# Determinants of publication likelihood and timeliness for clinical studies

## TL;DR

This paper explores factors influencing the likelihood and speed of publishing clinical trial results across three major domains: cardiovascular disease, cancer, and COVID-19.

## Contribution

The study identifies specific study design and operational features that predict publication likelihood and timeliness in clinical trials.

## Key findings

- Trials with larger enrollment, more sites, and result posting were published faster.
- Cancer trials had the lowest publication rate (32.9%), while COVID-19 trials had the highest (49.6%).
- Supportive care trials and those with basic science focus were associated with slower publication.

## Abstract

Timely dissemination of clinical trial results is essential to advance knowledge, guide practice, and improve outcomes, yet many trials remain unpublished, limiting impact. We examine what drives publication and timelines across three major clinical domains.

We analyzed study design and factors associated with dissemination of interventional trials, focusing on cardiovascular disease (CVD), cancer, and COVID-19. A total of 10,785 trials (CVD: 5929; cancer: 4210; COVID-19: 646) were linked to PubMed publications using National Clinical Trial identifiers. Study design, operational, and transparency-related features were assessed as predictors of time to publication, defined as the interval from study completion to first publication, using Cox proportional hazards model.

COVID-19 trials had the highest publication rate (49.6%), followed by CVD (42.3%) and cancer (32.9%), likely reflecting pandemic-related prioritization. Faster publication was associated with larger enrollment, more sites, result posting, randomization, DMC presence, and higher blinding levels (all p < 0.05). Slower publication was linked to supportive care or diagnostic trials (CVD), basic science (cancer), and later COVID-19 trial completion. In subgroups, U.S. facility presence (CVD) and phase 3 design (cancer) predicted faster publication, while healthy volunteer inclusion (CVD) predicted slower publication. Among DMC trials, more secondary outcomes were linked to faster publication across all disease areas.

Key study design and operational factors consistently predict whether and when trials are published. Strengthening methodological rigor, result reporting, and multi-site collaboration may accelerate timely dissemination into peer-reviewed literature.