Do declarative titles affect readers’ perceptions of research findings? A randomized trial

Elizabeth Wager, Douglas G. Altman, Iveta Simera, Tudor P. Toma

Many journals prohibit the use of declarative titles that state study findings, yet a few journals encourage or even require them. We compared the effects of a declarative versus a descriptive title on readers' perceptions about the strength of evidence in a research abstract describing a randomized trial. Study participants (medical or dental students or doctors attending lectures) read two abstracts describing studies of a fictitious treatment (Anticox) for a fictitious condition (Green's syndrome). The first abstract (A1) described an uncontrolled, 10-patient, case series, and the second (A2) described a randomized, placebo-controlled trial involving 48 patients. All participants rated identical A1 abstracts (with a descriptive title) to provide baseline ratings and thus reduce the effects of inter-individual variability. Participants were randomized so that half rated a version of A2 with a descriptive title and half with a declarative title. For each abstract, participants indicated their agreement with the statement "Anticox is an effective treatment for pain in Green's syndrome" using 100 mm visual analogue scales (VAS) ranging from "disagree completely" to "agree completely." VAS scores were measured by an investigator who was unaware of group allocation. One hundred forty-four participants from four centres completed the study. There was no significant difference between the declarative and the descriptive title groups' confidence in the study conclusions as expressed on VAS scales-in fact, the mean difference between A1 and A2 was smaller for the declarative title group than that for the descriptive title group (32.6 mm, SD 27.4 vs. 39.8 mm, SD 22.6, respectively,p = 0.09). We found no evidence that the use of a declarative title affected readers' perceptions about study conclusions. This suggests that editors' fears that declarative titles might unduly influence readers' judgements about study conclusions may be unfounded, at least in relation to reports of randomized trials. However, our study design had several limitations, and our findings may not be generalizable to other situations.