Selection and presentation of imaging figures in the medical literature.

Background: Images are important for conveying information, but there is no empirical evidence on whether imaging figures are properly selected and presented in the published medical literature. We therefore evaluated the selection and presentation of radiological imaging figures in major medical journals.

Methodology/principal Findings: We analyzed articles published in 2005 in 12 major general and specialty medical journals that had radiological imaging figures. For each figure, we recorded information on selection, study population, provision of quantitative measurements, color scales and contrast use. Overall, 417 images from 212 articles were analyzed. Any comment/hint on image selection was made in 44 (11%) images (range 0-50% across the 12 journals) and another 37 (9%) (range 0-60%) showed both a normal and abnormal appearance. In 108 images (26%) (range 0-43%) it was unclear whether the image came from the presented study population. Eighty-three images (20%) (range 0-60%) had any quantitative or ordered categorical value on a measure of interest. Information on the distribution of the measure of interest in the study population was given in 59 cases. For 43 images (range 0-40%), a quantitative measurement was provided for the depicted case and the distribution of values in the study population was also available; in those 43 cases there was no over-representation of extreme than average cases (p = 0.37).

Significance: The selection and presentation of images in the medical literature is often insufficiently documented; quantitative data are sparse and difficult to place in context.