The results of randomized trials are commonly presented at major medical congresses in cardiovascular medicine during late-breaking trial sessions.1–4 Trials highlighted in these sessions are typically relevant for practicing clinicians and often inform practice guidelines following their simultaneous or nonsimultaneous publication in top tier peer reviewed medical journals.5

The simultaneous or parallel publication of a late-breaking trial (eg, when the release of the full paper is concomitant to the congress presentation of the study) enhances the dissemination of the results at a time when the visibility and the impact of the study are at a critical moment owing to news outlets and press releases.6 The rapid access to a reference of peer reviewed data that expand those included in the congress presentation has the potential to increase the impact of the study as it relates to citations, social media metrics, and implementation in clinical practice.7 In addition, a simultaneous publication can bring value to multiple stakeholders, including authors, journals, medical societies, congresses, study sponsors, and readers themselves.8 Many journals and conferences have now developed guidelines for simultaneous publications and make public calls for these submissions.9 However, the process of developing simultaneous publication can pose multiple challenges, including shortened timelines, reviewer fatigue, manuscript rejection, and tight management of processes and timelines.10

In the case of nonsimultaneous publication (eg, when there is a certain time lag between the presentation of a study and its publication), the reporting of the study results may not benefit from the same degree of dissemination, and the authors may miss the opportunity to gain additional impact in the short term.11 However, delaying publication also has potential benefits. For example, following conference presentation, the authors benefit from the comments received, which may lead to improving the manuscript before publication. On the other hand, some readers interpret delays that are too long as a sign of publication bias.12

To our knowledge, the practice of simultaneous publication has not been thoroughly investigated so far. Academic cardiovascular medicine is a highly competitive field with several conferences and publications, making it an ideal area to investigate this phenomenon. In this cross-sectional study, we aimed to compare the characteristics, predictors, and impact of simultaneous vs nonsimultaneous publication in the field of cardiovascular medicine.

This study provides valuable insights into the phenomenon of simultaneous publication of randomized clinical trials in cardiovascular medicine (figure 3). Our results suggest that trials selected for presentation in the main conference room and those with shorter review times are more likely to be published at the time of their presentation. Additionally, we found that simultaneous publications are associated with higher citation and mention metrics compared with nonsimultaneous publications.

Figure 3.

Central illustration. Illustrates the main aspects of the study design and results. On the left, the study flow is outlined, showcasing the aims and methods used. On the right, findings are detailed, highlighting both the predictors and the impact of simultaneous publication. 95%CI, 95% confidence interval; ACC, American Congress of Cardiology; AHA, American Heart Association; ESC, European Society of Cardiology; OR, odds ratio; TCT, transcatheter cardiovascular therapeutics.

(0.28MB).

The decision by authors to publish a trial simultaneously may be influenced by several factors, such as the need for rapid dissemination of study findings and the desire for early impact and visibility. However, the appeal of the characteristics of the study to conference scientific committees and journals also plays a significant role. Other factors that may contribute to variation in the number of studies published simultaneously across different journals are editorial policies, reviewers’ preferences, and the specific field of study. Several challenges may hinder authors from achieving their goal of simultaneous publication. Various factors, including delays in final manuscript submission, lengthy peer review processes, initial rejections, or unsuccessful attempts to publish in higher impact journals, have diverse implications. Conversely, some authors may choose to respond to calls for science from major conferences even before completing their analyses and crafting a concise key message. These authors leverage potential acceptance as late breakers to secure a place in prestigious medical journals. This scenario emphasizes the need for rigorous assessment of proposed research and underscores the crucial roles of reviewers and editors, even when working under tight timelines. These aspects collectively highlight the intricate nature of decision-making processes in research dissemination.

The growing interest in simultaneous publication among scholars and journals has led some journals to encourage submissions for rigorous but short peer review to increase visibility and dissemination of findings.6,8,13 Nevertheless, no study has provided evidence supporting the practice, or investigated the predictors and features of simultaneous publication, making our study significant in emphasizing its importance and exploring its characteristics. We found similar proportions of studies published simultaneously and nonsimultaneously, and the proportion of studies with simultaneous publication (approximately 1 out of 2) remained constant over time. While authors, conferences, and journals have become more accustomed to simultaneous publication practices over time, the consistent release of such studies can be attributed to persistent underlying factors that may limit substantial growth. These factors encompass the unique characteristics of individual studies and broader trends in scientific knowledge, as well as the ability of the study to address gaps in the existing body of knowledge.

The observation that studies published simultaneously were more commonly presented in the main conference room, reflecting the interest of the scientific committees of the conference in ensuring maximum exposure to its results, highlights the prominent role of the committees responsible for abstract selection, and possibly the indirect influence of their choice on the journals’ publication priorities. In fact, the selection of late-breaking trials usually, but not necessarily, precedes the submission of the manuscript to a top tier scientific Journal, and journal editors may be more inclined to accept studies that are predicted to have wider dissemination and resonance.14

Perhaps not surprisingly, a short review time was also significantly associated with a higher chance of simultaneous publication, indicating the challenge faced by journal reviewers and authors in preparing a peer reviewed manuscript in time for the presentation. This is possibly a spurious association because several top tier journals offer fast track review options to authors who consider submitting a late-breaking trial for potential publication.9 However, this finding also highlights the potential threat associated with a shorter review process. Under such time constraints, reviewers and editors may face heightened pressure to expedite their evaluations, which can potentially lead to reduced accuracy. Reviewers may also find themselves more inclined to accept manuscripts without all comments to the first round being fully addressed, and their comments and decisions may lack the usual level of precision. Similarly, authors, who have to prepare manuscripts and revisions within tight timelines, may be more susceptible to errors or to delivering work that is not as thoroughly prepared. Our study cannot establish the quality of the review process for simultaneous vs nonsimultaneous publications but suggests implications that may warrant further investigation.

When the review time was excluded from the model for statistical adjustment, one more independent predictor emerged. Trials with a characterizing collective name (eg, an acronym) were more likely to be published simultaneously than trials with no name. The reasons for this finding are difficult to identify but could be related to the implicit bias that tends to favor trials with a branded identity. Typically, the design of these trials is known years in advance, anticipated in major conferences, and recorded in repositories such as clinicaltrials.gov.

Consistently, we found that studies published simultaneously were more likely to be cited in the literature and mentioned on social media and news outlets. Interestingly, for total citation number, every additional week of observation was found to be associated with an increase of 0.73 citations; however, this increment was less consistent for 1-month mentions and 1-year citations (table 5 of the supplementary data). Other factors may also contribute to the increased visibility and impact of studies published simultaneously, and correlation does not imply causation. However, these findings may suggest that simultaneous publication can increase the immediate impact of research findings and their impact over time. This effect may ultimately result in an increase in the impact factor of journals accepting late-breaking trials, representing a compelling implicit reason for journals to accept these articles.

Our study revealed that trials presented in the main conference room and with shorter review times were more likely to be published simultaneously. Simultaneous publication was found to be associated with higher short- and long-term citation rates, as well as more short-term mentions. These results shed light on the practice of simultaneous publication and suggest that simultaneous publication is a key component of a successful dissemination strategy.

No funding was received for the study design, conduct, or analysis.

This study, concentrating on the metrics of publications, did not require approval from an ethics committee nor did it involve direct patient data, negating the need for informed consent. Furthermore, the SAGER guidelines for sex and gender reporting were not applicable to our study since our primary subjects were publications, not individual patients. Moreover, we did not collect any variables related to the authors of these publications. The study is reported based on STROBE guidelines for reporting of observational research (table 1 of the supplementary data).

No artificial intelligence methodologies or tools were used in the formulation or analysis of this manuscript.

M. Spagnolo and A. Greco contributed to data curation, formal analysis, methodology, writing, and visualization. D. Capodanno contributed to conceptualization, review and editing, supervision, and validation. All other authors contributed to data curation and review.

None.