The 2017 Virginia Apgar Collection Part II: Maternal Safety and Abstract Reasoning.

724 www.anesthesia-analgesia.org March 2017 • Volume 124 • Number 3 Copyright © 2017 International Anesthesia Research Society DOI: 10.1213/ANE.0000000000001881 This month’s Anesthesia & Analgesia is the second of 2 issues featuring work presented at the 2016 meeting of the Society for Obstetric Anesthesia and Perinatology (SOAP). The February issue focused on analgesic innovations and included 5 original investigations. This month’s issue focuses on the theme of maternal safety and includes original investigations of the epidemiology of cardiac arrest during the hospitalization for delivery in Canada,1 maternal morbidity and mortality among Asian and Pacific Islander women in the United States,2 transcutaneous carbon dioxide measurements in women receiving intrathecal morphine for cesarean delivery,3 and the optimal oxytocin infusion rate to maintain uterine contractility during elective cesarean delivery.4 The 2016 Gerard W. Ostheimer review links this collection of original investigations to recent publications relating to maternal morbidity, mortality, and innovations in patient safety.5 Together, the full collection of articles in the February and March issues is named in honor of Dr. Virginia Apgar. Dr. Apgar first presented her scoring system for newborns as an “abstract” in 1952 at the 27th Annual Congress of Anesthetists (a joint meeting of the International Anesthesia Research Society and International Society of Anesthetists). The paper was published less than a year later in this journal.6 The journey from abstract to full peer-reviewed publication is the subject of a study by Gerlach et al7 in this issue. The authors examined the frequency with which research abstracts presented at the SOAP annual meetings from 2010 to 2014 were published in peer-review journals by January 2016. Of all abstracts presented, only 27% of matched publications are available through PubMed. In comparison, the publication rate for abstracts presented at major meetings for cardiology, urology, and ophthalmology ranged from 55% to 66%. Although the study was conducted carefully, there are some reasons to think that the reported publication rate may be an underestimate. An abstract may report 1 component of a larger study, with the overall work submitted for publication but not individually counted. In addition, the interval between abstract presentation and the final PubMed search was only 23 months for abstracts presented in 2014. This interval may not be long enough for a lengthy peer-review process and publication schedule, particularly if the manuscript requires multiple rounds of revision or rejection and resubmission. In fact, Gerlach et al7 report a slightly lower percentage of abstracts published by 2016 from the 2013 to 2014 meetings compared with those from 2011 to 2012. In addition, it is possible that some of the clinical research presented at SOAP has been published in nonindexed journals, making the publications hard to find with electronic search strategies. It also should be noted that the meetings Gerlach et al7 used as benchmarks for the SOAP abstract publication rate may not provide fair or equivalent comparisons. These included national and international, large, general-interest anesthesia meetings (American Society of Anesthesiologists [ASA], International Anesthesia Research Society [IARS]), and large meetings of other specialties (American Urological Association, American Heart Association, American College of Cardiology), all of which are quite different from the small (400–500 attendees) subspecialty SOAP meeting. A more relevant comparison would be the abstract publication rates from other anesthesia subspecialty meetings (Society for Pediatric Anesthesia [SPA], Society of Cardiovascular Anesthesiologists [SCA], Society for Ambulatory Anesthesia [SAMBA], Society of Critical Care Anesthesiologists [SOCCA], etc), or from subspecialty meetings in other medical specialties, but unfortunately these data are not available. In addition, abstract publication rates within other specialties are cited from older studies, and it also is possible or probable that, as the result of increasing clinical demands, current fellows and faculty have less time available now to write manuscripts and navigate the peer-review process. Even with the aforementioned caveats, we congratulate Gerlach et al7 for examining this issue; their efforts particularly are noteworthy because data on abstract publication rates have not been examined for any other anesthesiology subspecialty. The study prompts us to reflect on a number of questions of relevance to the SOAP meeting, to the field of obstetric anesthesia, and to anesthesia subspecialities more generally. What is the purpose of abstract presentation at specialty meetings, and is it acceptable that this is the only The 2017 Virginia Apgar Collection Part II: Maternal Safety and Abstract Reasoning