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Matvienko-Sikar K, O'Shea J, Kennedy S, Thomas SD, Avery K, Byrne M, McHugh S, O' Connor DB, Saldanha IJ, Smith V, Toomey E, Dwan K, Kirkham JJ. Selective outcome reporting in trials of behavioural health interventions in health psychology and behavioural medicine journals: a review. Health Psychol Rev 2024:1-15. [PMID: 38923431 DOI: 10.1080/17437199.2024.2367613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 06/09/2024] [Indexed: 06/28/2024]
Abstract
Selective outcome reporting can result in overestimation of treatment effects, research waste, and reduced openness and transparency. This review aimed to examine selective outcome reporting in trials of behavioural health interventions and determine potential outcome reporting bias. A review of nine health psychology and behavioural medicine journals was conducted to identify randomised controlled trials of behavioural health interventions published since 2019. Discrepancies in outcome reporting were observed in 90% of the 29 trials with corresponding registrations/protocols. Discrepancies included 72% of trials omitting prespecified outcomes; 55% of trials introduced new outcomes. Thirty-eight percent of trials omitted prespecified and introduced new outcomes. Three trials (10%) downgraded primary outcomes in registrations/protocols to secondary outcomes in final reports; downgraded outcomes were not statistically significant in two trials. Five trials (17%) upgraded secondary outcomes to primary outcomes; upgraded outcomes were statistically significant in all trials. In final reports, three trials (7%) omitted outcomes from the methods section; three trials (7%) introduced new outcomes in results that were not in the methods. These findings indicate that selective outcome reporting is a problem in behavioural health intervention trials. Journal- and trialist-level approaches are needed to minimise selective outcome reporting in health psychology and behavioural medicine.
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Affiliation(s)
| | - Jen O'Shea
- School of Applied Psychology, University College Cork, Cork, Ireland
| | | | - Siobhan D Thomas
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Kerry Avery
- Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | - Molly Byrne
- School of Psychology, University of Galway, Galway, Ireland
| | - Sheena McHugh
- School of Public Health, University College Cork, Cork, Ireland
| | | | - Ian J Saldanha
- Center for Clinical Trials and Evidence Synthesis, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Valerie Smith
- School of Nursing, Midwifery, and Health Systems, University College Dublin, Dublin, Ireland
| | - Elaine Toomey
- School of Nursing & Midwifery, University College Galway, Galway, Ireland
| | - Kerry Dwan
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - Jamie J Kirkham
- Centre for Biostatistics, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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Bellucci C, Hughes K, Toomey E, Williamson PR, Matvienko-Sikar K. A survey of knowledge, perceptions and use of core outcome sets among clinical trialists. Trials 2021; 22:937. [PMID: 34924001 PMCID: PMC8684586 DOI: 10.1186/s13063-021-05891-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 11/28/2021] [Indexed: 12/16/2022] Open
Abstract
Background Core outcome sets (COS) are standardised sets of outcomes, which represent the minimum outcomes that should be measured and reported in clinical trials. COS can enhance comparability across health trials by reducing heterogeneity of outcome measurement and reporting and potentially minimising selective outcome reporting. Examining what researchers involved in trials know and think about COS is essential to increase awareness and promote COS uptake. The aim of this study is therefore to examine clinical trialists’ knowledge, perceptions and experiences of COS. Methods An online survey design was used. Participants were clinical trialists, operationalised for the current study as researchers named as the contact person on a trial registered on the International Standard Randomised Controlled Trial Number (ISRCTN) Trial repository between 1 January 2019 and 21 July 2020. Survey items assessed clinical trialists’ familiarity with and understanding of COS, along with experiences of COS use and development. Results Of 1913 clinical trialists contacted to participate, 62 (3%) completed the survey. Forty (65%) participants were familiar with COS and, of those familiar with COS, 21 (55%) had been involved in a trial that used a COS. Of clinical trialists who used COS in a trial(s), less than half (n = 9, 41%) reported that all COS outcomes were used. The main barriers to using COS are poor knowledge about COS (n = 43, 69%) and difficulties identifying relevant COS (n = 42, 68%). Clinical trialists also reported perceptions of COS as restrictive and often containing too many outcomes. The main enablers to using COS are clear understanding (n = 51, 82%) and perceived importance of COS (n = 44, 71%). Conclusions Enhancing clinical trialists’ use of all COS outcomes is needed to reduce outcome heterogeneity and enhance comparability across trial findings. Enhancing awareness of COS importance among researchers and funders is needed to ensure that COS are developed and used by clinical trialists. Education and training may further promote awareness and understanding of COS. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05891-5.
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Affiliation(s)
- Chiara Bellucci
- School of Public Health, University College Cork, Cork, Ireland
| | - Karen Hughes
- MRC Hub for Trials Methodology Research Network, Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Elaine Toomey
- School of Allied Health, University of Limerick, Limerick, Ireland
| | - Paula R Williamson
- MRC/NIHR Trials Methodology Research Partnership, Department of Biostatistics, University of Liverpool, Liverpool, UK
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Matvienko-Sikar K, Avery K, Blazeby JM, Devane D, Dodd S, Egan AM, Gorst SL, Hughes K, Jacobsen P, Kirkham JJ, Kottner J, Mellor K, Millward CP, Patel S, Quirke F, Saldanha IJ, Smith V, Terwee CB, Young AE, Williamson PR. Use of core outcome sets was low in clinical trials published in major medical journals. J Clin Epidemiol 2021; 142:19-28. [PMID: 34715310 DOI: 10.1016/j.jclinepi.2021.10.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 10/08/2021] [Accepted: 10/20/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To examine current practices in late-phase trials published in major medical journals and examine trialists' views about core outcome set (COS) use. STUDY DESIGN AND SETTING A sequential multi-methods study was conducted. We examined late-phase trials published between October 2019 and March 2020 in JAMA, NEJM, The Lancet, BMJ, and Annals of Internal Medicine. The COMET database was searched for COS potentially relevant to trials not reporting using a COS; overlap of trial and COS outcomes was examined. An online survey examined awareness of, and decisions to search for and use a COS. RESULTS Ninety-five trials were examined; 93 (98%) did not report using a COS. Relevant COS were identified for 31 trials (33%). Core outcomes were measured in 9 (23%) studies; all trials measured at least one core outcome. Thirty-one trialists (33%) completed our survey. The most common barrier to COS use was trialist's own outcome preferences and choice (68%). The most common perceived facilitator was awareness and knowledge about COS (90%). CONCLUSION COS use in this cohort of trials was low, even when relevant COS were available. Increased use of COS in clinical trials can improve evaluation of intervention effects and evidence synthesis and reduce research waste.
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Affiliation(s)
| | - Kerry Avery
- NIHR Bristol Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Jane M Blazeby
- NIHR Bristol Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Declan Devane
- Aras Moyola, School of Nursing and Midwifery, National University of Ireland, Galway, 26 Upper Newcastle, Galway, H91 E3YV, Ireland; Health Research Board Trials Methodology Research Network, National University of Ireland, Galway, Ireland
| | - Susanna Dodd
- Department of Health Data Science, University of Liverpool (a member of Liverpool Health Partners), MRC/NIHR Trials Methodology Research Partnership, Liverpool, UK
| | - Aoife M Egan
- Division of Endocrinology, Diabetes and Metabolism, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Sarah L Gorst
- Department of Health Data Science, University of Liverpool (a member of Liverpool Health Partners), MRC/NIHR Trials Methodology Research Partnership, Liverpool, UK
| | - Karen Hughes
- Department of Health Data Science, University of Liverpool (a member of Liverpool Health Partners), MRC/NIHR Trials Methodology Research Partnership, Liverpool, UK
| | | | - Jamie J Kirkham
- Centre for Biostatistics, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Jan Kottner
- Charité-Universitätsmedizin Berlin, Institute of Clinical Nursing Science, Berlin, Germany
| | - Katie Mellor
- Centre for Statistics in Medicine, Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Christopher P Millward
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK; Institute of Systems, Molecular & Integrative Biology, University of Liverpool, Liverpool, UK
| | - Smitaa Patel
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Fiona Quirke
- Health Research Board Trials Methodology Research Network, National University of Ireland, Galway, Ireland; College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Ian J Saldanha
- Department of Health Services, Center for Evidence Synthesis in Health, Policy and Practice, and Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Valerie Smith
- School of Nursing and Midwifery, University of Dublin Trinity College, Ireland
| | - Caroline B Terwee
- Department of Epidemiology and Data Science, Amsterdam UMC, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Amber E Young
- Centre for Surgical Research, Population Health Sciences Bristol Medical School, Bristol, UK
| | - Paula R Williamson
- Department of Health Data Science, University of Liverpool (a member of Liverpool Health Partners), MRC/NIHR Trials Methodology Research Partnership, Liverpool, UK
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