Evaluation of spin in the abstracts of otolaryngology randomized controlled trials

Abstracts of randomized controlled trials in splint therapy for temporomandibular disorders: Reporting quality and spin

BACKGROUND

Poor reporting quality and spin in randomized controlled trial (RCT) abstracts can lead to misinterpretation and distorted interpretation of results.

OBJECTIVES

This methodological study aimed to assess the reporting quality and spin among RCT abstracts on splint therapy for temporomandibular disorders (TMD) and explore the association between spin and potentially related factors.

METHODS

The authors searched PubMed for RCTs on splint therapy for TMD. The reporting quality of each abstract was assessed using the original 16-item CONSORT for abstracts checklist. The authors evaluated the presence and characteristics of spin only in abstracts with nonsignificant primary outcomes according to pre-determined spin strategies. Logistic regression analyses were performed to identify factors associated with the presence of spin.

RESULTS

A total of 148 abstracts were included in the reporting quality evaluation. The mean overall CONSORT score (OCS) was 5.86 (score range: 0-16). Only interventions, objectives and conclusions were adequately reported. Of the 61 RCT abstracts included for spin analysis, spin was identified in 38 abstracts (62.3%), among which 32 abstracts (52.3%) had spin in the Results section and 21 (34.4%) had spin in the Conclusions section. A significantly lower presence of spin was found in studies with exact p-value reporting (OR: 0.170; 95% CI: 0.032-0.887; p = .036) and a two-arm comparison design (OR: 11.777; 95% CI: 2.171-63.877; p = .004).

CONCLUSIONS

The reporting quality of RCT abstracts on splint therapy for TMD is suboptimal and the prevalence of spin is high. More awareness and joint efforts are needed to improve reporting quality and minimize spin.

Assessment of spin in the abstracts of randomized controlled trials in dental caries with statistically nonsignificant results for primary outcomes: A methodological study

The study aimed to assess the prevalence of spin in the titles and abstracts of RCTs in dental caries with statistically nonsignificant primary outcomes and to assess the risk indicators which may be associated with spin. Any original publication reporting a two-arm RCT in dental caries with clearly identified statistically nonsignificant primary outcomes published from January 1, 2015 until October 28, 2022 were included. PubMed was searched electronically to identify the eligible publications. The prevalence of spin in titles and abstracts were assessed and categorized into spin patterns based on a pre-determined classification scheme. The association between spin and the potential risk indicators at study, author, journal, institutional, and national level was assessed. A total of 234 eligible RCT publications were included. The prevalence of spin in the titles and abstracts was 3% (95%CI: 2% to 6%) and 79% (95%CI: 74% to 84%), respectively. The most common spin patterns in the results and conclusion sections, respectively, were results focusing on statistically significant within-group comparisons (23%), and conclusions focusing only on statistically significant results without acknowledgment of statistically nonsignificant results for the primary outcomes (26%). The spin was significantly associated with number of study centers (single-center vs. multicenter) (OR=2.131; 95%CI: 1.092 to 4.158; P=0.03), trial designs (non-parallel designs vs. parallel designs) (OR=0.395; 95%CI: 0.193 to 0.810; P=0.01), and overall H index of institutions for last authors (OR=0.998; 95%CI: 0.996 to 0.999; P<0.01), while it was not significantly associated with the other indicators. In the RCT publications with statistically nonsignificant results for primary outcomes in dental caries, the prevalence of spin may be low in the titles but high in the abstracts. Single-center studies with parallel designs and a lower overall H index of institutions for last authors may be more likely to have spin in the abstracts.

Spin in the Abstracts of Meta-analyses and Systematic Reviews: Quadriceps Tendon Graft for Anterior Cruciate Ligament Reconstruction

BACKGROUND

Spin is a reporting bias that misrepresents research. Ultimately it can affect surgeon decision making and patient care. Anterior cruciate ligament (ACL) reconstruction is common, but debate continues over optimal treatment modalities.

PURPOSE

To identify the prevalence of spin in meta-analysis and systematic review abstracts regarding the treatment of ACL injuries with quadriceps tendon graft.

STUDY DESIGN

Cross-sectional study.

METHODS

Electronic libraries (MEDLINE, Embase, Web of Science, Google Scholar) were searched for meta-analyses and systematic reviews regarding the treatment of ACL tears with quadriceps tendon graft. The 9 most severe types of spin commonly found in abstracts were used as an evaluation tool to assess the articles. Two reviewers each performed a blinded assessment of each article for spin. A third reviewer helped after review was done to address any discrepancies between the original reviewers. Further evaluation included year of publication, number of citations, journal impact factor, and A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) score.

RESULTS

The electronic database search resulted in 986 articles, of which 13 met our inclusion criteria. After review, we found that 53.8% (7/13) of the included articles contained 1 of the 9 most severe forms of spin. Of the 13 articles, 15.4% (n = 2) contained 2 types of spin, and 38.5% (n = 5) contained 1 type of spin. No studies contained ≥3 types of spin. Of the types of spin evaluated, the most prevalent (n = 4; 30.8%) was type 3 ("selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention"). All studies, regardless of the presence of spin, were found to be low or critically low quality according to the AMSTAR-2 assessment.

CONCLUSION

This study demonstrated the presence of spin in 53.8% of meta-analysis and systematic review abstracts pertaining to quadriceps tendon graft for ACL reconstruction. Orthopaedic surgeons should learn to recognize spin as they review articles when deciding the treatment course for ACL injuries. Additionally, strict criteria should be considered to reduce the prevalence of spin in orthopaedic literature.

Evaluation of Spin in the Clinical Literature of Suture Tape Augmentation for Ankle Instability

Background

Spin is defined as the use of specific reporting strategies to highlight the beneficial effect of a treatment despite nonsignificant results. The presence of spin in peer-reviewed literature can negatively impact clinical and research practices. The purpose of this study was to identify the quantity and types of spin present in primary studies and systematic reviews using suture tape augmentation for ankle instability as a model.

Methods

This study was conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Each abstract was assessed for the presence of the 15 most common types of spin. Extracted data included study title, authors, publication year, journal, level of evidence, study design, funding, reported adherence to PRISMA guidelines, and PROSPERO registration. Full texts of systematic reviews were used in the assessment of study quality per A Measurement Tool to Assess Systematic Reviews Version 2 (AMSTAR 2).

Results

Nineteen studies were included in the final sample. At least 1 type of spin was identified in each study except one (18 of 19, 94.7%). The most common type of spin observed was type 3 ("selective reporting or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention") (6 of 19, 31.6%), The second most reported category of spin was type 4 ("the conclusion claims safety based on non-statistically significant results with a wide confidence interval") (4 of 19, 21.1%). Among systematic reviews, we identified type 5 ("the conclusion claims the beneficial effect of the experimental treatment despite a high risk of bias in primary studies") in 4 out of 6 (66.7%) of the articles that were included. No significant associations were found between study characteristics and type of spin.

Conclusion

In this exploration of the introduction of a new technology, we identified spin to be highly present in the abstracts of primary studies and systematic reviews concerning suture tape augmentation for ankle instability. Steps should be taken by scientific journals to ensure that spin is minimized in the abstract to accurately reflect the quality of the intervention.

Abstracts of randomized controlled trials in the field of dentofacial trauma: Reporting quality and spin

BACKGROUND/AIM

Abstracts of randomized controlled trials (RCTs) provide a summary of the entire trial report. Their transparent, detailed, and accurate reporting is essential for clinical decision-making and evidence-based dental practice. The aim of this study was to assess the reporting quality and prevalence of spin in abstracts of RCTs in the field of dentofacial trauma.

MATERIALS AND METHODS

The PubMed database was searched to identify RCT reports published between 2017 and 2021 in the field of dentofacial trauma. The reporting quality of abstracts was assessed according to the 16-item CONSORT for Abstracts checklist and measured with an overall quality score (OQS, range: 0-16). Linear regression analyses were used to identify factors associated with reporting quality. Among the included RCTs, parallel-group RCTs with non-significant primary outcomes were selected for spin assessment using predefined spin strategies.

RESULTS

One hundred and twelve eligible abstracts were identified and included. The mean OQS was 4.51 (SD, 1.35; 95% CI, 4.26-4.76). Abstracts with more than 250 words (p = .004) and a structured format (p = .032) had significantly better reporting quality. Of the 30 abstracts that were eligible for spin assessment, spin was identified in 23 (76.7%). Among these, spin was observed in the Conclusions sections of 22 abstracts (73.3%) and the Results sections of 9 abstracts (30.0%).

CONCLUSIONS

Among RCT abstracts in the field of dentofacial trauma, the reporting quality was sub-optimal and the prevalence of spin was relatively high. Strict adherence to the CONSORT for Abstracts guidelines is needed to ensure complete and transparent reporting. Relevant stakeholders need to make concerted efforts to avoid spin.

Analysis of Spin in RCTs of Spine Surgery Using ORG-LOC Grading Tool

BACKGROUND

Even in highly credible research models, such as randomised control trials (RCTs), many pitfalls do exist that a practitioner must be aware of, to get the actual sense of the research. The one such pitfall that is much more common but ironically less explored is the Writers' bias or the spin. Particularly in the abstracts, it is a potential source of deception to the readers.

METHODS

We selected 250 recent RCTs from the top 5 spine journals. Baseline data and CONSORT Adherence Score (CAS) were collected. Abstracts of the RCTs were graded using the level of confidence (LOC) grading tool developed by the Orthopaedic Research Group. All possible associations of spin were studied to assess the significance.

RESULTS

The median CAS was 11 (IQR 10-12). Only 47.6% (n = 119) articles had High LOC with no or one non-critical spin in abstract. 12.4% (n = 31) had Moderate LOC and 28% (n = 70) had Low LOC. The rest had Critically Low LOC with more than one critical spin. Of the variables analyzed in multivariate regression analysis, only CAS had a (negative) correlation with the LOC of the abstracts.

CONCLUSIONS

Spin-based grading of RCTs is the need of the hour to aid readers to interpret the true essence of research papers. 40% of the RCTs in top spine journals had low to critically low LOC. Objective structuring of abstracts with adherence to CONSORT guidelines is the way forward to prevent spin.

Evaluation of spin in the abstracts of systematic reviews and meta-analyses relating to postoperative nausea and vomiting

INTRODUCTION

Spin - the beautification of study results to emphasise benefits or minimise harms - is a deceptive reporting strategy with the potential to affect clinical decision-making adversely. Few studies have investigated the extent of spin in systematic reviews. Here, we sought to address this gap by evaluating the presence of the nine most severe forms of spin in the abstracts of systematic reviews on treatments for postoperative nausea and vomiting (PONV). PONV has the potential to increase hospital costs and patient burden, adversely affecting outcomes.

METHODS

We developed search strategies for MEDLINE and Embase to identify systematic reviews focused on PONV. Following title and abstract screening of the reviews identified during the initial search, those that met inclusion criteria were evaluated for the presence of spin and received a revised AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews) appraisal by two investigators in a masked, duplicate manner. Study characteristics for each review were also extracted in duplicate.

RESULTS

Our systematic search returned 3513 studies, of which 130 systematic reviews and meta-analyses were eligible for data extraction. We found that 29.2% of included systematic reviews contained spin (38/130). Eight of the nine types of spin were identified, with spin type 3 ('selective reporting of or overemphasis on efficacy outcomes or analysis favouring the beneficial effect of the experimental intervention') being the most common. Associations were found between spin and funding source. Spin was more likely in the abstracts of privately funded than nonfunded studies, odds ratio (OR) 2.81 [95% confidence interval (CI), 0.66 to 11.98]. In the abstracts of studies not mentioning funding spin was also more likely than in nonfunded studies, OR 2.30 (95% CI, 0.61 to 8.70). Neither of these results were statistically significant. Significance was found in the association between the presence of spin and AMSTAR-2 ratings: 'low' quality studies were less likely to contain spin than 'high' quality, OR 0.24 (95% CI, 0.07 to 0.88): 'critically low' studies were also less likely to contain spin than 'high' quality studies, OR 0.21 (95% CI, 0.07 to 0.65). There were no other associations between spin and the remaining extracted study characteristics or AMSTAR-2 ratings.

CONCLUSION

Spin was present in greater than 29% of abstracts of systematic reviews and meta-analyses regarding PONV. Various stakeholders must take steps to improve the reporting quality of abstracts on PONV.

Spin in the Abstracts of Randomized Controlled Trials in Operative Dentistry: A Cross-sectional Analysis

OBJECTIVE

To assess the presence and characteristics of spin in recently published RCT abstracts in operative dentistry and to investigate potential factors associated with the presence of spin.

METHODS AND MATERIALS

The PubMed database was searched to identify parallel-group RCTs published between 2015 and 2019 in the field of operative dentistry, which compared two or more groups and had nonsignificant results for the primary outcome. Two authors evaluated independently the presence and characteristics of spin among these abstracts. Multivariable logistic regression analyses were conducted to identify factors associated with the presence of spin in the Results and the Conclusions sections, respectively.

RESULTS

A total of 77 RCT abstracts were included, among which 58 (75.3%) showed at least one type of spin. Spin was identified in the Results and Conclusions sections of 32 (41.6%) and 45 (58.4%) abstracts, respectively. 19 RCTs (24.7%) presented spin in both the Results and the Conclusions section of abstracts. The presence of spin in the Results section of abstracts was significantly associated with source of funding (OR=8.10; p=0.025) and number of treatment arms was associated with the presence of spin in the Conclusions section of abstracts (OR=5.66; p=0.005).

CONCLUSION

The occurrence rate of spin in the sample of operative dentistry RCTs abstracts is high.

Spin in Abstracts of Systematic Reviews and Meta-analyses of Melanoma Therapies: Cross-sectional Analysis

BACKGROUND

Spin is defined as the misrepresentation of a study's results, which may lead to misperceptions or misinterpretation of the findings. Spin has previously been found in randomized controlled trials and systematic reviews of acne vulgaris treatments and treatments of various nondermatological conditions.

OBJECTIVE

The purpose of this study was to quantify the presence of spin in abstracts of systematic reviews and meta-analyses of melanoma therapies and identify any related secondary characteristics of these articles.

METHODS

We used a cross-sectional approach on June 2, 2020, to search the MEDLINE and Embase databases from their inception. To meet inclusion criteria, a study was required to be a systematic review or meta-analysis pertaining to the treatment of melanoma in human subjects, and reported in English. We used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) definition of systematic reviews and meta-analyses. Data were extracted in a masked, duplicate fashion. We conducted a powered bivariate linear regression and calculated odds ratios for each study characteristic.

RESULTS

A total of 200 systematic reviews met the inclusion criteria. We identified spin in 38% (n=76) of the abstracts. The most common type of spin found was type 3 (selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention), occurring 40 times; the least common was type 2 (title claims or suggests a beneficial effect of the experimental intervention not supported by the findings), which was not present in any included abstracts. We found that abstracts pertaining to pharmacologic interventions were 3.84 times more likely to contain spin. The likelihood of an article containing spin has decreased annually (adjusted odds ratio 0.91, 95% CI 0.84-0.99). No significant correlation between funding source or other study characteristics and the presence of spin was identified.

CONCLUSIONS

We have found that spin is fairly common in the abstracts of systematic reviews of melanoma treatments, but the prevalence of spin in these abstracts has been declining from 1992-2020.

Evaluation of spin in the abstracts of emergency medicine systematic reviews and meta-analyses

INTRODUCTION

The objective of this study was to assess for spin - a form of reporting that overemphasizes benefits or downplay harms - within abstracts of systematic reviews and meta-analyses related to the clinical practice of emergency medicine (EM).

METHODS

PubMed was searched for systematic reviews and meta-analyses published since 2015 in either EM or general medical journals that examined an aspect of emergency medical care. In a duplicate, masked fashion, article titles and abstracts were screened to determine eligibility based on predetermined inclusion criteria. The included full-text studies were read and evaluated for spin using a previously determined search strategy. Two authors further evaluated study quality using the AMSTAR-2 tool.

RESULTS

Our PubMed search identified 478 systematic reviews and meta-analyses, of which a random sample of 200 was selected for data extraction. Spin within the abstract of the manuscript was identified in 34.5% (69/200) of the included reviews. We identified seven of the nine spin types, with two types being most common: (1) conclusion claiming a benefit despite high risk of bias among studies reviewed (19.5% of abstracts), and (2) conclusion claiming a benefit despite reporting bias (14.5%). No significant associations were found between the presence of spin and any of the evaluated study characteristics, the AMSTAR-2 appraisal, or the journal of publication.

CONCLUSION

Spin is commonly present in abstracts of EM systematic reviews. The reporting quality for EM systematic reviews requires improvement. Measures should be taken to improve the overall review process and way information is conveyed through abstracts.

The presence and characteristics of 'spin' among randomized controlled trial abstracts in orthodontics

OBJECTIVES

To identify the presence and characteristics of spin (using reporting strategies to distort study results and mislead readers) within randomized controlled trial (RCT) abstracts published in orthodontic journals, and to explore the association between spin and potentially related factors.

METHODS

A manual search was conducted to identify abstracts of RCTs with statistically non-significant primary outcomes published in five leading orthodontic journals between 2015 and 2020. Spin in the Results and Conclusions sections of each included abstract was evaluated and categorized according to pre-determined spin strategies. Logistic regression analyses were employed to explore the association between spin and relevant factors.

RESULTS

A total of 111 RCT abstracts were included, of which 69 (62.2 per cent) were identified with spin. In the Results section, 47 (42.3 per cent) abstracts had spin, and 'focusing on significant within-group comparison for primary outcomes' was the most frequent spin strategy. In the Conclusions section, 57 (51.4 per cent) abstracts presented spin, with the most common strategy being 'claiming equivalence or non-inferiority for statistically nonsignificant results'. According to multivariable logistic regression analysis, a significantly lower presence of spin was found in studies with international collaboration (odds ratio [OR]: 0.331, 95 per cent confidence interval [CI]: 0.120-0.912, P = 0.033) and trial registration (OR: 0.336, 95 per cent CI: 0.117-0.962, P = 0.042).

CONCLUSION

The prevalence of spin is high among RCT abstracts in orthodontics. Clinicians need to be aware of the definition and presence of spin. Concerted efforts are needed from researchers and other stakeholders to address this issue.

Spin Infrequently Occurs in Abstracts of Systematic Reviews For The Pharmacological Treatment of Type 2 Diabetes Mellitus

AIMS

Currently, there is a growing body of research demonstrating that spin - the misinterpretation and distortion of a study's findings - is common in different fields of medicine. To our knowledge, no study has investigated its presence in systematic reviews focused on diabetic therapies.

METHODS

We performed a cross-sectional study by searching MEDLINE and Embase for systematic reviews focused on pharmacologic treatments for type 2 diabetes mellitus. Our search retrieved 26,490 records, from which 199 studies were extracted in a masked, duplicate fashion. Each study was evaluated for the nine most severe types of spin and other study design parameters. Spin was presented as frequencies and odds ratios to identify associations between study characteristics.

RESULTS

Spin was identified in the abstracts of 15 systematic reviews (15/199, 7.5%). Spin type 5 was the most common type identified (7/199, 3.5%). Spin types 1, 2, 4, and 8 were not identified. In the last 5 years (2016-2021), 7 systematic reviews contained spin within their abstract. There was no association between spins presence and any extracted study characteristic .

CONCLUSIONS

Our findings show that spin infrequently occurs in abstracts of systematic reviews focused on pharmacologic therapies for type 2 diabetes mellitus. However, any amount of spin can lead to the distortion of a reader's interpretation of the study's findings. Thus, we provide recommendations with rationale to prevent spin in future systematic reviews.

Abstracts for reports of randomised trials of COVID-19 interventions had low quality and high spin

OBJECTIVES

To assess the reporting quality of abstracts for published randomized controlled trials (RCTs) of interventions for coronavirus disease 2019 (COVID-19), including the use of spin strategies and the level of spin for RCTs with statistically non-significant primary outcomes, and to explore potential predictors for reporting quality and the severity of spin.

STUDY DESIGN AND SETTING

PubMed was searched to find RCTs that tested interventions for COVID-19, and the reporting quality and spin in the abstracts were assessed. Linear regression analyses were used to identify potential predictors.

RESULTS

Forty RCT abstracts were included in our assessment of reporting quality, and a higher word count in the abstract was significantly correlated with higher reporting scores (95% CI 0.044 to 0.658, P=0.026). Multiple spin strategies were identified. Our multivariate analyses showed that geographical origin was associated with severity of spin, with research from non-Asian regions containing fewer spin strategies (95% CI -0.760 to -0.099, P=0.013).

CONCLUSIONS

The reporting quality of abstracts of RCTs of interventions for COVID-19 is far from satisfactory. A relatively high proportion of the abstracts contained spin, and the findings reported in the results and conclusion sections of these abstracts need to be interpreted with caution.

Spin in the abstracts of systematic reviews and metaanalyses focused on percutaneous coronary intervention

CONTEXT

"Spin" is a form of bias that involves highlighting study results in a way that presents the conclusions about benefit or efficacy beyond the scope of the data. Spin in the abstract of published studies has the potential to affect patient care, making investigations about its presence and prevalence important for readers.

OBJECTIVES

To evaluate the most severe types of spin in the abstracts of systematic reviews and metaanalyses focused on percutaneous coronary intervention.

METHODS

Using a cross sectional study design, the authors searched MEDLINE and Embase with the terms "percutaneous coronary intervention," "percutaneous coronary revascularization," "PCI," "systematic review," "meta analysis," and "meta-analysis." To be considered for this study, the article must have (1) focused on PCI; (2) had either a systematic review or metaanalysis study design; (3) been conducted on human subjects; and (4) been available in English. Reviews were excluded if these criteria were not met. Each included article was assessed for the nine most severe types of spin as defined in a previously published article, as well as other study characteristics (type of intervention being compared, date the review was received, adherence of systematic review and/or meta-analysis to Preferred Reporting for Systematic Reviews or Metanalyses (PRISMA) guidelines, requirement of PRISMA guidelines by the publishing journal, the publishing journal's five-year impact factor, and sources of funding).

RESULTS

Our database search retrieved 7,038 records; 2,190 duplicates were removed. Initial title and abstract screening led to the exclusion of 4,367 records, and an additional 281 records were excluded during full text screening. An arbitrary limit of 200 articles was applied for this analysis; five additional articles were excluded for ineligible study design, so 195 were included in our final analysis. Spin was present in the abstracts of 43 studies from that pool (22.1%). Spin type 3-selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention-occurred most frequently (29; 14.8%). The presence of spin was not associated with any of the extracted study characteristics.

CONCLUSIONS

Our data showed that spin occurred in more than one in every five systematic reviews or metaanalyses of PCI. Spin has the potential to distort a reader's ability to translate the true findings of a study; therefore, efforts are needed to prevent spin from appearing in article summaries.

Evaluation of spin in the abstracts of systematic reviews and meta-analyses of treatments and interventions for smoking cessation

INTRODUCTION

Smoking cessation treatments and available evidence continue to evolve. To stay current with the latest research, physicians often refer to abstracts of systematic reviews. Because abstracts of systematic reviews may have direct effects on patient care, the information within them should be free of 'spin'. Spin is a specific way of reporting, intentional or not, to highlight that the beneficial effect of the experimental treatment in terms of efficacy or safety is greater than that shown by the results (i.e. overstate efficacy and/or understate harm).

METHODS

We searched systematic reviews and meta-analyses focused on interventions and treatments for smoking cessation. Full-text screening, data extraction, evaluation of spin, and quality assessment were conducted in masked, duplicate fashion. Study and journal characteristics were also recorded to determine whether they were associated with the presence of spin.

RESULTS

A total of 200 systematic reviews that met inclusion criteria were included in the final analyses. Spin occurred in 3.5% (7/200) of the systematic review abstracts included in our sample. No study characteristics were significantly associated with spin.

CONCLUSIONS

Of the reviewed abstracts in systematic reviews and meta-analyses, 96.5% of those that focused on smoking cessation were free of spin. However, the existence of spin warrants further steps to improve the scientific accuracy of abstracts on smoking cessation treatments. By identifying and acknowledging the presence of spin in systematic reviews, we hope to increase awareness about reporting practices in an ultimate effort to improve the integrity of scientific research as a whole.

Evaluation of Spin in the Abstracts of Systematic Reviews and Meta-Analyses Focused on Tinnitus

HYPOTHESIS

The objective was to investigate the prevalence of spin in abstracts of systematic reviews and meta-analyses covering the treatment of tinnitus. We hypothesized that spin would be present in these articles and a significant relationship would exist between spin usage and extracted study characteristics.

BACKGROUND

Spin, the misrepresentation of study findings, can alter a clinician's interpretation of a study's results, potentially affecting patient care. Previous work demonstrates that spin is present in abstracts of randomized clinical trials.

METHODS

Using a cross-sectional analysis, we conducted a systematic search using MEDLINE and Embase databases on June 2, 2020, for systematic reviews focused on tinnitus treatment. Investigators performed screening and data extraction in a masked, duplicate fashion.

RESULTS

Forty systematic reviews met inclusion criteria, and spin was identified in four of them. Spin in abstracts most frequently occurred when conclusions claimed the beneficial effect of the experimental treatment despite high risk of bias in primary studies (n = 3). The other form of spin found was the conclusion claims safety based on nonstatistically significant results with a wide confidence interval (n = 1). There was no significant association between spin and any of our extracted study characteristics.

CONCLUSION

Spin was observed in 10% of abstracts of systematic reviews and meta-analyses covering the treatment of tinnitus. Although this percentage may be small, we recommend that medical journals provide a more detailed framework for abstract structure and require the inclusion of risk of bias assessment results in abstracts to prevent the incorporation of spin.

Evaluation of spin in the abstracts of systematic reviews and meta-analyses of studies on opioid use disorder

BACKGROUND

Spin, or the inappropriate formatting of information to emphasize certain outcomes, should not be present in research. This study focuses on identifying and characterizing the presence of spin in systematic review and meta-analysis abstracts that focus on the treatment of opioid use disorder. Methods: Search strategies were developed to identify studies pertaining to the treatment of opioid use disorder. The studies were then screened by two authors. These qualifying studies were then evaluated for the presence of spin within their abstracts by two trained authors. These studies were also evaluated by the AMSTAR-2 standards to evaluate the quality of the qualifying systematic reviews by two trained reviewers. Results: The sample in this study included 113 systematic reviews and meta-analyses. Spin was present in 20 of these studies (20/113, 17.7%). The most common spin form was spin type 3 (6/20, 30%), followed by types 5 and 9 (both 4/20, 20%), type 6 (3/20, 15%), type 7 (2/20, 10%), and type 8 (1/20, 5%). The remaining spin types 1, 2, and 4 were not present in the sample. Of the 113 included studies, the most common intervention type was pharmacologic (93/113, 82%). No significant association was found between the quality of a systematic review and the presence of spin. Conclusions: Findings in this study show positive trends in prevalence of five forms of spin evaluated in abstracts of systematic reviews and meta-analyses looking at treatments for opioid use disorder. However, study quality had no significant association with the presence of spin. Misrepresentation of results, or spin, may alter a clinician's perceptions about treatment efficacies. Therefore, increasing physician awareness of spin may improve clinical decision-making.

Spin the Abstracts of Systematic Reviews and Meta-Analyses Regarding the Treatment of Ménière's Disease

OBJECTIVES

To identify, quantify, and characterize the presence of spin-specific strategies leading to misrepresentation of study results-in the abstracts of systematic reviews and meta-analyses of Ménière's disease treatment.

METHODS

Using a cross-sectional design, we searched MEDLINE and Embase on May 28, 2020, for systematic reviews and meta-analyses focused on Ménière's disease treatment. Returned searches were screened, and data were extracted in a masked, duplicate fashion.

RESULTS

Our sample included 36 systematic reviews and meta-analyses. Of the 36 included studies, 22 (61.1%) abstracts contained spin while 14 (38.9%) did not. The most common spin types were selective reporting of benefit (10/36, 27.8%) or harm (8/36, 22.2%). Other types of spin occurred when findings were extrapolated to the global improvement of the disease (5/36, 13.9%), beneficial effects were reported with high risk of bias in primary studies (3/36, 8.3%), and when beneficial effects were extrapolated to an entire class of interventions (1/36, 2.8%). No instances of other spin types occurred. Abstracts containing spin were substantively associated with studies of critically low methodological quality compared with studies with low and moderate quality. No studies had a methodological rating of high quality. No associations were observed between spin and intervention types, journal recommendation of adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses, or funding. We found a negative correlation (r = -.31) between abstract word limit and presence of spin.

CONCLUSIONS

Our study highlights that spin in the abstracts of systematic reviews of Ménière's disease is common, and it further enhances the discussion surrounding spin in abstracts of scientific research. Spin in an abstract does not discredit a study's findings; however, its occurrence should be eliminated.

Evaluation of spin in the abstracts of systematic reviews and meta-analyses related to the treatment of proximal humerus fractures

BACKGROUND

Research has shown that many physicians rely solely on abstracts to make clinical decisions. However, many abstracts have been shown to be misleading. The primary objective of this study was to identify the prevalence of spin - bias towards particular results - within the abstracts of systematic reviews and meta-analyses pertaining to the treatment of proximal humerus fractures, one of the most common osteoporotic fractures among elderly patients.

METHODS

We systematically searched MEDLINE and Embase databases to identify systematic reviews and meta-analyses examining the treatment of proximal humerus fractures. Screening and data extraction occurred in a masked, duplicate fashion. The nine most severe types of spin that occur within abstracts were extracted along with study characteristics, including journal recommendations to adhere to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and year in which the review was performed, to identify potential associations. We subsequently explored the association between spin and the methodological quality of a systematic review using the revised A MeaSurement Tool to Assess systematic Reviews (AMSTAR 2) appraisal instrument.

RESULTS

Our search retrieved 505 articles, of which 73 systematic reviews met inclusion criteria. We found that 34.2% (25/73) of the included systematic reviews contained spin. Spin type 3 (selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention) was the most common type identified (12/73, 16.4%). Three spin types were not identified in any of the abstracts. Spin was 3.2 (OR 3.2; 95% CI, 1.02-10.02) times more likely to be present in systematic reviews published in journals recommending adherence to PRISMA. Furthermore, the odds of an abstract containing spin was 1.25 (OR 1.25; 95% CI, 1.02-1.52) times more likely to be present in systematic reviews for each year after 2000. No other study characteristics were associated with spin. The methodological quality of 24 studies were rated as "critically low" (32.9%), 14 were "low" (19.2%), 28 were "moderate" (38.4%), and 7 were "high" (9.6%), but these findings were not associated with spin.

CONCLUSION

Spin was present in systematic review abstracts regarding treatment of proximal humerus fractures. Measures such as education on the subject of spin and improved reporting standards should be implemented to increase awareness and reduce incidence of spin in abstracts.

LEVEL OF EVIDENCE OF THE STUDY PERFORMED

Basic Science Study; Research Methodology.

Evaluation of Spin in the Abstracts of Systematic Reviews and Meta-analyses Covering Treatments for Achilles Tendon Ruptures

Background:

Approximately 18 in every 100 000 people have experienced a ruptured Achilles tendon. Despite the prevalence of this condition, treatment options remain contested.

Hypothesis/purpose:

The objective of this study was to evaluate the use of spin—reporting practices that may exaggerate benefit or minimize harm—in abstracts of systematic reviews related to Achilles tendon repair. We also evaluated whether particular study characteristics were associated with spin.

Study design:

Cross-sectional.

Methods:

We developed a search strategy for Ovid MEDLINE and Ovid Embase for systematic reviews focused on Achilles tendon treatment. Following title and abstract screening of these search returns, these reviews were evaluated for spin (according to a previously developed classification scheme) and received AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews–2) appraisals by 2 investigators in a masked, duplicate manner. Study characteristics for each review were also extracted in duplicate.

Results:

Our systematic search returned 251 articles of which 43 systematic reviews and meta-analyses were eligible for data extraction. We found that 65.1% of included studies contained spin (28/43). Spin type 3 was the most common type, occurring in 53.5% (23/43) of abstracts. Spin types 5, 6, 1, and 4 occurred in 16.3% (7/43), 9.3% (4/43), 7% (3/43), and 5.3% (1/43), respectively. Spin types 2, 7, 8, and 9 did not occur. AMSTAR-2 appraised 32.6% (14/43) of the studies as “moderate” quality, 32.6% (14/43) as “low” quality, and 34.9% (15/43) as “critically low” quality. No systematic reviews were rated as “high” quality. There was no significant association between the presence of spin and the following study characteristics: intervention type, article discussing Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) adherence, journal recommending PRISMA adherence, funding sources, journal 5-year impact factor, year the review was received for publication, or AMSTAR-2 critical appraisals.

Conclusion:

Spin was present in abstracts of systematic reviews and meta-analyses—covering Achilles tendon tear treatment. Steps should be taken to improve the reporting quality of abstracts on Achilles tendon treatment as well as other common orthopedic conditions.

Clinical relevance:

In order to avoid negative patient outcomes, articles should be free of spin within the abstract.

Evaluation of Spin in Abstracts of Systematic Reviews and Meta-analyses Focused on Treatments of Erectile Dysfunction: A Cross-sectional Analysis

INTRODUCTION

It is predicted that erectile dysfunction will affect around 322 million men worldwide by 2025. Because of the large volume of literature on the topic, physicians often turn to systematic reviews and meta-analyses-and particularly abstracts of such articles-for clinical guidance. Thus, it is crucial that findings are not misrepresented in abstracts. In this study, we evaluated the use of spin (ie, the misreporting of study findings by overstating or selectively reporting efficacy results, minimizing harms, or making unwarranted clinical recommendations) in the abstracts of systematic reviews on erectile dysfunction.

METHODS

A search strategy was developed using the MEDLINE and Embase databases to retrieve systematic reviews focused on treatments for erectile dysfunction. 2 investigators independently screened the titles and abstracts from the reviews for study inclusion. Investigators analyzed the included systematic reviews for 9 of the most severe types of spin using a previously developed classification scheme and rated them for methodological quality using the revised A MeaSurement Tool to Assess systematic Reviews (AMSTAR) in a masked, duplicate manner. Study characteristics for each review were also extracted in duplicate.

RESULTS

Our search returned 2,224 articles, of which 102 systematic reviews and meta-analyses were included in the final analysis. A total of 31.4% (32/102) of systematic reviews contained spin. 8 types of spin were identified in our sample. Type 3 (selective reporting of or overemphasis on efficacy outcomes) and type 5 (conclusion claims beneficial effect despite high risk of bias) were the most common types of spin, each occurring in 10.8% (11/102) of abstracts. There was no significant association between the presence of spin and the extracted study characteristics or methodological quality.

CONCLUSION

Spin was present in systematic reviews and meta-analyses covering erectile dysfunction treatments. Steps should be taken to improve the reporting quality of abstracts on erectile dysfunction treatment. Reddy AK, Lulkovich K, Ottwell R, et al. Evaluation of Spin in Abstracts of Systematic Reviews and Meta-analyses Focused on Treatments of Erectile Dysfunction: A Cross-sectional Analysis. Sex Med 2020;9:100284.

Evaluation of misrepresented findings in the abstracts of acute respiratory distress syndrome randomized trials with nonsignificant primary endpoints

OBJECTIVE

We investigated the randomized controlled trials (RCTs) related to acute respiratory distress syndrome (ARDS) to assess the presentation and frequency of misrepresented research findings, also known as spin.

METHODS

We searched PubMed (MEDLINE) for studies published from January 1, 2011 to December 31, 2019. We included randomized controlled trials with an ARDS intervention and a nonsignificant primary endpoint. Trial screening and data extraction was performed on all studies independently and in duplicate. The primary endpoint was to investigate the frequency and manifestation of spin in RCT abstracts. Our secondary endpoint was to investigate associations between funding source and spin.

RESULTS

Our PubMed search returned 766 articles with 37 meeting inclusion criteria. Spin was present in 14 (14/37, 37.8%; 95% CI 22.5%-55.2%) abstracts. The most common manifestations of spin were claiming benefit based on a significant secondary endpoint (6/14, 42.9%), followed by the use of 'trend' statements, such as 'trend toward significance' (2/14, 14.3%; 95% CI 1.8%-42.8%). The most common spin in abstract conclusions was in the form of claiming benefit due to a significant secondary endpoint (3/4, 75%; 95% CI 19.4%-99.4%). Our secondary endpoint did not identify a significant difference in the prevalence of spin in publicly funded (5/19, 26.3%; 95% CI 9.1%-51.2%) compared to privately funded (4/12, 33.3%; 95% CI 9.9%-65.1%) studies (p>.05).

CONCLUSIONS

RCTs of ARDS interventions with nonsignificant primary endpoints often included spin in the abstract. Spin in the abstract may influence clinician appraisal and interpretation of diagnostic or treatment modalities.

Evaluation of "Spin" in the Abstracts of Randomized Controlled Trial Reports in Cardiology

CONTEXT

The misrepresentation and distortion of research findings, known as "spin," has been shown to affect clinical decision making. Spin has been found in randomized controlled trials (RCTs) published in various fields of medicine.

OBJECTIVE

To evaluate the abstracts of RCTs found in the cardiology literature for spin.

METHODS

The authors searched PubMed using a specific string of keywords to identify previously published articles documenting RCTs of cardiovascular treatments in humans. To be included, a cardiology trial had to randomize humans to an intervention, statistically compare 2 or more groups, and have a nonsignificant primary endpoint. Records were excluded if they did not meet these criteria. Data extraction was double-blinded and done using a pilot-tested Google Form. Items extracted from each trial included the title, journal, funding source, comparator arm, primary endpoint, statistical analysis of the primary endpoint, secondary endpoints, statistical analysis of secondary endpoints, and trial registration number (if reported). The 2 authors who screened records for inclusion were then asked whether spin was present in the abstract of the randomized trial. Spin in the title, abstract results, abstract conclusions, and selection of reported endpoints were considered.

RESULTS

Of the 651 PubMed citations retrieved by our search string, 194 RCTs with a clearly defined primary endpoint were identified. Of these 194 RCTs, 66 trials contained nonsignificant primary endpoints and were evaluated for spin. Of these trials, spin was identified in 18 of the 66 abstracts (27.3%).

CONCLUSIONS

Spin was present in our sample of cardiology RCTs. Spin may influence clinical decision making by creating false impressions of the true validity of a drug or intervention.

An Evaluation of the Presence of Spin in the Abstracts of Tonsillectomy Systematic Reviews

OBJECTIVES/HYPOTHESIS

Spin-the practice of adding or omitting information intentionally or unintentionally to make the results of a study more favorable-may influence clinical decision making, especially when present in study abstracts. Here, we quantify and characterize the presence of spin in the abstracts of systematic reviews regarding tonsillectomy.

METHODS

This study is an analysis of systematic review abstracts. Searches were conducted on September 23, 2019 on PubMed and Embase using the advanced search feature to retrieve systematic reviews regarding tonsillectomies. The nine most severe forms of spin were then evaluated. Spin was classified by two investigators in parallel, with each blinded to the classifications of the other. Study characteristics were also recorded in duplicate. Consensus meetings between investigators were held to resolve disagreements.

RESULTS

In the 85 included systematic reviews, at least one form of spin was present in 44.7% (38/85) of abstracts. Journals with higher impact factors were less likely to contain spin in the abstracts of systematic reviews (point biserial correlation coefficient of -0.30). No statistically significant associations were found between the presence of spin and intervention type (P = .56) or adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (P = .08); however, there was a significant association between spin and funding source (P = .03).

CONCLUSIONS

Spin was common in the abstracts of our sample of tonsillectomy systematic reviews. Researchers, clinicians, and peer reviewers could benefit from learning to recognize spin in medical literature. Further research is needed into the effects of spin on clinical decision making.

LEVEL OF EVIDENCE

NA Laryngoscope, 2020.

Spin in the abstracts of randomized controlled trials in periodontology and oral implantology: A cross-sectional analysis

OBJECTIVES

To investigate the presence and characteristics of spin (a distorted interpretation to make research findings seem favorable) in abstracts of randomized controlled trials (RCTs) in periodontology and oral implantology, and to explore its associated factors and influence on the subsequent literature.

MATERIALS AND METHODS

PubMed was searched to identify recent RCTs in periodontology and oral implantology, whose primary outcome was non-significant. Spin in abstracts was assessed and categorized according to pre-determined spin strategies. The associations between study characteristics and the presence / severity of spin were analyzed using multivariable logistic regressions.

RESULTS

196 abstracts were included, 137 (69.9%) of which had spin. 57 (29.1%) abstracts had spin in the Results Section, 126 (64.3%) had spin in the Conclusion Section. The main spin strategies in the Results and Conclusion Sections were focusing on secondary outcomes (16.3%) and focusing on within-group comparisons (28.6%), respectively. The presence of spin was associated with number of centers (OR=0.28, 95% CI: 0.11-0.73; p=0.009) while its severity was associated with topic (OR=0.24, 95% CI: 0.08-0.70; p=0.009).

CONCLUSIONS

The frequency of spin is relatively high among published RCT abstracts in periodontology and oral implantology. Findings reported in these abstracts need to be interpreted with caution.

Abstracts of published randomised controlled trials in Endodontics: Reporting quality and spin

AIMS

To assess the reporting quality of recently published randomised controlled trial (RCT) abstracts in Endodontics, to investigate factors associated with reporting quality, and to evaluate the existence and characteristics of spin. Spin refers to reporting strategies that distort study results and misguide readers.

METHODOLOGY

The PubMed database was searched to identify abstracts of RCTs in the field of Endodontics published during 2017 to 2018. Two authors assessed the reporting quality of each included abstract using the original 16-item CONSORT for Abstracts checklist, with the overall quality score (OQS, range: 0 to 16) being the primary outcome measure. For each individual item, a score of '1' was given if it was described adequately, and '0' if the description was inadequate. Linear regression analyses were conducted to identify factors associated with reporting quality. For the evaluation of spin, two authors selected parallel-group RCTs with a nonsignificant primary outcome from the included abstracts, and evaluated independently the existence and characteristics of spin among these abstracts.

RESULTS

A total of 162 abstracts were included for assessment of reporting, for which the mean OQS was 3.97 (SD, 1.30; 95 % CI, 3.77 to 4.17). According to multivariable analysis, origin from Europe (P=0.001) and reporting of the exact P value (P=0.020) were significantly associated with better reporting. Forty abstracts with statistically nonsignificant results for their primary outcome were included for spin evaluation, among which 34 (85.0%) had at least one type of spin. Thirty-two abstracts (94.1%) had spin in their conclusions section, and six abstracts (17.6%) had spin in the results section.

CONCLUSIONS

The reporting quality of RCT abstracts in Endodontics needs to be improved. The occurrence rate of spin in the sample of abstracts of RCTs in the field of Endodontics was high. Relevant stakeholders are recommended to be familiar with the CONSORT for Abstracts guideline and develop active strategies to ensure its implementation.

Reporting quality and spin in abstracts of randomized clinical trials of periodontal therapy and cardiovascular disease outcomes

OBJECTIVE

Poor reporting in randomized clinical trial (RCT) abstracts reduces quality and misinforms readers. Spin, a biased presentation of findings, could frequently mislead clinicians to accept a clinical intervention despite non-significant primary outcome. Therefore, good reporting practices and absence of spin enhances research quality. We aim to assess the reporting quality and spin in abstracts of RCTs evaluating the effect of periodontal therapy on cardiovascular (CVD) outcomes.

METHODS

PubMed, Scopus, the Cochrane Central Register of Controlled Trials (CENTRAL), and 17 trial registration platforms were searched. Cohort, non-randomized, non-English studies, and pediatric studies were excluded. RCT abstracts were reviewed by 2 authors using the CONSORT for abstracts and spin checklists for data extraction. Cohen's Kappa statistic was used to assess inter-rater agreement. Data on the selected RCT publication metrics were collected. Descriptive analysis was performed with non-parametric methods. Correlation analysis between quality, spin and bibliometric parameters was conducted.

RESULTS

24 RCTs were selected for CONSORT analysis and 14 fulfilled the criteria for spin analysis. Several important RCT elements per CONSORT were neglected in the abstract including description of the study population (100%), explicitly stated primary outcome (87%), methods of randomization and blinding (100%), trial registration (87%). No RCT examined true outcomes (CVD events). A significant fraction of the abstracts appeared with at least one form of spin in the results and conclusions (86%) and claimed some treatment benefit in spite of non-significant primary outcome (64%). High-quality reporting had a significant positive correlation with reporting of trial registration (p = 0.04) and funding (p = 0.009). Spinning showed marginal negative correlation with reporting quality (p = 0.059).

CONCLUSION

Poor adherence to the CONSORT guidelines and high levels of data spin were found in abstracts of RCTs exploring the effects of periodontal therapy on CVD outcomes. Our findings indicate that journal editors and reviewers should consider strict adherence to proper reporting guidelines to improve reporting quality and reduce waste.

Evaluation of Spin in the Abstracts of Systematic Reviews and Meta-Analyses Focused on the Treatment of Acne Vulgaris: Cross-Sectional Analysis

Background

Spin is the misrepresentation of study findings, which may positively or negatively influence the reader’s interpretation of the results. Little is known regarding the prevalence of spin in abstracts of systematic reviews, specifically systematic reviews pertaining to the management and treatment of acne vulgaris.

Objective

The primary objective of this study was to characterize and determine the frequency of the most severe forms of spin in systematic review abstracts and to evaluate whether various study characteristics were associated with spin.

Methods

Using a cross-sectional study design, we searched PubMed and EMBASE for systematic reviews focusing on the management and treatment of acne vulgaris. Our search returned 316 studies, of which 36 were included in our final sample. To be included, each systematic review must have addressed either pharmacologic or nonpharmacologic treatment of acne vulgaris. These studies were screened, and data were extracted in duplicate by two blinded investigators. We analyzed systematic review abstracts for the nine most severe types of spin.

Results

Spin was present in 31% (11/36) of abstracts. A total of 12 examples of spin were identified in the 11 abstracts containing spin, with one abstract containing two instances of spin. The most common type of spin, selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention, was identified five times (5/12, 42%). A total of 44% (16/36) of studies did not report a risk of bias assessment. Of the 11 abstracts containing spin, six abstracts (55%) had not reported a risk of bias assessment or performed a risk of bias assessment but did not discuss it. Spin in abstracts was not significantly associated with a specific intervention type, funding source, or journal impact factor.

Conclusions

Spin is present in the abstracts of systematic reviews and meta-analyses covering the treatment of acne vulgaris. This paper raises awareness of spin in abstracts and emphasizes the importance of its recognition, which may lead to fewer incidences of spin in future studies.

The SSSPIN study-spin in studies of spin: meta-research analysis

OBJECTIVES

To identify and calculate the prevalence of spin in studies of spin.

DESIGN

Meta-research analysis (research on research).

SETTING

35 studies of spin in the scientific literature.

MAIN OUTCOME MEASURES

Spin, categorised as: reporting practices that distort the presentation and interpretation of results, creating misleading conclusions; discordance between results and their interpretation, with presentation of favourable conclusions that are not supported by the data or results; attribution of causality when study design does not support it; and over-interpretation or inappropriate extrapolation of results.

RESULTS

Five (14%) of 35 spin studies contained spin categorised as reporting practices that distort the presentation and interpretation of results (n=2) or categorised as over-interpretation or inappropriate extrapolation of results (n=3).

CONCLUSION

Spin occurs in research on spin. Although researchers on this topic should be sensitive to spinning their findings, our study does not undermine the need for rigorous interventions to reduce spin across various research fields.

CONCLUSION WITH SPIN

Our hypothesis that spin will be less prevalent in spin studies than in studies on other topics has been proven. Spin scholars are less likely to spin their conclusions than other researchers, and they should receive substantial resources to launch and test interventions to reduce spin and research waste in reporting.