Evidence map›Paper›PMID 42098823›Full record

ArticleTrials2026

Publication bias and time to the publication of randomised trials conducted in sub-Saharan Africa: a cross-sectional study.

Ameer Hohlfeld, Lorenzo Douglas Maurice Bennie, Tamara Kredo, Michael Clarke

Abstract read
In one paragraph

Article in Trials, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Ameer HohlfeldCochrane South Africa, South African Medical Research Council, Cape Town, South Africa. ameer.hohlfeld@mrc.ac.za.ORCID http://orcid.org/0000-0003-1710-1265
Lorenzo Douglas Maurice BennieCochrane South Africa, South African Medical Research Council, Cape Town, South Africa.
Tamara KredoDivision of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
Michael ClarkeDivision of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.

Funding

South African Medical Research Council 42525
6 · The paper itself

Abstract

backgroundIdeally, evidence-based decisions about healthcare interventions should be informed by access to up-to-date information from all relevant RCTs, making it essential that the reports are published soon after study completion. However, studies have consistently shown that between 25 and 50% of clinical trials remain unpublished or are only published many years after completion. The WHO has noted a slow but steady increase in the number of RCTs since the mid-2000s, particularly in sub-Saharan Africa (SSA). However, the extent of publication bias of SSA RCTs remains unknown. Therefore, our study objectives were to assess (1) the proportion of completed RCTs from SSA that have been published and (2) the time from completion to publication.

methodsThis cross-sectional study, consisting of a retrospective analysis of registered SSA RCTs, aims to report the proportion of completed and terminated SSA RCTs registered in ClinicalTrials.gov and the Pan African Clinical Trials Registry (PACTR) and their time to publication.

resultsOur search yielded 7896 records, of which 3026 RCTs met our inclusion criteria for analysis. We identified journal publications for 1983 (65.5%) RCTs. The overall median time to publication from the primary completion date was 34.2 months (95% CI: 32.4 to 35.5).

conclusionsOverall, we found a substantial proportion (34.5%) of unpublished SSA RCTs. Moreover, the median time to publication from primary completion was 34.2 months. The persistence of publication bias threatens the integrity of evidence-based healthcare practice, particularly given that consumers depend on peer-reviewed journal publications as conventional and trusted sources to stay informed. Our findings underscore the importance of continued research to test and implement preventative strategies to mitigate publication bias.

Indexed as

Publication BiasRandomized Controlled Trials as TopicAfrica South of the SaharaCross-Sectional StudiesHumansPeriodicals as TopicRetrospective StudiesTime FactorsPublication biasRandomised controlled trialsResearch waste

Identifiers

PMID42098823
PMCPMC13321576

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.