Related to the previous post, I wondered aloud at journal club whether the unavailability of an article is a bias. I can imagine that people looking for articles will opt for free first, then (if they have turned on their Google library link) see if their library has it. If it is unavailable, I can imagine that people skip that article and go to the one they can access.
Scenario: someone is preparing for a journal club and is looking for evidence for treatment of a certain condition. They search Google or PubMed (not accessing it via their library’s website – not knowing that the library enabled their collection to show in the results), and their article of choice which is of the highest evidence available is 1) not free and 2) when they click on the publisher’s link, they find out that they have to pay for the article. This person then goes to their university library which they still have access to, to see if they have it. The uni library doesn’t (neither does the hospital library) but the university library offers an ILL service (as do hospital libraries). But the person decides it is too much bother and goes back to the search results to look for something readily accessible.
Is this bias?
I think it could be. If you have time before your meeting to order and be sent the article, you could be looking at the best article with the highest level of evidence available. People involved in writing systematic reviews should (and do) utilise ILL services for included articles. If a rigorous search has been done which naturally would include articles not immediately available, inclusion and exclusion criteria should not include article availability.
So what I am I saying here? As well as being biased by flashy titles, people also are biased by availability: if it isn’t immediately accessible, people will move to 2nd or 3rd choice.
I have to say I’ve been biased this way. Bias surely can be a minefield!