1
|
Giannakoulas DG, Koletsi D, Tzanetakis GN. Assessment of spin in abstracts of Endodontic Systematic Reviews with meta-analyses published between 2010 and 2022. Are we in need of more transparent interpretation of findings? Int Endod J 2022; 55:1347-1358. [PMID: 36107016 DOI: 10.1111/iej.13832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 07/27/2022] [Accepted: 09/12/2022] [Indexed: 11/28/2022]
Abstract
AIM Spin refers to reporting, interpretation and extrapolation related distortion or manipulation of the findings of a study. The aim of this report was to identify the prevalence and extent of spin in the abstracts of systematic reviews (SRs) including meta-analyses in the scientific field of Endodontics. METHODOLOGY A sensitive and inclusive search strategy in PubMed was developed to identify eligible SRs with meta-analyses in Endodontics, supplemented by an electronic search within 3 major specialty journals, from January 1, 2010 to April 16, 2022. Inclusion and extent of spin was recorded, per domain and following issues related to misleading reporting, interpretation and inappropriate extrapolation of meta-analyses' findings. Association of spin with publication characteristics such as year, journal type, number of authors, continent of authorship, funding, primary study design and significance of the outcome was explored. RESULTS A hundred and eighty-six SRs with meta-analyses were retrieved, and inclusion of spin was detected in 125 abstracts (67.2%), for one or more domains. The majority of abstracts were affected by more than one types of spin (91/125; 72.8%). There was evidence that abstracts of meta-analyses of non-significant findings had 60% lower odds for inclusion of spin (Odds ratio, OR: 0.40; 95%CI: 0.19, 0.83; p= 0.04), after adjusting for year, journal type and number of authors. CONCLUSIONS Misleading reporting and misinterpretation of findings in abstracts of meta-analyses is evident in endodontic research. Efforts should be reinforced to increase awareness within the scientific and academic community to improve adherence to transparent reporting and interpretation.
Collapse
Affiliation(s)
- Dimitrios G Giannakoulas
- Department of Endodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Despina Koletsi
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Giorgos N Tzanetakis
- Department of Endodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
2
|
Mheissen S, Khan H, Seehra J, Pandis N. Are longitudinal randomised controlled oral health trials properly analysed? A meta-epidemiological study. J Dent 2022; 124:104182. [PMID: 35691454 DOI: 10.1016/j.jdent.2022.104182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Longitudinal designs with multiple outcome measurements are commonly encountered in oral health randomised controlled trials (RCTs). The aim of this meta epidemiological study was to assess whether optimal statistical analysis approaches have been used in longitudinal oral health RCTs. DATA SOURCES PubMed search was undertaken in September 2021 for longitudinal oral health RCTs with at least 3 repeated outcome measurements which have been published between 2016- 2020 in the highest impact general and specialty dental journals. STUDY SELECTION Study selection and data extraction were accomplished independently and in duplicate. The statistical methods undertaken in the selected articles were tabulated, and the association between study characteristics and use of optimal analyses were assessed using X2 or Fisher's exact test and logistic regression. RESULTS Five hundred and five oral health RCTs were deemed eligible for inclusion. Of these, only 28.3% RCTs used optimal statistical analyses for a longitudinal trial design. For the trials with an optimal statistical approach, the most frequent test used was repeated measures analysis of variance (RM-ANOVA) followed by mixed effect models (MEM). The use of optimal statistical tests was predicated by the involvement of a statistician (OR: 2, 95% CI:1.27 - 3.18, p<0.01), the journal impact factor (OR:1.19, 95% CI;1.1 - 1.29), continent of first author (likelihood ratio test p=0.01), number of the authors (OR:1.22, 95% CI;1.12-1.3, p<0.001), protocol registration (OR: 1.48, 95%CI; 1 to 2.2, p=0.05), funding(OR:2.4, 95%CI; 1.6 - 3.7, p<0.001), and dental specialty (likelihood ratio test p<0.001). CONCLUSIONS Most longitudinal oral health RCTs did not use optimal statistical analyses. Greater awareness of optimal analyses used to assess longitudinal data reported in oral health trials is required to circumvent the reporting of suboptimal inferences, selective reporting and research waste. CLINICAL SIGNIFICANCE Further progress is required to avoid suboptimal statistical analyses and fully utilise the benefits of the repeated measurements over time in oral health RCTs.
Collapse
Affiliation(s)
- Samer Mheissen
- Syrian Board in Orthodontics, Former instructor in Orthodontic Department, Syrian Ministry of Health, Specialist Orthodontist in Private Practice, Syria- Damascus.
| | - Haris Khan
- CMH institute of dentistry Lahore, National University of Medical Sciences, Punjab, Pakistan
| | - Jadbinder Seehra
- Centre for Craniofacial Development & Regeneration, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Floor 25, Guy's Hospital, London, SE1 9RT, United Kingdom
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Switzerland
| |
Collapse
|
3
|
Mheissen S, Khan H, Almuzian M, Alzoubi EE, Pandis N. Do longitudinal orthodontic trials use appropriate statistical analyses? A meta-epidemiological study. Eur J Orthod 2021; 44:352-357. [PMID: 34561710 DOI: 10.1093/ejo/cjab069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND In orthodontic trials, longitudinal designs with multiple outcome measurements over time are common. The aim of this epidemiological study was to examine whether optimal statistical analysis approaches have been used in longitudinal orthodontic trials. METHODS Pubmed was searched in August 2021 for longitudinal orthodontic trials with at least three time points of outcome assessment published in the 2017-20 period. Study selection and data extraction were done independently and in duplicate. The analysis approaches undertaken were tabulated and associations between study characteristics and the use of optimal analysis or not were assessed using Fisher's exact test and logistic regression. RESULTS One hundred forty-seven out of 563 unique records were deemed eligible for inclusion. Only 26.50% of these trials used an optimal statistical analysis for longitudinal data where the data structure is accounted for. None of the study characteristics except the statistical significance of the results were associated with the appropriateness of the statistical analysis. The odds of significant results in studies with suboptimal analyses were higher than that in studies with optimal longitudinal analyses (odds ratio: 3.48, 95% confidence interval: 1.62, 7.46, P = 0.001). For the studies with optimal analysis, the most frequent test was repeated-measure analysis of variance (RM-ANOVA). The reporting of the statistical analysis section was suboptimal in the majority of the trials. CONCLUSION Most longitudinal orthodontic trials are not analysed using optimal statistical approaches. Inferences and interpretation of their results are likely to be compromised.
Collapse
Affiliation(s)
- Samer Mheissen
- Syrian Board in Orthodontics, Orthodontic Department, Syrian Ministry of Health, Private Practice, Damascus, Syria
| | - Haris Khan
- Orthodontic Department, CMH Institute of Dentistry Lahore, National University of Medical Sciences, Punjab, Pakistan
| | | | | | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Switzerland
| |
Collapse
|
4
|
Guo F, Fang X, Li C, Qin D, Hua F, He H. The presence and characteristics of 'spin' among randomized controlled trial abstracts in orthodontics. Eur J Orthod 2021; 43:576-582. [PMID: 34397084 DOI: 10.1093/ejo/cjab044] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
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.
Collapse
Affiliation(s)
- Feiyang Guo
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, China.,Department of Orthodontics, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, China
| | - Xiaolin Fang
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, China
| | - Chang Li
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, China
| | - Danchen Qin
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, China.,Department of Orthodontics, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, China
| | - Fang Hua
- Department of Orthodontics, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, China.,Centre for Evidence-Based Stomatology, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, China.,Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health, Science Centre, UK
| | - Hong He
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, China.,Department of Orthodontics, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, China
| |
Collapse
|
5
|
Makou O, Eliades T, Koletsi D. Reporting, interpretation, and extrapolation issues (SPIN) in abstracts of orthodontic meta-analyses published from 2000 to 2020. Eur J Orthod 2021; 43:567-575. [PMID: 33740054 DOI: 10.1093/ejo/cjab009] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AIM To assess the prevalence of and identify factors associated with SPIN in abstracts of orthodontic meta-analyses. MATERIALS AND METHODS Electronic search was performed within the contents of five orthodontic journals and the Cochrane Database of Systematic Reviews (CDSR) to identify meta-analyses of studies involving humans, from 1 January 2000 until 31 August 2020. Inclusion of SPIN in the abstract of meta-analyses, defined as misleading reporting, misleading interpretation, and inappropriate extrapolation of the findings, was documented. Extent of SPIN and associations with journal and year of publication, type of study, number of authors, continent of authorship, methodologist involvement, funding, and significance of the primary outcome were investigated. RESULTS One hundred and nine meta-analyses were identified, with the highest proportion being published in the European Journal of Orthodontics (EJO: 31/109; 28.4%). Inclusion of SPIN, in at least one domain, was recorded in nearly half (53/109; 48.6%) of the studies, of which 30 (56.6%) included 2 or more domains of SPIN. Meta-analyses of observational studies presented 1.66 times higher risk for including SPIN in their abstracts compared with interventional ones [95% confidence intervals (CIs): 1.14, 2.40; P = 0.007], after adjusting for a number of predictors. Studies with a large number of authors (≥6) presented 1.76 times higher risk of SPIN (≥6 versus 1-3: 95% CIs: 1.04, 2.97; Wald test, P = 0.021), conditional on the pre-defined predictors. CONCLUSIONS Flaws in the reporting and interpretation of the findings of abstracts of meta-analyses, as framed by inclusion of SPIN are persistent in orthodontic research, being more prevalent in meta-analyses of observational studies. Consistent, multidirectional efforts should be endorsed to improve the quality of the disseminated research findings.
Collapse
Affiliation(s)
- Olga Makou
- Dentistry Department, Cardenal Herrera University of Valencia, Valencia, Spain
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Despina Koletsi
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| |
Collapse
|
6
|
Pandis N, Fleming PS, Katsaros C, Ioannidis JPA. Dental Research Waste in Design, Analysis, and Reporting: A Scoping Review. J Dent Res 2020; 100:245-252. [PMID: 33054504 DOI: 10.1177/0022034520962751] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Research waste is highly prevalent across biomedical investigations. We aimed to assess the evidence on the extent of research waste in dental research. We performed a scoping review of empirical evaluations of dental studies assessing the prevalence and impact of limitations in design, conduct, analysis, and reporting of research. PubMed was searched using specific terms to retrieve studies dealing with design, conduct, analysis, and reporting of studies in dentistry, with no year or language restrictions. Of the 1,807 publications identified from the search and from manual searches, 71 were included in this review. The topic and article selection was based on the expert opinion of the authors. The existing evidence suggests that, although there are improvements over time, substantial deficiencies in all areas (design, conduct, analysis, reporting) were prevalent in dental research publications. Waste in research is a multifaceted problem without a simple solution. However, an appreciation of optimal research design and execution is a prerequisite and should be underpinned by policies that include appropriate training in research methods and properly aligned incentives.
Collapse
Affiliation(s)
- N Pandis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, Medical Faculty, University of Bern, Bern, Switzerland
| | - P S Fleming
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - C Katsaros
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, Medical Faculty, University of Bern, Bern, Switzerland
| | - J P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
| |
Collapse
|
7
|
González Espinosa D, de Oliveira Moreira PE, da Sousa AS, Flores-Mir C, Normando D. Stability of anterior open bite treatment with molar intrusion using skeletal anchorage: a systematic review and meta-analysis. Prog Orthod 2020; 21:35. [PMID: 32888097 PMCID: PMC7474024 DOI: 10.1186/s40510-020-00328-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/15/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The aim of this systematic review and meta-analysis is to assess the degree of stability of anterior open bite (AOB) treatment performed through the molar intrusion supported with skeletal anchorage at least 1 year posttreatment. METHODS This study was registered in PROSPERO (CRD42016037513). A literature search was conducted to identify randomized (RCT) or non-randomized clinical trials based including those considering before and after design. Data sources were electronic databases including PubMed, Cochrane Library, Science Direct, Google Scholar, Scopus, Lilacs, OpenGrey, Web of Science, and ClinicalTrials.gov . The quality of evidence was assessed through the JBI tool and certainty of evidence was evaluated through the GRADE tool. Random effects meta-analysis was conducted when appropriate. RESULTS Six hundred twenty-four articles met the initial inclusion criteria. From these, only 6 remained. The mean posttreatment follow-up time was 2.5 years (SD = 1.04). The overbite showed a standardized mean relapse of - 1.23 mm (95% CI - 1.64, - 0.81, p < 0.0001). Maxillary and mandibular incisors presented a non-significant mean relapse, U1-PP - 0.04 mm (95% CI - 0.55, 0.48) and L1-MP - 0.10 mm (95% CI - 0.57, 0.37). Molar intrusion showed a relapse rate around 12% for the maxillary molars and a 27.2% for mandibular molars. CONCLUSION The stability of AOB through molar intrusion using TADs can be considered relatively similar to that reported to surgical approaches, since 10 to 30% of relapse occurs both in maxillary and mandibular molars. The level of certainty ranged between very low and low. RCTs reporting dropout during the follow-up are in dire need.
Collapse
Affiliation(s)
- Daybelis González Espinosa
- Department of Orthodontics, Faculty of Dentistry, Dental School, Federal University of Pará (UFPA), Augusto Correa St., no. 1, Belém, Pará, 66075-110, Brazil.,Facultad de Odontologia, Universidad Católica Redemptoris Mater, Managuá, Nicaragua
| | - Paulo Eliezer de Oliveira Moreira
- Department of Orthodontics, Faculty of Dentistry, Dental School, Federal University of Pará (UFPA), Augusto Correa St., no. 1, Belém, Pará, 66075-110, Brazil
| | - Amanda Silva da Sousa
- Department of Orthodontics, Faculty of Dentistry, Dental School, Federal University of Pará (UFPA), Augusto Correa St., no. 1, Belém, Pará, 66075-110, Brazil
| | - Carlos Flores-Mir
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - David Normando
- Department of Orthodontics, Faculty of Dentistry, Dental School, Federal University of Pará (UFPA), Augusto Correa St., no. 1, Belém, Pará, 66075-110, Brazil.
| |
Collapse
|