Research presentations and clinical vignettes often make their first appearance at scientific meetings. Previous studies have attempted to evaluate the transmission from abstract level presentation at national scientific meetings to widely disseminated scholarly works (Egloff et al., 2017; Scherer et al., 2018). However, there is limited literature on the topic of the translational effect of research presented at local or regional medical specialty meetings. The goal of this project was to characterize the proportion and format in which abstracts presented at the Oregon Chapter meeting of the American College of Physicians (ACP) progress onto broader scholarly formats.

We conducted a retrospective cohort review of abstracts submitted to the Oregon ACP annual meeting. For our analysis, we included available abstract data including authors, abstract title, submission category, and learner level.

For the primary outcome, we searched for subsequent peer-reviewed publication by entering the primary author’s last name and abstract title into PUBMED, Google Scholar, and Google Search. For each database, the first 40 search results were screened for relation to the original submitted abstract. Projects met the primary outcome if we identified a matching full-length publication in a peer-reviewed journal. For secondary outcomes, the same search strategy was implemented. Projects were screened for submission to national ACP meetings, other medical specialty meetings, and web-based non-peer-reviewed publications searchable through above methods. We also evaluated the relations between learner levels (Resident vs Student) to subsequent dissemination using a Fisher Exact Test. We completed our search as of Nov 1st, 2018, allowing for >12 months since the most recent group of abstract submission. Given the nature of this project as a review completed with publicly available research data that did not include human subjects, formal IRB exemption was not pursued (Sullivan, 2011).

From the 2014-2017 ACP Oregon Chapter Meetings, there were a total of 423 accepted abstract submissions. There were 5 categories for poster presentation, and an Oral Clinical Vignette presentation format (absolute number/percentage of total): Clinical Vignette poster (348/82.2%), Oral Clinical Vignette (24/5.7%), Quality Improvement -Patient Safety (23/5.4%), Clinical Research (18/4.3%), Basic Research (9/2.1%), & High Value Care (1/0.2%).

Of the 423 projects analyzed, 16 (3.8%) met the primary outcome criteria of publication in a peer-reviewed journal. 5 projects met criteria for both primary and secondary outcomes. 46 (10.9%) projects met criteria for the secondary outcome of dissemination outside of the ACP-Oregon chapter meeting. In all, 62 (14.7%) of projects met either primary and/or secondary outcomes and continued onto formats reaching a broader scholastic audience. There was a statistical difference between the number of resident projects (37 of 244; 10.7%) compared to student projects (25 of 79; 31.6%) that went onto wider dissemination (p<0.0001) (Table 1).

Of projects meeting secondary outcome criteria, 40 were presented at the National ACP Abstract Competition. 32 of these projects solely met secondary outcome criteria through participation in the National ACP abstract competition (32 of 46 projects, 69.6%). Of the 40 of these projects, 22 were presented by residents, 18 were presented by students.

This study provides baseline scholastic output data for a medical specialty organization state chapter abstract competition, showing that 3.8% of projects further developed into a peer-reviewed manuscript and a total of 14.7% of student and resident presentations developed further to reach larger scholarly audiences (meeting either primary or secondary outcome). Given the paucity of reports in the literature with similar context (i.e. State level, medical specialty organizations, & include clinical vignette abstracts), these data provide a baseline for future study and comparison.

A 2018 Cochrane meta-analysis on the full publication of results initially presented as abstracts, reports that 37.4% of abstracts progress onto a full publication (Scherer et al., 2018). Our observed rate of 3.8% is nearly an order of magnitude less than that. We hypothesize that this difference is a multifactorial. First, abstracts being presented at a national or international meeting compared to a state level abstract introduces a selection bias that selects for projects of higher “quality” or “impact” which has been associated with increased rates of publication (Scherer et al., 2018). Additionally, our observed publication rate includes all abstracts presented, while other researchers may omit studying publication rates of clinical vignette abstracts as part of their protocol (Egloff et al., 2017). Authors attempting to publish case reports (clinical vignettes) have several added barriers to publication compared to other research styles including lack of mentoring, fewer journals accepting case reports, and publication fees (Nissen and Wynn, 2012; Li, Wilson and Lau, 2019).

Another finding from this study showed that abstracts with students as primary author were more likely to progress onto wider dissemination. We believe that this difference is most driven by higher a higher proportion of clinical vignette submissions by residents (Students, 57 of 79 = 72.2%; Residents, 315 of 344 = 91.6%). As discussed above, case reports have added barriers to publication compared to clinical or bench research. Additionally, this disproportion is being driven by similar absolute numbers of ACP National Presentations among students and residents, but dissimilar proportions given more total abstract submissions by residents. Notably, the sponsoring organization (American College of Physicians) national abstract competition was the only additional scholarly output for over half of the projects (32/62= 51.6%). We attribute this high proportion to the low barrier to submit to the national meeting given similar abstract formats and the fact that a small number of winning abstracts are given immediate acceptance to the national contest. These data highlight the importance of linking state & regional meetings with larger national meetings to support learner scholarship.

Limitations of this study include the potential that search criteria may not return all relevant publications; especially If abstract titles are different enough from subsequent publication titles such as in cases where the authors use word-play in their abstract titles. Additionally, our search was complete 12 months after the most recent annual meeting. Effectively, this provided a follow-up period from time to presentation to analysis of 12 to 48 months depending on competition year. Previous studies have used a minimum of 24 months follow up as this is generally regarded as the window in which most abstracts will be published (Scherer et al., 2018). To monitor for effect of a shortened follow-up window, an ad-hoc Chi-Square analysis of abstracts meeting primary or secondary outcome by year showed no significant relation from time since presentation to wider dissemination (p=0.325).

From 2014-2017, a state level medical specialty abstract competition had high levels of participation through clinical vignette presentation, but low proportions of projects continued to be disseminated in broader scholastic audiences. With these data, our next steps are to see if applying targeted mentoring for case reports and clinical vignettes may improve publications rates over time in order to better support learner scholarship.