title: Barriers to and facilitators of interventions to counter publication bias: thematic analysis of scholarly articles and stakeholder interviews.
abstract: BACKGROUND
  When the nature and direction of research results affect their chances of publication, a distortion of the evidence base - termed publication bias - results. Despite considerable recent efforts to implement measures to reduce the non-publication of trials, publication bias is still a major problem in medical research. The objective of our study was to identify barriers to and facilitators of interventions to prevent or reduce publication bias.
  
  
  METHODS
  We systematically reviewed the scholarly literature and extracted data from articles. Further, we performed semi-structured interviews with stakeholders. We performed an inductive thematic analysis to identify barriers to and facilitators of interventions to counter publication bias.
  
  
  RESULTS
  The systematic review identified 39 articles. Thirty-four of 89 invited interview partners agreed to be interviewed. We clustered interventions into four categories: prospective trial registration, incentives for reporting in peer-reviewed journals or research reports, public availability of individual patient-level data, and peer-review/editorial processes. Barriers we identified included economic and personal interests, lack of financial resources for a global comprehensive trial registry, and different legal systems. Facilitators identified included: raising awareness of the effects of publication bias, providing incentives to make data publically available, and implementing laws to enforce prospective registration and reporting of clinical trial results.
  
  
  CONCLUSIONS
  Publication bias is a complex problem that reflects the complex system in which it occurs. The cooperation amongst stakeholders to increase public awareness of the problem, better tailoring of incentives to publish, and ultimately legislative regulations have the greatest potential for reducing publication bias.
authors.forename: Christina
authors.initials: C
authors.lastname: Kien
authors.forename: Barbara
authors.initials: B
authors.lastname: Nußbaumer
authors.forename: Kylie J
authors.initials: KJ
authors.lastname: Thaler
authors.forename: Ursula
authors.initials: U
authors.lastname: Griebler
authors.forename: Megan G
authors.initials: MG
authors.lastname: Van Noord
authors.forename: Petra
authors.initials: P
authors.lastname: Wagner
authors.forename: Gerald
authors.initials: G
authors.lastname: Gartlehner
mesh_terms: D035843:Biomedical Research / Q000592:standards*; D006801:Humans; D010380:Peer Review; D011446:Prospective Studies; D017594:Publication Bias; D011643:Publishing / Q000592:standards*; D012042:Registries / Q000592:standards*; D058028:Research Report / Q000592:standards*; D011795:Surveys and Questionnaires; D006113:United Kingdom