Are medical conferences useful? And for whom?

CONFERENCES ORGANIZED BY MEDICAL SOCIETIES and related organizations are a dominant feature of the academic, professional, and social life of all health-related disciplines. These events come in all sizes, from relatively small, local gatherings, workshops, and symposia to large international megacongresses that mobilize tens of thousands of clinicians, researchers, exhibitors, and staff to build small-sized towns for a few days. The total number of medical conferences is unknown. One source lists 2012 health-related conferences that took place in 2011, including 259 that were online webinars and others that occurred in physical locations around the globe. Clearly, this list is incomplete and represents a fraction of such conferences. An estimate of more than 100 000 medical meetings per year may not be unrealistic, when local meetings are also counted. The cumulative cost of these events worldwide is not possible to fathom. Do medical conferences serve any purpose? In theory, these meetings aim to disseminate and advance research, train, educate, and set evidence-based policy. Although these are worthy goals, there is virtually no evidence supporting the utility of most conferences. Conversely, some accumulating evidence suggests that medical congresses may serve a specific system of questionable values that may be harmful to medicine and health care. Problems start with the travel needed to attend a conference. The fuel waste caused by participants traveling to various destinations across the country and around the globe is immense, corresponding to an estimated environmental burden of more than 10 000 tons of carbon per each midsized international conference. The availability of a plethora of conferences promotes a mode of scientific citizenship in which a bulk production of abstracts, with no or superficial peer review, leads to mediocre curriculum vita building. Even though most research conferences have adopted peer-review processes, the ability to judge an abstract of 150 to 400 words is limited and the process is more of sentimental value. Reviewers may screen primarily the names and affiliations to inform an opinion about the work. Such peer review differs from that used at equivalent meetings in engineering or computer science, at which full proceedings papers are presented, reviewed, and published. Moreover, in these sciences postpublication review benefits from the immediate demonstration that the technology works or does not work—as opposed to the nebulous or nonexistent validation of many biomedical findings. Moreover, many abstracts reported at the medical meetings are never published as full-text articles, even though abstract presentations can nevertheless communicate to wide audiences premature and sometimes inaccurate results. It has long been documented that several findings change when research reports undergo more extensive peer review and are published as completed articles. Late-breaker sessions in particular have become extremely attractive prominent venues within medical conferences because seemingly they represent the most notable latest research news. However, it is unclear why these data cannot be released immediately when they are ready and it is unclear why attending a meeting far from home is necessary to hear them. A virtual online late-breaker portal could be established for the timely dissemination of important findings. Meetings may also create a branding system that builds the reputations of scientists working in the field and promotes herding after elevated prestigious opinion leaders. Opinion leaders are experts whose valued utterances can exercise wide influence regardless of, in the absence of, or even against evidence. Gaining the podium for the plenary presentation or important sessions at a major meeting confers prestige, even though there is little safeguard that what these featured speakers say has any value and quality. Each professional society and organization creates its cadre of leaders, with meetings making these leaders visible to the members who usually participate passively by listening. Given the dynamics of large professional societies and conferences, leadership is sometimes judged not on scientific merit, hard work, and originality of thought but rather on the ability to navigate power circles. Some young scientists may be even discouraged to think that merit, hard work, and originality