Do world conferences live up to their promise?

T his issue of Injury Prevention is scheduled for distribution at the 7th World Conference on Injury Prevention and Safety Promotion in Vienna. Barring the predictably unpredictable quirks of publishing, each delegate will have received a copy. Many can still recall the first conference in Sweden 15 or so years ago, and some will have attended each successive meeting. The total of attendees, past and present, may now be large enough to begin to try to assess how well these biennial pilgrimages meet their goals. There is no way to judge with certainty the success of a conference. Much may depend on the weather (awful in Montreal, delightful in Melbourne) or on which of our old friends showed up. One criterion for success is that held by the organizers: a good balance sheet, which equates to the number of attendees. But bigger is not necessarily better. Balance may be more important—fewer attendees from more countries. For example, this conference may have attracted a higherthan-usual number from some European countries. Viewing the world through the undoubtedly distorted lens of an editor, my impression has been that much of Europe is a desert when it comes to injury prevention. If it proves true that many of the papers given in Vienna originated from those desert lands, this would be one positive score. Still, total attendance may be an appropriate measure even if it is confounded by location, which, in turn, reflects cost considerations. Montreal is easier to reach than Delhi and who could resist Vienna except those with shallow pocketbooks. Apart from numbers and broader representation, the question that remains is what other criteria we can use to show whether such conferences are worthwhile? Do large international meetings provide more than simply an opportunity to renew old acquaintances and to have precious one-on-one corridor conversations, invaluable as these may be? In what ways do they enhance the field, helping all who attend reach the shared goal? One goal shared by many who attend is the hope that the conference will spur governmental action on injury control, at least in the host country, but preferably on a broader international scale. Thus an element in some previous conferences is formulating a Declaration as was first done in Melbourne. These are truly commendable and thoughtful statements about what needs to be done. But it is difficult to discover whether they actually change policies or programs at any level: international, national, or local. This would be a valuable research project, but I fear the results may be disappointing. And, even if my pessimism is misplaced, Declarations alone cannot justify holding these conferences. A second obvious goal of world conferences is to facilitate an exchange of information. Thus, abstracts are submitted for presentation in some form or other. The selection process involves review by scientific peers who, in my experience, are diligent and work hard at a largely thankless job. But it would be foolish to pretend that this review is comparable to the scrutiny applied to papers submitted to any peer reviewed journal. With the best of intentions, forming a judgment on the basis of an abstract alone, is a flawed and frustrating exercise. Even it there were not a premium on accepting most submissions to encourage attendance (as there clearly is for these international conferences), there remains much room for error. A few are false negatives—rejections of what later prove to be good work. These will eventually get published, so the harm done is minimal. A far more likely and more serious risk is the many false positives—that is, papers that are accepted that do not deserve the imprimatur of true peer review. At least half of all papers presented at scientific meetings are not subsequently published in peer reviewed journals. No matter how conscientiously abstracts are screened, until a paper presented at a conference is published in a peer reviewed journal, we cannot be certain of its scientific credentials. This means that listeners should take what they hear with a large grain of salt. What are some other criteria for success? Following the Fifth Conference (Amsterdam) John Langley wrote a provocative commentary suggesting some areas where we can do better and others where we do well. On the positive side he listed the expansion of simultaneous translation which helps overcome the language barrier that plagues so much international work. On the debit side, Langley suggested that we look more critically at the quality of invited lectures, state of the art presentations, and plenary sessions. He also expressed surprise at the small European contingent in Amsterdam. If the same applies to Vienna, my optimism about the European desert finally blossoming will have been misplaced. (For the record, Injury Prevention has published many papers from the UK and Sweden, a few from several other European countries, but none from most others. The reason for this remains a mystery. Perhaps countries like Germany, Austria, or Switzerland prevent most injuries and have no reason to study the problem further!) In his critique, alongside complaints about travel costs, banquets costs, the food served, and scheduling important sessions for 7 pm, Langley expressed disappointment with the quality of the plenary sessions. He felt that broad sweeping speeches by senior people in the field providing general overviews convey little new—or useful—information. He also suggested that posters be invited alongside oral presentations. In part the goal was to reduce the perception that posters are consolation prizes, but also because he thought this a better