my protocol was published in January. Here’s what I learned through the process.

Reasons to Publish a Systematic Review Protocol (For the Good of Science)
·      Just as with clinical trials, the publication of a protocol for a systematic review alerts other researchers in the field to the work being conducted, thus reducing duplication of efforts.
·      Defining the goals and processes to be used in the systematic review before it’s conducted (a priori) likely reduces bias.
·      According to a 2017 study comparing reviews with and without a published protocol, reviews with published protocols were more likely to be thorough and transparent in their reporting of methods in the resulting review. (However, this may just be because those who are likely to publish a protocol are also more likely to be generally thorough and transparent… but if that’s the case, which side would you like to be on?)

Reasons to Publish a Systematic Review Protocol (For Your Own Good)
·      Set yourself up for success. Submitting a protocol to a peer-reviewed journal gives you an opportunity to resolve any issues and automatically improve the quality of your final review manuscript before you even press “submit.” That means less work at the end of the day, and likely a shorter time window from submission of your final review to its publication. For instance, my reviewers asked that I further elaborate and clarify the history and importance of physical activity guidelines, which ultimately strengthened the introduction to my SR.
·      Save yourself room. Going in-depth in your published protocol means you can spend less space on the methods section of your final review, leaving you with more room for the meat of the paper: the results and discussion sections. Simply discuss your methods more briefly and cite your published protocol for further reading (and, lest I forget to mention, citing yourself is the ultimate power move).
·      Grow your CV. By getting their protocol published, a young researcher can add a precious first-author citation to their vitae. These don’t grow on trees, and publishing a protocol is like a two-for-one deal.
·      Stay accountable. Publishing your protocol for the world to see may be just the motivation you need to finish the task – and quickly, now that everyone’s waiting to see the results!

Reasons Not to Publish a Protocol (and Just Stick to PROSPERO Instead)
·      Financial burden. Publishing is not usually a cheap endeavor, and unless you have additional support, charges and fees may be better spent on the final review.
·      Opportunity cost. Honestly consider how much additional time and psychic bandwidth it may take you to get a protocol published, from the drafting to the revisions and everything in between (like editing every reference with a fine-toothed comb). Is it time that you’d rather spend on working on the review?
·      Longer time to publish. As per the above, it’s possible that the work of publishing a protocol may protract the entire process. That same 2017 study found that the median time from the search to submission of a review for which a protocol had been published was 325 days, and 578 days to publication of the final document. This stands in contrast to the matched reviews for which a protocol was not published, which only took a median of 122 days to submission and 358 days to publication.

A (By All means Non-Exhaustive) List of Places to Publish a Systematic Review Protocol
·      BMJ Open
·      Cochrane Database of Systematic Reviews
·      Environment International
·      JBI Database of Systematic Reviews and Implementation Reports
·      Medicine
·      Systematic Reviews

If you’re adequately convinced after weighing the costs and benefits, dust off your PRISMA-P checklist (heads up: the journals above will need you to show how you’ve fulfilled each criterion) and get writing.