title: Time-lag bias in trials of pediatric antidepressants: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To determine whether there is evidence of a time-lag bias in the publication of pediatric antidepressant trials.
  
  
  METHODS
  We conducted a meta-analysis of published and unpublished randomized placebo-controlled trials of serotonin reuptake inhibitors (SRIs) in subjects less than 18 years of age with major depressive disorder. Our main outcomes were (1) time to publication of positive versus negative trials, and (2) proportion of treatment responders in trials with standard (<3 years after study completion) versus delayed publication.
  
  
  RESULTS
  We identified 15 randomized, placebo-controlled trials of SRIs for pediatric depression. Trials with negative findings had a significantly longer time to publication (median years ± standard deviation = 4.2 ± 1.9) than trials with positive findings (2.2 ± 0.9; log-rank χ(2) = 4.35, p = .037). The estimated efficacy in trials with standard publication time (number needed to treat = 7, 95% CI = 5-11) was significantly greater than those with delayed publication (17, 95% CI = 9-∞; χ(2) = 4.98, p = .025). The inflation-adjusted impact factor of journals for published trials with positive (15.33 ± 11.01) and negative results (7.54 ± 7.90) did not statistically differ (t = 1.4, df = 10, p = .17).
  
  
  CONCLUSIONS
  Despite a small number of trials of SRIs for pediatric antidepressants, we found a significant evidence of time-lag bias in the publication of findings. This time-lag bias altered the perceived efficacy of pediatric antidepressants in the medical literature. Time-lag bias is not unique to child psychiatry and reflects a larger problem in scientific publishing.
authors.affiliation: Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT 06520, USA.
authors.forename: Magdalena M
authors.initials: MM
authors.lastname: Reyes
authors.forename: Kaitlyn E
authors.initials: KE
authors.lastname: Panza
authors.forename: Andrés
authors.initials: A
authors.lastname: Martin
authors.forename: Michael H
authors.initials: MH
authors.lastname: Bloch
mesh_terms: D000293:Adolescent; D002648:Child; D002665:Child Psychiatry / Q000941:ethics; D003865:Major Depressive Disorder / Q000188:drug therapy*; D016527:Drug Costs; D006801:Humans; D055811:Journal Impact Factor; D017063:Outcome Assessment, Health Care; D017594:Publication Bias; D011643:Publishing / Q000191:economics / Q000941:ethics; D016032:Randomized Controlled Trials as Topic / Q000191:economics*; D012107:Research Design; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors