Monthly Archives: July 2018

Is article unavailability another type of bias?

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!

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Alert! It’s Flashy Title bias!!!

Picture the scene: I’m at a journal club and we are talking about bias. The leader brings up a list (a long one!) of different types of bias from Randomised Controlled Trials: A Users Guide [Alejandro R Jadad]. I spot ‘Flashy Title bias’ amongst the list and the leader brings it back up onto the screen and people laugh. So what is Flashy Title bias? Maybe the title of this blog post is one! This bias refers to papers with attractive titles that interest journalists and the public and therefore have the opposite reaction from academics and healthcare professionals.

But wait – here is a problem. People who want to publish and have their papers discovered by others are advised to have ‘a good title’. So what does that mean? Editage Insights advises that: the title must clearly indicate aboutness, be brief but attractive, include keywords that people would use to find the article in databases, and avoid jargon and uncommon abbreviations. They do mention the ‘book by it’s cover’ bias (aka flashy title bias) but also reiterate attractiveness and persuasiveness. So what to do? It is necessary to have a balance here of informative and attractiveness. Avoid titles that sound like click-bait but don’t settle for boring or plain.  This video from Editage Insights gives a good summary of how to come to a good title: