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DOI: 10.1055/a-2224-9357
Promotional language in radiology publications: increasing use of “excellent”, “favorable”, “promising”, “robust”, and “unique”
Werbesprache in radiologischen Publikationen: Zunahme der Verwendung der Wörter „ausgezeichnet“, „günstig“, „vielversprechend“, „robust“ und „einzigartig“Abstract
Purpose To investigate if radiology researchers are increasingly promoting their scientific findings by more frequently using positive words in their publications.
Materials and Methods This study included all articles that were published in 14 general radiology journals between 2003 and 2022. The title and abstract of each article were assessed for the presence of positive, negative, neutral, and random words, according to predefined sets of words for each category. Usage of positive, negative, neutral, and random words was calculated for each year and corrected for the total number of articles in each year. Temporal trends between 2002 and 2023 and the relationship between positive word usage and journal impact factor (IF) were assessed.
Results Positive word usage (Mann-Kendall tau of 0.895, P< 0.001) and neutral word usage (Mann-Kendall tau of 0.463, P = 0.005) showed significant upward temporal trends. Negative word usage and random word usage did not show any significant temporal trends. Five positive words showed significantly increased usage over time and were present in more than 1 % of titles/abstracts in at least one year: “excellent” (Mann-Kendall tau of 0.800, P< 0.001), “favorable” (Mann-Kendall tau of 0.547, P< 0.001), “promising” (Mann-Kendall tau of 0.607, P< 0.001), “robust” (Mann-Kendall tau of 0.737, P< 0.001), and “unique” (Mann-Kendall tau of 0.747, P< 0.001). There was no significant association between positive word usage and journal IF.
Conclusion Radiology researchers appear to increasingly promote their scientific findings by more frequently using positive words in their publications over the past two decades.
Key Points
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Positive word usage in titles/abstracts has strongly increased between 2003–2022
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“Excellent”, “favorable”, “promising”, “robust”, and “unique” were most often used
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This trend occurred in all general radiology journals, regardless of impact factor
Citation Format
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Kwee T, Kwee R. Promotional language in radiology publications: increasing use of “excellent”, “favorable”, “promising”, “robust”, and “unique”. Fortschr Röntgenstr 2024; 196: 945 – 955
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Zusammenfassung
Ziel Untersuchung, ob Radiologieforscher ihre wissenschaftlichen Erkenntnisse zunehmend fördern, indem sie in ihren Veröffentlichungen häufiger positive Wörter verwenden.
Material und Methoden Diese Studie umfasste alle Artikel, die zwischen 2003 und 2022 in 14 allgemeinen radiologischen Fachzeitschriften veröffentlicht wurden. Titel und Abstract jedes Artikels wurden auf das Vorhandensein von positiven, negativen, neutralen und zufälligen Wörtern hin überprüft, gemäß vordefinierter Wortsets für jede Kategorie. Die Verwendung von positiven, negativen, neutralen und zufälligen Wörtern wurde für jedes Jahr berechnet und auf die Gesamtzahl der Artikel in jedem Jahr korrigiert. Temporäre Trends zwischen 2002 und 2023 sowie die Beziehung zwischen der Verwendung positiver Wörtern und dem Impact Factor (IF) der Zeitschrift wurden bewertet.
Ergebnisse Die Verwendung positiver Wörter (Mann-Kendall Tau von 0,895, P< 0,001) und neutraler Wörter (Mann-Kendall Tau von 0,463, P = 0,005) zeigte signifikante zeitliche Trends nach oben. Die Verwendung von negativen Wörtern und zufälligen Wörtern zeigte keine signifikanten zeitlichen Trends. Fünf positive Wörter zeigten eine signifikant zunehmende Verwendung im Laufe der Zeit und waren in mindestens einem Jahr in mehr als 1 % der Titel/Abstracts vorhanden: „excellent“ (Mann-Kendall Tau von 0,800, P< 0,001), „favorable“ (Mann-Kendall Tau von 0,547, P< 0,001), „promising“ (Mann-Kendall Tau von 0,607, P< 0,001), „robust“ (Mann-Kendall Tau von 0,737, P< 0,001) und „unique“ (Mann-Kendall Tau von 0,747, P< 0,001). Es gab keine signifikante Verbindung zwischen der Verwendung positiver Wörter und dem IF der Zeitschrift.
Schlussfolgerung Es scheint, dass Radiologieforscher in den letzten zwei Jahrzehnten ihre wissenschaftlichen Erkenntnisse zunehmend fördern, indem sie in ihren Veröffentlichungen häufiger positive Wörter verwenden.
Kernaussagen
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Die Verwendung von positiven Wörtern in Titeln/Abstracts von Veröffentlichungen in allgemeinen Radiologiezeitschriften hat zwischen 2003 und 2022 stark zugenommen.
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„Ausgezeichnet“, „günstig“, „vielversprechend“, „robust“ und „einzigartig“ waren die fünf positiven Wörter, die sowohl im Laufe der Zeit zunehmend verwendet wurden als auch am häufigsten vorkamen.
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Der Anstieg der Verwendung positiver Wörter wurde in allen allgemeinen Radiologiezeitschriften festgestellt, unabhängig vom Impact Faktor.
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Abbreviations
Introduction
Scientific output, both in terms of quantity and impact, is considered a major criterion for academic employment, promotions, and prestige [1]. Publishing in prestigious journals is frequently a target for researchers. However, journals, and particularly those with a high impact factor (IF), only accept a minority of submitted manuscripts. Not surprisingly, publication pressure on academic researchers is generally regarded as high [2] [3] [4].
Too much publication pressure may decrease the quality of the science when the aim of researchers shifts to producing “publishable” results at the expense of performing high-quality and meaningful research [2] [3] [4]. This is further aggravated by the fact that studies with positive results are more likely to be published and to be published faster than those with negative results [5] [6].
Publication pressure and publication bias may also affect the way in which scientists communicate their results in scientific publications. A previous publication in the British Medical Journal showed that the absolute frequency of positive words (such as “robust,” “novel,” “innovative,” and “unprecedented”) in scientific abstracts in PubMed increased from 2.0 % (1974–1980) to 17.5 % (2014), which translates to a relative increase of 775 % over four decades [7]. It has been postulated that scientists assume that results and their implications have to be exaggerated and overstated in order to get published [7]. Whether or not this phenomenon also plays a role in the field of radiology is still unclear. This knowledge is important to understand how the text of published radiology research should be interpreted by the readers of these articles. We hypothesized that the frequency of positive words in the radiological literature has increased over the past two decades, and that this temporal pattern can be observed throughout the entire range of journal IFs.
The purpose of this study was therefore to investigate if radiology researchers are increasingly promoting their scientific findings by more frequently using positive words in their publications.
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Materials and Methods
Study selection
This study included all articles that were published in 14 general radiology journals (Radiology, Investigative Radiology, Korean Journal of Radiology, European Radiology, American Journal of Roentgenology, Radiologia Medica, Journal of the American College of Radiology, Academic Radiology, European Journal of Radiology, Canadian Association of Radiologists Journal, British Journal of Radiology, Clinical Radiology, Clinical Imaging, and Acta Radiologica, with IFs ranging between 29.146 and 1.701 [8]) between January 1, 2003 and December 31, 2022. The selection of these journals was based on their scope (general radiology rather than a subspecialty field) and IF. Ethical review board approval and informed consent were not required for this bibliometric analysis.
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Data extraction
The title and abstract of each article were assessed for the presence of any positive word, any negative word, any neutral word, and any random word, according to predefined sets of words for each category. These sets of words were adapted from a previous study [7] and are displayed in [Table 1]. The analysis of each abstract for the presence of any positive word, any negative word, any neutral word, and any random word was done using combinations of different search strings in PubMed, which are displayed in Supplementary Table 1. The publication year of each article and the IF of the journal in which it was published were manually extracted.
Category |
Words |
Positive words (n = 25) |
Amazing, Assuring, Astonishing, Bright, Creative, Encouraging, Enormous, Excellent, Favorable, Groundbreaking, Hopeful, Innovative, Inspiring, Inventive, Novel, Phenomenal, Prominent, Promising, Reassuring, Remarkable, Robust, Spectacular, Supportive, Unique, Unprecedented |
Negative words (n = 25) |
Detrimental, Disappointing, Disconcerting, Discouraging, Disheartening, Disturbing, Frustrating, Futile, Hopeless, Impossible, Inadequate, Ineffective, Insignificant, Insufficient, Irrelevant, Mediocre, Pessimistic, Substandard, Unacceptable, Unpromising, Unsatisfactory, Unsatisfying, Useless, Weak, Worrisome |
Neutral words (n = 25) |
Animal, Blood, Bone, Brain, Condition, Design, Disease, Experiment, Human, Intervention, Kidney, Liver, Man, Men, Muscle, Patient, Prospective, Rodent, Significant, Skin, Skull, Treatment, Vessel, Woman, Women |
Random words (n = 100) |
Manager, Substance, Law, Dust, Bite, Butter, Fold, Mind, Protect, Insurance, Test, Father, Letter, Friend, Power, Edge, Linen, Scale, Bread, Statement, Weather, Smell, Glass, Food, Level, Steam, Soap, Help, Rule, Wind, Interest, Purpose, Hole, Fight, Representative, Danger, Prose, Change, Discussion, Company, Direction, Balance, Organization, Size, Trade, Rice, Invention, Heat, Road, Mountain, Electric, Good, Natural, Sweet, Dead, Strange, Thin, Political, Open, Bitter, Dark, Complex, Warm, Full, Red, Kind, Possible, Strong, Free, Quick, Slow, Cut, Narrow, Certain, Dependent, Flat, Acid, Fixed, Responsible, False, Great, Like, Green, Cold, Poor, Low, Opposite, Bright, Military, Fertile, Second, Left, Wrong, Hanging, Gray, Mixed, Angry, Foolish, Loose, Late |
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Data analysis
The number of articles with any positive word in the title/abstract was divided by the total number of articles for all 14 journals together and for each year between 2003 and 2022 separately. In this way, “positive word usage” was calculated for each year. Similarly, negative word usage, neutral word usage, and random word usage were calculated for each year. Mann-Kendall tests were done to test for any temporal changes in word usage between 2003 and 2022. Temporal analyses were also done for each individual positive word (i. e., “Amazing”, “Assuring”, “Astonishing”, “Bright”, “Creative”, “Encouraging”, “Enormous”, “Excellent”, “Favorable”, “Groundbreaking”, “Hopeful”, “Innovative”, “Inspiring”, “Inventive”, “Novel”, “Phenomenal”, “Prominent”, “Promising”, “Reassuring”, “Remarkable”, “Robust”, “Spectacular”, “Supportive”, “Unique”, and “Unprecedented”). Only those positive words that showed significantly increased usage over time and that were present in more than 1 % of titles/abstracts in at least one year were considered relevant. Subsequently, a linear regression analysis was performed to assess the association between the presence of any positive word in the title/abstract and journal IF. P-values less than 0.05 were considered statistically significant. Statistical analyses were performed using R version 4.2.2 software (R Foundation for Statistical Computing) and MedCalc Statistical Software version 18.5 (MedCalc, Ostend, Belgium).
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Results
Articles
A total of 94,550 articles were published in the 14 included journals between 2003 and 2022. The total annual number of articles, and annual numbers of articles with at least one positive word, negative word, neutral word, and random word in the title/abstract between 2003 and 2022 are displayed in [Table 2].
Year |
Total no. of articles (with percentage increase or decrease compared to the year 2003 between parentheses) |
No. of articles with at least one positive word in the title or abstract |
No. of articles with at least one negative word in the title or abstract |
No. of articles with at least one neutral word in the title or abstract |
No. of articles with at least one random word in the title or abstract |
2003 |
3035 |
206 |
61 |
1770 |
1764 |
2004 |
3331 (+ 9 %) |
200 |
59 |
1930 |
1987 |
2005 |
3580 (+ 18 %) |
258 |
77 |
2131 |
2248 |
2006 |
3590 (+ 18 %) |
317 |
67 |
2265 |
2394 |
2007 |
3679 (+ 21 %) |
321 |
80 |
2344 |
2433 |
2008 |
3896 (+ 28 %) |
357 |
88 |
2569 |
2694 |
2009 |
4047 (+ 33 %) |
412 |
107 |
2772 |
2898 |
2010 |
4138 (+ 36 %) |
445 |
84 |
2814 |
2988 |
2011 |
4747 (+ 56 %) |
519 |
93 |
3374 |
3552 |
2012 |
5064 (+ 67 %) |
510 |
109 |
3531 |
3708 |
2013 |
4663 (+ 54 %) |
505 |
96 |
3178 |
3383 |
2014 |
4525 (+ 49 %) |
473 |
83 |
3154 |
3363 |
2015 |
5098 (+ 68 %) |
568 |
126 |
3553 |
3749 |
2016 |
5231 (+ 72 %) |
657 |
136 |
3629 |
3835 |
2017 |
5113 (+ 68 %) |
645 |
113 |
3594 |
3751 |
2018 |
5611 (+ 85 %) |
707 |
134 |
3898 |
4080 |
2019 |
5519 (+ 82 %) |
733 |
139 |
3828 |
3941 |
2020 |
6677 (+ 120 %) |
965 |
146 |
4724 |
4748 |
2021 |
6948 (+ 129 %) |
1011 |
148 |
4785 |
4889 |
2022 |
6058 (+ 99 %) |
910 |
126 |
4099 |
4177 |
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Temporal trends in the use of positive, negative, neutral, and random words
Positive word usage (Mann-Kendall tau of 0.895, P< 0.001) and neutral word usage (Mann-Kendall tau of 0.463, P = 0.005) showed significant upward temporal trends. The annual frequency of positive words increased from 7 % in 2003 to 15 % in 2022 (relative increase of 120 %), and the annual frequency of neutral words increased from 58 % in 2003 to 68 % in 2022 (relative increase of 16 %). Negative word usage (Mann-Kendall tau of 0.242, P = 0.1443) and random word usage (Mann-Kendall tau of 0.305, P = 0.064) did not show any significant temporal trends. Temporal trends are visually displayed in [Fig. 1], [2], [3], [4].








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Temporal trends in the use of individual positive words
Five positive words showed significantly increased usage over time and were present in more than 1 % of titles/abstracts in at least one year: “excellent” (Mann-Kendall tau of 0.800, P< 0.001), “favorable” (Mann-Kendall tau of 0.547, P< 0.001), “promising” (Mann-Kendall tau of 0.607, P< 0.001), “robust” (Mann-Kendall tau of 0.737, P< 0.001), and “unique” (Mann-Kendall tau of 0.747, P< 0.001) ([Table 3]). Temporal trends are visually displayed in [Fig. 5], [6], [7], [8], [9].










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Association between positive word usage and journal IF
There was no significant association between positive word usage and journal IF (β coefficient of 0.006 per unit increase in journal IF, P = 0.917).
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Post hoc analysis: temporal trends in the use of individual neutral words
Five neutral words showed significantly increased usage over time and were present in more than 1 % of titles/abstracts in at least one year: “brain” (Mann-Kendall tau of 0.747, P = 0.002), “disease” (Mann-Kendall tau of 0.385, P = 0.019), “intervention” (Mann-Kendall tau of 0.522, P = 0.001), “prospective” (Mann-Kendall tau of 0.702, P< 0.001), and “treatment” (Mann-Kendall tau of 0.617, P< 0.001).
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Discussion
The results of this study show that the use of positive words in the titles/abstracts of publications in general radiology journals has strongly increased between 2003 and 2022. Negative word usage remained stable in the same time span. This suggests that researchers in the field of radiology are increasingly promoting their research findings. Increasing use of promotional language is thought to be a reaction of researchers to increasing publication pressure and publication bias favoring positive results over negative results [2] [3] [4] [5] [6]. Note that previous research has shown that radiology researchers also perceive publication bias as a widespread phenomenon [9]. Although the increasing use of promotional language may not directly equal scientific misconduct, it can be questioned if this practice represents another type of research “spin” [10]. Spin has been defined as specific intentional or unintentional reporting that fails to faithfully reflect the nature and range of findings and that could affect the impression the results produce in readers [10]. Readers of scientific articles may indeed be misled when irrelevant, doubtful, or still unproven research findings are misrepresented with positive wording. This, in turn, may potentially lead to the clinical implementation of research findings that are useless or even harmful, and the execution of additional, useless research on the same topic that may be a waste of resources. On the other hand, readers of general radiology journals may also lose their confidence in the reliability of the research that is published. This may potentially lead them to ignore important research findings that could actually be beneficial to clinical practice or that deserve further investigation. Altogether, the overuse of positive words may disrupt the perception and credibility of radiology research findings, and negatively affect clinical decision making and future research. The fact that the frequency of positive words in publications has increased over the past two decades also suggests that the use of positive words increases the chance of getting an article accepted for publication, basically amplifying the phenomenon of publication bias. Journal editors and reviewers may have to be more vigilant to check that the words that are used by scientists accurately reflect the nature of their findings. Special attention can be paid to the words “excellent”, “favorable”, “promising”, “robust”, and “unique”. Journals could establish author guidelines for balancing enthusiastic language with factual accuracy to maintain the integrity of research communication and instruct reviewers to ensure adherence to these guidelines. Because many authors also perform peer reviews for journals, such a policy may potentially reverse the overuse of positive words. The increase in positive word usage was found throughout the entire range of journal IFs, which indicates that addressing this topic is relevant to all journals. Interestingly, the use of neutral words also showed a significant temporal increase over time, albeit moderately. The neutral words “brain”, “disease”, “intervention”, “prospective”, and “treatment” contributed most to this growth. This may reflect the types of research that have increasingly been performed between 2003 and 2022 and perhaps also due to the fact that the overall length of the abstracts has somewhat increased in this time period.
One previous study by Vinkers et al. [7] performed a similar analysis in the general medical literature by analyzing all abstracts in PubMed between 1974 and 2014. The authors of that study reported the absolute frequency of positive words to have increased from 2.0 % (1974–1980) to 17.5 % (2014), corresponding to a relative increase of 775 % [7]. The positive word usage in the radiological literature showed a similar upward temporal trend in the past two decades, although less steep compared to the general medical literature in the past four decades [7]. Nevertheless, the use of positive words in the radiological literature has continued to increase since 2014. Vinkers et al. [7] reported that the positive words “robust”, “novel”, “innovative”, and “unprecedented” were most prevalent. The word “robust” was also popular in the radiological literature, but otherwise different positive words were preferred by radiology researchers. Vinkers et al. [7] also reported that the increase in positive word use over the last 10 years of their research period was significantly lower in the group of high IF journals than the frequency pattern of positive words across all journals. It was speculated that this difference could be the result of a more thorough and critical editorial and peer review process in high IF journals [7]. However, there was no correlation between positive word usage and journal IF in the radiological literature. It can be argued that the increase in positive words may be attributed to general language trends in society. However, a previous study by Vinkers et al. [7] already showed that this is likely not the case, at least for the period between 1974 and 2014. Whether or not the spread of social media has any association with positive word usage in scientific literature remains unclear. Further research is necessary to investigate the impact of positive language on readers' perceptions and citation rates of articles in radiology. Future research should also investigate if positive word usage will continue to increase in the coming years.
The present study had some limitations. First, limited sets of positive, negative, neutral, and random words were used. However, these sets of words had been validated by previous similar research published in the British Medical Journal that also showed that the addition of more positive words yielded similar results [7]. Second, because of the vast amount of data (94,550 articles were included) and search limitations in PubMed, it was only possible to search in titles and abstracts for the presence of any positive, negative, neutral, or random word, rather than analyzing the entire article text for the total number of words in each category. Third, individual (positive) words were not assessed in the context of their use. Therefore, the exact intent and weight of these words in the titles and abstracts of the articles that were analyzed, and whether or not they truly represent “overselling” of research findings remain unclear.
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Conclusion
In conclusion, radiology researchers appear to increasingly promote their scientific findings by more frequently using positive words in their publications over the past two decades.
Exaggerating research findings with the increasing use of positive words can be considered as another type of research “spin” that may be misleading and potentially lead to the clinical implementation of research findings that are useless or even harmful.
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Conflict of Interest
The authors declare that they have no conflict of interest.
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References
- 1 Abbott A, Cyranoski D, Jones N. et al. Metrics: Do metrics matter?. Nature 2010; 465: 860-862
- 2 Tijdink JK, Vergouwen AC, Smulders YM. Publication pressure and burn out among Dutch medical professors: a nationwide survey. PLoS One 2013; 8 (09) e73381
- 3 Haven TL, Bouter LM, Smulders YM. et al. Perceived publication pressure in Amsterdam: survey of all disciplinary fields and academic ranks. PLoS One 2019; 14: e0217931
- 4 Suart C, Neuman K, Truant R. The impact of the COVID-19 pandemic on perceived publication pressure among academic researchers in Canada. PLoS One 2022; 17 (06) e0269743
- 5 Treanor L, Frank RA, Cherpak LA. et al. Publication bias in diagnostic imaging: conference abstracts with positive conclusions are more likely to be published. Eur Radiol 2020; 30 (05) 2964-2972
- 6 Treanor LM, Frank RA, Atyani A. et al. Reporting bias in imaging diagnostic test accuracy studies: are studies with positive conclusions or titles submitted and published faster?. Am J Roentgenol 2021; 216 (01) 225-232
- 7 Vinkers CH, Tijdink JK, Otte WM. Use of positive and negative words in scientific PubMed abstracts between 1974 and 2014: retrospective analysis. BMJ 2015; 351: h6467
- 8 Journal Citation Reports (InCites). 2021 https://jcr.clarivate.com/ Accessed 20 April 2023.
- 9 Kwee RM, Almaghrabi MT, Kwee TC. Scientific integrity and fraud in radiology research. Eur J Radiol 2022; 156: 110553
- 10 Boutron I, Ravaud P. Misrepresentation and distortion of research in biomedical literature. Proc Natl Acad Sci U S A 2018; 115: 2613-2619
Correspondence
Publication History
Received: 09 November 2023
Accepted: 27 November 2023
Article published online:
19 February 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
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References
- 1 Abbott A, Cyranoski D, Jones N. et al. Metrics: Do metrics matter?. Nature 2010; 465: 860-862
- 2 Tijdink JK, Vergouwen AC, Smulders YM. Publication pressure and burn out among Dutch medical professors: a nationwide survey. PLoS One 2013; 8 (09) e73381
- 3 Haven TL, Bouter LM, Smulders YM. et al. Perceived publication pressure in Amsterdam: survey of all disciplinary fields and academic ranks. PLoS One 2019; 14: e0217931
- 4 Suart C, Neuman K, Truant R. The impact of the COVID-19 pandemic on perceived publication pressure among academic researchers in Canada. PLoS One 2022; 17 (06) e0269743
- 5 Treanor L, Frank RA, Cherpak LA. et al. Publication bias in diagnostic imaging: conference abstracts with positive conclusions are more likely to be published. Eur Radiol 2020; 30 (05) 2964-2972
- 6 Treanor LM, Frank RA, Atyani A. et al. Reporting bias in imaging diagnostic test accuracy studies: are studies with positive conclusions or titles submitted and published faster?. Am J Roentgenol 2021; 216 (01) 225-232
- 7 Vinkers CH, Tijdink JK, Otte WM. Use of positive and negative words in scientific PubMed abstracts between 1974 and 2014: retrospective analysis. BMJ 2015; 351: h6467
- 8 Journal Citation Reports (InCites). 2021 https://jcr.clarivate.com/ Accessed 20 April 2023.
- 9 Kwee RM, Almaghrabi MT, Kwee TC. Scientific integrity and fraud in radiology research. Eur J Radiol 2022; 156: 110553
- 10 Boutron I, Ravaud P. Misrepresentation and distortion of research in biomedical literature. Proc Natl Acad Sci U S A 2018; 115: 2613-2619

















