Factors associated with the reporting quality of low back pain systematic review abstracts in physical therapy: a methodological study

Narrative bias ("spin") is common in randomised trials and systematic reviews of cannabinoids for pain

ABSTRACT

We define narrative bias as a tendency to interpret information as part of a larger story or pattern, regardless of whether the facts support the full narrative. Narrative bias in title and abstract means that results reported in the title and abstract of an article are done so in a way that could distort their interpretation and mislead readers who had not read the whole article. Narrative bias is often referred to as "spin." It is prevalent in abstracts of scientific papers and is impactful because abstracts are often the only part of an article read. We found no extant narrative bias instrument suitable for exploring both efficacy and safety statements in randomized trials and systematic reviews of pain. We constructed a 6-point instrument with clear instructions and tested it on randomised trials and systematic reviews of cannabinoids and cannabis-based medicines for pain, with updated searches to April 2021. The instrument detected moderate or severe narrative bias in the title and abstract of 24% (8 of 34) of randomised controlled trials and 17% (11 of 64) of systematic reviews; narrative bias for efficacy and safety occurred equally. There was no significant or meaningful association between narrative bias and study characteristics in correlation or cluster analyses. Bias was always in favour of the experimental cannabinoid or cannabis-based medicine. Put simply, reading title and abstract only could give an incorrect impression of efficacy or safety in about 1 in 5 papers reporting on these products.

Flawed, futile, and fabricated-features that limit confidence in clinical research in pain and anaesthesia: a narrative review

The randomised controlled trial is the foundation of clinical research; yet there is concern that many trials have flaws in design, conduct, and reporting that undermine trustworthiness. Common flaws in trials include high risk of bias, small size, outcomes irrelevant to clinical care and patient's experience, and inability to detect efficacy even if present. These flaws carry forward into systematic reviews, which can confer the label of 'high-quality evidence' on inadequate data. Trials can be futile because their flaws mean that they cannot deliver any meaningful result in that different results in a small number of patients would be sufficient to change conclusions. Some trials have been discovered to be fabricated, the number of which is growing. The fields of anaesthesia and pain have more fabricated trials than other clinical fields, possibly because of increased vigilance. This narrative review examines these themes in depth whilst acknowledging an inescapable conclusion: that much of our clinical evidence is in trouble, and special measures are needed to bolster quality and confidence.

Thirty-year survey of bibliometrics used in the research literature of pain: Analysis, evolution, and pitfalls

During the last decades, the emergence of Bibliometrics and the progress in Pain research have led to a proliferation of bibliometric studies on the medical and scientific literature of pain (B/P). This study charts the evolution of the B/P literature published during the last 30 years. Using various searching techniques, 189 B/P studies published from 1993 to August 2022 were collected for analysis-half were published since 2018. Most of the selected B/P publications use classic bibliometric analysis of Pain in toto, while some focus on specific types of Pain with Headache/Migraine, Low Back Pain, Chronic Pain, and Cancer Pain dominating. Each study is characterized by the origin (geographical, economical, institutional, …) and the medical/scientific context over a specified time span to provide a detailed landscape of the Pain research literature. Some B/P studies have been developed to pinpoint difficulties in appropriately identifying the Pain literature or to highlight some general publishing pitfalls. Having observed that most of the recent B/P studies have integrated newly emergent software visualization tools (SVTs), we found an increase of anomalies and suggest that readers exercise caution when interpreting results in the B/P literature details.

Reporting according to the preferred reporting items for systematic reviews and meta-analyses for abstracts (PRISMA-A) depends on abstract length

OBJECTIVE

To evaluate reporting of abstracts of systematic reviews according to the preferred reporting items for systematic reviews and meta-analyses for abstracts (PRISMA-A) 2013 checklist.

STUDY DESIGN AND SETTING

A random sample of 534 systematic reviews on effectiveness indexed in PubMed between 2000 and 2019 was assessed. Adherence of abstracts to PRISMA-A was analysed using descriptive statistics. Results were stratified by number of words, structure, and year of publication.

RESULT

The mean score of fully reported PRISMA-A items was 5.4 of 12, with adherence varying widely between items (0% to 98.8%). Cochrane reviews received higher mean total scores than non-Cochrane reviews (6.3 vs. 5.2). Adherence to PRISMA-A increased linearly with increasing word count. In non-Cochrane reviews, authors of structured abstracts more often adhered to PRISMA-A than those of unstructured abstracts. No improvements in reporting of abstracts were found after the implementation of PRISMA-A in 2013.

CONCLUSION

Adherence to PRISMA-A shows great potential for improvement. Therefore, authors, editors, and reviewers should be made aware of PRISMA-A by referring to it in the journal submission guidelines. As adherence to PRISMA-A increases with the number of words, journals should consider to increase the word limit to 250-300 words.