there are many reasons why researchers choose to publish the results of their research but one of the most important is to contribute to the advancement of medicine and science .
when research involves human subjects , sharing results is more than a personal choice , it is an ethical obligation ( 1 ) .
publishing results ensures that patient care is based on good science and that the field of medicine advances according to accurate knowledge .
it is also part of the commitment researchers make to research subjects . according to prominent bioethicists
, the risks of clinical research are only justified if society gains knowledge , which is only possible when results are shared ( 2 ) .
although these principles are widely accepted , a substantial amount of human research continues to go unreported and unpublished .
this article explores researchers ' ethical obligation to report the results of research involving human subjects and discusses current challenges and solutions .
an important starting point for this discussion is a brief review of the declaration of helsinki .
the declaration of helsinki is a set of international ethical principles regarding the conduct of human research .
it was initially published in 1964 and has been amended 7 times , the most recent revision occurring in 2013 ( 3 ) .
it is a cornerstone document in the field of human research ethics and has been referred to as " the most widely accepted guidance worldwide on medical research involving human participants"(4 ) .
many medical journals , including the journal of korean medical science , refer to the declaration in their requirements for publication ( 5 , 6 ) .
the declaration includes a section on the ethical requirement of registering , publishing and disseminating research results ( 1 ) .
the section addresses two main requirements : 1 ) that research involving human subjects must be registered in a publicly accessible database and 2 ) that there is an ethical obligation regarding publication and dissemination of research results .
the declaration specifically states that , " researchers , authors , sponsors , editors and publishers all have ethical obligations with regard to the publication and dissemination of the results of research " ( 1 ) .
it goes on to clarify that negative , inconclusive and positive results all must be published or made publicly available ( 1 ) .
although publication of research results is a widely accepted component of ethical research , in actual practice it is often neglected or substantially delayed ( 7 ) .
for example , one study found that only 46% of us nih - funded trials were published in a peer - reviewed , medline - indexed journal within 30 months of completion ( 8) . a similar finding was discovered of vaccine trials conducted in multiple countries .
( 9 ) found that " the proportion of trials published 12 , 24 , 36 , and 48 months after completion was 12% , 29% , 53% , and 73% , respectively " ( 9 ) .
similarly , a study at a university in germany found that only half of the studies approved by the ethics committee at the institution resulted in subsequent publication ( 10 ) .
non - publication of results wastes resources and denies the field of medicine the opportunity to learn from the outcomes .
multiple studies have found that trials with negative results are published significantly less often and significantly less quickly than trials with positive results ( 11 , 12 ) .
an analysis in the field of psychiatry compared published literature against us fda reviews of research involving antidepressant agents .
based on the published literature it appeared that 94% of studies were positive but the fda analysis indicated that only 51% were positive ( 13 ) .
this discrepancy was because most of the negative results were not published or were published in a way that conveyed a positive outcome .
the authors of the analysis concluded that the actual efficacy of the antidepressant drug class is less than would be expected based on published literature alone ( 13 ) .
for example , one study conducted at a hospital in spain followed the publication outcomes of all drug - evaluating clinical trials approved by the ethics committee of the institution .
the study found that trials with positive results were published significantly more often and significantly more quickly than trials with negative results ( 11 ) .
additionally , a study that included manuscripts from multiple countries , including the republic of korea , found that the number of articles reporting positive results increased by over 20% during the years of 1990 through 2007 and that corresponding authors in asian countries reported more positive results than those in the us and europe ( 14 ) .
the higher publication of positive results is a responsibility not only to researchers or authors but also to editors and reviewers .
some editors and reviewers devalue negative results or inconclusive findings and automatically reject the manuscript . since human subject studies frequently produce negative or inconclusive results , the negative attitude of some editors and reviewers may be a barrier to publication .
the icmje recommends that editors make editorial decisions based on factors such as the manuscript 's overall quality and relevance to the journal , and not on the conclusiveness of the results ( 15 ) .
the international committee of medical journal editors ( icmje ) reminds editors that negative and inconclusive results can make an important contribution to science and that findings that are not statistically significant may provide important data for a subsequent meta - analysis ( 15 ) .
the declaration of helsinki and the icmje both require registration of clinical trials in a publicly accessible database before patient enrollment ( 1 , 16 ) .
this means that all journals that follow icmje guidance , including jkms , only publish manuscripts on trials that were properly registered .
clinical trial registration is important because it improves transparency , helps to reduce research duplication , contributes to the scientific evidence base and circumvents the issues of publication bias and selective reporting ( 17 ) .
studies suggest that data in registries may also be more complete than what is published in medical literature .
for example , the us registry [ clinicaltrials.gov ] requires results reporting and one study found that the results in the registry , especially serious adverse events , were more complete than the results in published articles ( 18 ) .
however , the strength of registries depends on researchers ' submission of timely and accurate data and evidence suggests that concerning gaps still exist ( 19 ) .
although publication of research results is a widely accepted component of ethical research , in actual practice it is often neglected or substantially delayed ( 7 ) .
for example , one study found that only 46% of us nih - funded trials were published in a peer - reviewed , medline - indexed journal within 30 months of completion ( 8) . a similar finding was discovered of vaccine trials conducted in multiple countries .
( 9 ) found that " the proportion of trials published 12 , 24 , 36 , and 48 months after completion was 12% , 29% , 53% , and 73% , respectively " ( 9 ) .
similarly , a study at a university in germany found that only half of the studies approved by the ethics committee at the institution resulted in subsequent publication ( 10 ) .
non - publication of results wastes resources and denies the field of medicine the opportunity to learn from the outcomes .
multiple studies have found that trials with negative results are published significantly less often and significantly less quickly than trials with positive results ( 11 , 12 ) .
an analysis in the field of psychiatry compared published literature against us fda reviews of research involving antidepressant agents .
based on the published literature it appeared that 94% of studies were positive but the fda analysis indicated that only 51% were positive ( 13 ) .
this discrepancy was because most of the negative results were not published or were published in a way that conveyed a positive outcome .
the authors of the analysis concluded that the actual efficacy of the antidepressant drug class is less than would be expected based on published literature alone ( 13 ) .
for example , one study conducted at a hospital in spain followed the publication outcomes of all drug - evaluating clinical trials approved by the ethics committee of the institution .
the study found that trials with positive results were published significantly more often and significantly more quickly than trials with negative results ( 11 ) .
additionally , a study that included manuscripts from multiple countries , including the republic of korea , found that the number of articles reporting positive results increased by over 20% during the years of 1990 through 2007 and that corresponding authors in asian countries reported more positive results than those in the us and europe ( 14 ) .
the higher publication of positive results is a responsibility not only to researchers or authors but also to editors and reviewers .
some editors and reviewers devalue negative results or inconclusive findings and automatically reject the manuscript . since human subject studies frequently produce negative or inconclusive results , the negative attitude of some editors and reviewers may be a barrier to publication .
the icmje recommends that editors make editorial decisions based on factors such as the manuscript 's overall quality and relevance to the journal , and not on the conclusiveness of the results ( 15 ) .
the international committee of medical journal editors ( icmje ) reminds editors that negative and inconclusive results can make an important contribution to science and that findings that are not statistically significant may provide important data for a subsequent meta - analysis ( 15 ) .
the declaration of helsinki and the icmje both require registration of clinical trials in a publicly accessible database before patient enrollment ( 1 , 16 ) .
this means that all journals that follow icmje guidance , including jkms , only publish manuscripts on trials that were properly registered .
clinical trial registration is important because it improves transparency , helps to reduce research duplication , contributes to the scientific evidence base and circumvents the issues of publication bias and selective reporting ( 17 ) .
studies suggest that data in registries may also be more complete than what is published in medical literature .
for example , the us registry [ clinicaltrials.gov ] requires results reporting and one study found that the results in the registry , especially serious adverse events , were more complete than the results in published articles ( 18 ) .
however , the strength of registries depends on researchers ' submission of timely and accurate data and evidence suggests that concerning gaps still exist ( 19 ) .
researchers in korea should remain committed to publishing the results of all human research they conduct .
jkms is an ideal choice for publishing because it is committed to publishing high - quality research regardless if the results are positive , negative , or inconclusive .
other journals also provide good publication options for manuscripts that may otherwise be hard to publish .
for example , several journals have launched sections focused on publishing negative results and a few journals exclusively publish negative or inconclusive results ( 20,21,22,23 ) .
this is not only a sound decision from an ethical and scientific standpoint , but may also benefit both the author and the publisher .
one of the aforementioned studies determined that even though positive results were published more often and more quickly than negative results , the impact factor between the two groups was not significantly different ( 11 ) .
researchers in korea should also abide by all trial registration requirements that govern the research they conduct .
the online registration system for clinical trials conducted in the republic of korea is the clinical research information service ( cris ) .
cris is a primary register of the who international clinical trials registry platform ( ictrp ) and was established at the korea centers for disease control and prevention ( kcdc ) with support from the ministry of health and welfare ( mohw ) ( 24 ) .
however , the reporting requirements may be updated in the future based on the who 's current evaluation of ictrp 's policy on results reporting ( 25 ) .
all individuals involved in conducting or publishing human research have an ethical obligation to disseminate results regardless of the conclusiveness . to meet this commitment , researchers should register their trials in a publicly accessible database and disseminate their findings through publication or other public mechanisms .
editors and reviewers should make editorial decisions based on manuscripts ' overall quality and relevance to the journal and not the conclusiveness of the results .
editors should also only publish papers regarding clinical trials that were properly registered . disseminating research results
this paper aimed to inform , review current gaps , and discuss solutions regarding this ethical obligation .
 researchers have an ethical responsibility to report the results of research involving human subjects . 
 dissemination of results ensures that patient care is based on good science and that the field of medicine advances based on complete and accurate knowledge . 
 however , current evidence suggests that publication is often neglected or substantially delayed , especially in the case of negative and inconclusive results . 
 researchers , editors and reviewers should value all high - quality research regardless of the conclusiveness of the results and ensure that all research involving human subjects is registered in a publicly accessible database . 
INTRODUCTION
INTERNATIONAL POLICY
CURRENT SITUATION
Publication
Negative and inconclusive results
Trial registration
SOLUTIONS FOR RESEARCHERS IN KOREA
CONCLUSION