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Foster BK, Hayes DS, Constantino J, Garsed JA, Baylor JL, Grandizio LC. Reporting Bias in Systematic Reviews and Meta-Analyses Related to the Treatment of Distal Radius Fractures: The Presence of Spin in the Abstract. Hand (N Y) 2024; 19:456-463. [PMID: 36131602 PMCID: PMC11067855 DOI: 10.1177/15589447221120848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Spin is a form of reporting bias which suggests a treatment is beneficial despite a statistically nonsignificant difference in outcomes. Our purpose was to define the prevalence of spin within the abstracts of distal radius fracture (DRF) systematic reviews (SRs) and meta-analyses (MA). We also sought to identify article characteristics that were more likely to contain spin. METHODS We performed a SR of multiple databases to identify DRF SRs and MAs. Articles were screened and analyzed by 3 reviewers. We recorded article and journal characteristics including adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, funding disclosures, methodologic quality (AMSTAR 2 instrument), impact factor, and country of origin. Presence of the 9 most severe types of spin in abstracts were recorded. Unadjusted odds ratios (ORs) were calculated to analyze the association between article characteristics and the presence of spin. RESULTS A total of 112 articles were included. Spin was present in 46% of abstracts, with type 1 spin ("conclusions not supported by findings") most frequent (19%). Spin was present in 43% of abstracts in PRISMA-adhering journals compared to 49% in journals that did not (OR = 0.79, 95% confidence interval [CI] = 0.37-1.68). For articles originating from China, spin was present in 61% of abstracts compared to 39% of abstracts from other countries (OR = 2.55, 95% CI = 1.13-5.75). CONCLUSIONS In addition to low article quality, there are high rates of spin within the abstracts of SRs and MAs related to treatment of DRF. Articles within journals that adhere to PRISMA do not appear to contain less spin.
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Frank F, Florens N, Meyerowitz-Katz G, Barriere J, Billy É, Saada V, Samuel A, Robert J, Besançon L. Raising concerns on questionable ethics approvals - a case study of 456 trials from the Institut Hospitalo-Universitaire Méditerranée Infection. Res Integr Peer Rev 2023; 8:9. [PMID: 37533089 PMCID: PMC10398994 DOI: 10.1186/s41073-023-00134-4] [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: 02/13/2023] [Accepted: 05/22/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND The practice of clinical research is strictly regulated by law. During submission and review processes, compliance of such research with the laws enforced in the country where it was conducted is not always correctly filled in by the authors or verified by the editors. Here, we report a case of a single institution for which one may find hundreds of publications with seemingly relevant ethical concerns, along with 10 months of follow-up through contacts with the editors of these articles. We thus argue for a stricter control of ethical authorization by scientific editors and we call on publishers to cooperate to this end. METHODS We present an investigation of the ethics and legal aspects of 456 studies published by the IHU-MI (Institut Hospitalo-Universitaire Méditerranée Infection) in Marseille, France. RESULTS We identified a wide range of issues with the stated research authorization and ethics of the published studies with respect to the Institutional Review Board and the approval presented. Among the studies investigated, 248 were conducted with the same ethics approval number, even though the subjects, samples, and countries of investigation were different. Thirty-nine (39) did not even contain a reference to the ethics approval number while they present research on human beings. We thus contacted the journals that published these articles and provide their responses to our concerns. It should be noted that, since our investigation and reporting to journals, PLOS has issued expressions of concerns for several publications we analyze here. CONCLUSION This case presents an investigation of the veracity of ethical approval, and more than 10 months of follow-up by independent researchers. We call for stricter control and cooperation in handling of these cases, including editorial requirement to upload ethical approval documents, guidelines from COPE to address such ethical concerns, and transparent editorial policies and timelines to answer such concerns. All supplementary materials are available.
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Affiliation(s)
| | - Nans Florens
- Department of Nephrology, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
| | | | - Jérôme Barriere
- Medical Oncology Department, Polyclinique Saint-Jean, Cagnes-sur-Mer, France
| | - Éric Billy
- Independent researcher, Strasbourg, France
| | - Véronique Saada
- Biopathology department, Gustave Roussy Anti-Cancer Center, Villejuif, France
| | | | - Jacques Robert
- Université de Bordeaux, INSERM Unité 1312, Bordeaux, France
| | - Lonni Besançon
- Media and Information Technology, Linköping University, Norrköping, Sweden.
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Guo F, Zhao T, Zhai Q, Fang X, Yue H, Hua F, He H. 'Spin' among abstracts of randomised controlled trials in sleep medicine: A research-on-research study. Sleep 2023; 46:zsad041. [PMID: 36861330 DOI: 10.1093/sleep/zsad041] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Indexed: 03/03/2023] Open
Abstract
STUDY OBJECTIVES 'Spin', using reporting strategies to distort study results, can mislead readers of medical research. This study aimed to evaluate the prevalence and characteristics of 'spin' among randomised controlled trial (RCT) abstracts published in sleep medicine journals, and to identify factors associated with its presence and severity. METHODS The search for RCTs published between 2010 and 2020 were conducted in seven reputable journals of sleep medicine. Abstracts of RCTs with statistically nonsignificant primary outcomes were included and analysed for 'spin', according to pre-determined 'spin' strategies. Chi-square tests or logistic regression analyses were performed to detect the association between characteristics of included abstracts and the presence and severity of 'spin'. RESULTS A total of 114 RCT abstracts were included in this study, of which 89 (78.1%) were identified as having at least one type of 'spin' strategy. Sixty-six abstracts (57.9%) had 'spin' in the Results section, 82 (71.9%) abstracts presented with 'spin' in the Conclusions section. The presence of 'spin' varied significantly among RCTs based on the different categories of research area (P=0.047) and the statistician involvement (P=0.045). Furthermore, research area (P=0.019) and funding status (P=0.033) were significant factors associated with the severity of 'spin'. CONCLUSIONS The prevalence of 'spin' is high among RCT abstracts in sleep medicine. This raise the need for researchers, editors and other stakeholders to be aware of the issue of 'spin' and make joint efforts to eliminate it in future publications.
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Affiliation(s)
- Feiyang Guo
- Hubei-MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Tingting Zhao
- Hubei-MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development and Sleep Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qianglan Zhai
- Hubei-MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xiaolin Fang
- Hubei-MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Haoze Yue
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Fang Hua
- Center for Dentofacial Development and Sleep Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Evidence-Based Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Orthodontics and Pediatric Dentistry, Optics Valley Branch, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Hong He
- Hubei-MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development and Sleep Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China
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"Spin" in Plastic Surgery Randomized Controlled Trials with Statistically Nonsignificant Primary Outcomes: A Systematic Review. Plast Reconstr Surg 2023; 151:506e-519e. [PMID: 36442055 DOI: 10.1097/prs.0000000000009937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND "Spin" refers to a manipulation of language that implies benefit for an intervention when none may exist. Randomized controlled trials (RCTs) in other fields have been demonstrated to employ spin, which can mislead clinicians to use ineffective or unsafe interventions. This study's objective was to determine the strategies, severity, and extent of spin in plastic surgery RCTs with nonsignificant primary outcomes. METHODS A literature search of the top 15 plastic surgery journals using MEDLINE was performed (2000 through 2020). Parallel 1:1 RCTs with a clearly identified primary outcome showing statistically nonsignificant results ( P > 0.05) were included. Screening, data extraction, and spin analysis were performed by two independent reviewers. The spin analysis was then independently assessed in duplicate by two plastic surgery residents with graduate-level training in clinical epidemiology. RESULTS From 3497 studies identified, 92 RCTs were included in this study. Spin strategies were identified in 78 RCTs (85%), including 64 abstracts (70%) and 77 main texts (84%). Severity of spin was rated moderate or high in 43 abstract conclusions (47%) and 42 main text conclusions (46%). The most identified spin strategy in the abstract was claiming equivalence for statistically nonsignificant results (26%); in the main text, focusing on another objective (24%). CONCLUSIONS This study suggests that 85% of statistically nonsignificant RCTs in plastic surgery employ spin. Readers of plastic surgery research should be aware of strategies, whether intentional or unintentional, used to manipulate language in reports of statistically nonsignificant RCTs when applying research findings to clinical practice.
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Fang X, Guo F, Chen Z, Hua F, Zhang L. Abstracts of randomized controlled trials in the field of dentofacial trauma: Reporting quality and spin. Dent Traumatol 2023; 39:276-284. [PMID: 36639886 DOI: 10.1111/edt.12815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 01/15/2023]
Abstract
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.
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Affiliation(s)
- Xiaolin Fang
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Feiyang Guo
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Centre for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zhi Chen
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Centre for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Lu Zhang
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Gulbrandsen MT, Filler RJ, Rice RC, Chung JH, Gulbrandsen TR, Phipatanakul WP, Liu JN. Spin in the Abstracts of Meta-analyses and Systematic Reviews: Midshaft Clavicle Fracture. J Orthop Trauma 2022; 37:e128-e134. [PMID: 36191349 DOI: 10.1097/bot.0000000000002497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Spin is a reporting bias that presents the beneficial effect of an experimental treatment as greater than what is found in the results of the study. This bias can result in patient care recommendations that are more subjective than objective. The purpose of this study is to identify the prevalence of spin in meta-analysis and systematic review abstracts regarding treatment of midshaft clavicle fractures. METHODS Electronic libraries (MEDLINE, Embase, Web of Science, Google Scholar) were systematically searched. Meta-analyses and systematic reviews regarding treatment of midshaft clavicular fractures were analyzed. The nine most severe types of spin commonly found in abstracts were used as an evaluation tool to assess the articles. Other variables analyzed include year of publication, journal impact factor, number of citations, and methodologic quality according to A Measurement Tool to Assess Systematic Reviews (AMSTAR-2). RESULTS The database search resulted in 401 articles, of which 53 met inclusion criteria. After review, it was found that 52.8% (28/53) of the included articles contained spin within the abstract. Of the nine most severe types of spin found in abstracts, type 3 spin ("selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention") was found to be the most prevalent 28.3% (15/53). CONCLUSION This study demonstrated the presence of spin in the majority of meta-analyses and systematic review abstracts pertaining to midshaft clavicular fractures. Orthopedic surgeons should be aware and recognize spin as they review articles when deciding the treatment course for such injuries. LEVEL OF EVIDENCE Level 3. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Matthew T Gulbrandsen
- Department of Orthopaedic Surgery, Loma Linda University School of Medicine, Loma Linda, CA
| | - Ryan J Filler
- Department of Orthopaedic Surgery, Loma Linda University School of Medicine, Loma Linda, CA
| | - Richard Casey Rice
- Department of Orthopaedic Surgery, Loma Linda University School of Medicine, Loma Linda, CA
| | - Jun Ho Chung
- Department of Orthopaedic Surgery, Loma Linda University School of Medicine, Loma Linda, CA
| | - Trevor R Gulbrandsen
- Department of Orthopaedic Surgery, University of Iowa Hospital, Iowa City, IA; and
| | - Wesley P Phipatanakul
- Department of Orthopaedic Surgery, Loma Linda University School of Medicine, Loma Linda, CA
| | - Joseph N Liu
- Department of Orthopaedic Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA
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Wise A, Mannem D, Arthur W, Ottwell R, Greiner B, Srouji D, Wildes D, Hartwell M, Wright DN, Khojasteh J, Vassar M. Spin within systematic review abstracts on antiplatelet therapies after acute coronary syndrome: a cross-sectional study. BMJ Open 2022; 12:e049421. [PMID: 35918107 PMCID: PMC9351322 DOI: 10.1136/bmjopen-2021-049421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Spin is a reporting practice in which study results are misrepresented by overestimating efficacy or underestimating harm. Prevalence of spin varies between clinical specialties, and estimates are based almost entirely on clinical trials. Little is known about spin in systematic reviews. DESIGN We performed a cross-sectional analysis searching MEDLINE and Embase for systematic reviews and meta-analyses pertaining to antiplatelet therapies following acute coronary syndrome on 2 June 2020. Data were extracted evaluating the presence of spin and study characteristics, including methodological quality as rated by A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2). All data extraction was conducted in a masked, duplicate manner from 2 June 2020 to 26 June 2020. PARTICIPANTS AND SETTING Not applicable. PRIMARY AND SECONDARY OUTCOME MEASURES We assessed abstracts of systematic reviews on antiplatelet therapy following acute coronary syndrome and evaluated the prevalence of the nine most severe types of spin. We additionally explored associations between spin and certain study characteristics, including quality. RESULTS Our searches returned 15 263 articles, and 185 systematic reviews met inclusion criteria. Of these 185 reviews, 31.9% (59/185) contained some form of spin in the abstract. Seven forms of spin (1, 2, 3, 4, 5, 7 and 9) among the nine most severe were identified. No instances of types 6 or 8 were found. There were no statistically significant relationships between spin and the evaluated study characteristics or AMSTAR-2 appraisals. CONCLUSIONS Spin was present in abstracts for systematic reviews and meta-analyses; subsequent studies are needed to identify correlations between spin and specific study characteristics. There were no statistically significant associations between spin and study characteristics or AMSTAR-2 ratings; however, implementing changes will ensure that spin is reduced in the field of cardiology as well as other fields of medicine.
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Affiliation(s)
- Audrey Wise
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Deepika Mannem
- Arkansas College of Osteopathic Medicine, Fort Smith, Arkansas, USA
| | - Wade Arthur
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Ryan Ottwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Benjamin Greiner
- The University of Texas Medical Branch at Galveston Department of Internal Medicine, Galveston, Texas, USA
| | - Derek Srouji
- Cardiology, Oklahoma State University Medical Center, Tulsa, Oklahoma, USA
| | - Daniel Wildes
- Cardiology, Oklahoma State University Medical Center, Tulsa, Oklahoma, USA
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Drew N Wright
- Samuel J. Wood Library & C.V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, New York, USA
| | - Jam Khojasteh
- School of Educational Foundations, Leadership and Aviation, Oklahoma State University - Tulsa, Tulsa, Oklahoma, USA
| | - Matthew Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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Bruns M, Manojkumar A, Ottwell R, Hartwell M, Arthur W, Roberts W, White B, Young J, Martin J, Wright DN, Chen S, Miao Z, Vassar M. Evaluation of spin in the abstracts of systematic reviews and meta-analyses relating to postoperative nausea and vomiting. Eur J Anaesthesiol 2022; 39:701-710. [PMID: 35796313 DOI: 10.1097/eja.0000000000001709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
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.
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Affiliation(s)
- Matthew Bruns
- From the Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma (MB, RO, MH, WA, WR, MV), Arkansas College of Osteopathic Medicine, Fort Smith, Arkansas (AM), Department of Internal Medicine, University of Oklahoma, School of Community Medicine, Tulsa, Oklahoma (RO), Department of Dermatology, St. Joseph Mercy Hospital, Ann Arbor, Michigan (RO), Department of Anesthesiology, Oklahoma State University Medical Center, Tulsa, Oklahoma (WR, BW, JY), Samuel J. Wood Library & C. V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, New York, USA (MH, DNW), Department of Anesthesia & Perioperative Medicine, MEDICI Centre, Western University, London, Ontario, Canada (JM), Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa (MV), School of Industrial Engineering and Management (SC) and Center for Health Systems Innovation, Oklahoma State University, Stillwater, Oklahoma, USA (ZM)
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Fang X, Wu X, Levey C, Chen Z, Hua F, Zhang L. Spin in the Abstracts of Randomized Controlled Trials in Operative Dentistry: A Cross-sectional Analysis. Oper Dent 2022; 47:287-300. [PMID: 35776961 DOI: 10.2341/21-025-lit] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2021] [Indexed: 12/12/2022]
Abstract
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.
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Affiliation(s)
- X Fang
- Xiaolin Fang, BDS, MSc, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - X Wu
- Xinyu Wu, BDS, MSc, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - C Levey
- Colin Levey, BMSc, BDS, PhD, School of Dentistry, University of Dundee, Dundee, UK
| | - Z Chen
- Zhi Chen, BDS, MSc, PhD, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - F Hua
- *Fang Hua, BDS, MSc, PhD, Centre for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - L Zhang
- *Lu Zhang, BDS, MSc, PhD, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Transparent and Reproducible Research Practices in the Surgical Literature. J Surg Res 2022; 274:116-124. [PMID: 35150944 DOI: 10.1016/j.jss.2021.09.024] [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: 01/20/2020] [Revised: 08/23/2021] [Accepted: 09/20/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Previous studies have established a baseline of minimal reproducibility in the social science and biomedical literature. Clinical research is especially deficient in factors of reproducibility. Surgical journals contain fewer clinical trials than non-surgical areas of medicine, suggesting that it should be easier to reproduce the outcomes of surgical literature. METHODS In this study, we evaluated a broad range of indicators related to transparency and reproducibility in a random sample of 387 articles published in Surgery journals between 2014 and 2018. RESULTS A small minority of our sample made available their materials (5.3%, 95% C.I. 2.4%-8.2%), protocols (1.2%, 0-2.5%), data (2.5%, 0.7%-4.2%), or analysis scripts (0.04%). Four studies were adequately pre-registered. No studies were explicit replications of previous literature. Most studies (58%), declined to provide a funding statement, while conflicts of interest were declared in a small fraction (9.3%). Most have not been cited by systematic reviews (83%) or meta-analyses (87%), and most were only accessible to paying subscribers (59%). CONCLUSIONS The transparency of the surgical literature could improve with adherence to baseline standards of reproducibility.
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Chellamuthu G, Muthu S, Damodaran UK, Rangabashyam R. "Only 50% of randomized trials have high level of confidence in arthroscopy and sports medicine"-a spin-based assessment. Knee Surg Sports Traumatol Arthrosc 2021; 29:2789-2798. [PMID: 34021767 DOI: 10.1007/s00167-021-06614-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 05/17/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE Pioneering works on the quality appraisal of RCTs have recognized and addressed most of the issues that affect the RCT quality but some issues such as "Writers' bias" or "Spin" are yet to be sorted out. Spin, particularly in the abstracts, is a potential source of deception to the readers. The purpose of this study is to grade the RCTs of arthroscopy and sports medicine based on a spin in their abstracts, analyze the prevalence of spin, and explore methods to remove spin. METHODS 250 recent RCTs from the top 5 arthroscopy and sports medicine journals were selected. Baseline data of the articles were collected. Consort Adherence Score (CAS) was calculated. The abstracts of the RCTs were graded using the Level Of Confidence (LOC) grading tool developed by the Orthopaedic Research Group. The association of the spin grade with other characteristics of the articles was analyzed. RESULTS The median CAS for the included studies was 9 (IQR 8-10). It was found that only 49.6% (n = 124) articles had high LOC with no or one non-critical spin in the abstract. 20.8% (n = 52) had Moderate LOC with more than one non-critical spin. 19.6% (n = 49) had at least one critical spin and 10% (n = 25) had more than one critical flaw making their results have Low and Critically Low LOC, respectively. Of the ten variables analyzed in multivariate regression analysis, it was found that CAS was the only significant factor that determines the level of confidence in the abstract of RCTs CONCLUSION: Spin is prevalent in abstracts of sports medicine and arthroscopy journals with 50.4% having some form of spin. Grading the LOC of the RCTs based on spin is the necessity of the day for the readers. Only 49.6% of the RCTs had high LOC. Objective structuring of the abstracts would help eliminate spin in the future. LEVEL OF EVIDENCE Level 1.
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Affiliation(s)
| | - Sathish Muthu
- Orthopaedic Research Group, Coimbatore, Tamil Nadu, India.
- Government Hospital, Velayuthampalayam, Karur, Tamil Nadu, India.
| | - Udaya Kumar Damodaran
- Orthopaedic Research Group, Coimbatore, Tamil Nadu, India
- Government Mohan Kumaramangalam Medical College, Salem, Tamil Nadu, India
| | - Rajkumar Rangabashyam
- Orthopaedic Research Group, Coimbatore, Tamil Nadu, India
- Central Prison Hospital Vellore, Vellore, Tamil Nadu, India
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12
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Ferrell MC, Schell J, Ottwell R, Arthur W, Bickford T, Gardner G, Goodrich W, Platts-Mills TF, Hartwell M, Sealey M, Zhu L, Vassar M. Evaluation of spin in the abstracts of emergency medicine systematic reviews and meta-analyses. Eur J Emerg Med 2021; 29:118-125. [PMID: 34456295 DOI: 10.1097/mej.0000000000000864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
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.
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Affiliation(s)
- Matthew C Ferrell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences
| | - Jace Schell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences
| | - Ryan Ottwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences
| | - Wade Arthur
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences
| | - Trevor Bickford
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences
| | - Gavin Gardner
- Department of Emergency Medicine, Oklahoma State University Medical Center, Tulsa, Oklahoma
| | - Will Goodrich
- Department of Emergency Medicine, Oklahoma State University Medical Center, Tulsa, Oklahoma
| | - Timothy F Platts-Mills
- Department of Emergency Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa
| | - Meghan Sealey
- Department of Statistics, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Lan Zhu
- Department of Statistics, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa
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13
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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: 12] [Impact Index Per Article: 4.0] [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.
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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
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14
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Faulkner JJ, Polson C, Dodd AH, Ottwell R, Arthur W, Neff J, Chronister J, Hartwell M, Wright DN, Vassar M. Evaluation of spin in the abstracts of systematic reviews and meta-analyses focused on the treatment of obesity. Obesity (Silver Spring) 2021; 29:1285-1293. [PMID: 34314111 DOI: 10.1002/oby.23192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 02/27/2021] [Accepted: 03/23/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Spin, i.e., the misrepresentation of research findings, has the potential to affect patient care. Evidence suggests that spin is prevalent in obesity randomized controlled trials. Therefore, the primary objective of this study was to evaluate spin in abstracts of systematic reviews covering obesity treatments. METHODS MEDLINE and Embase were searched to retrieve systematic reviews on obesity treatments. Each systematic review abstract was inspected for the nine most severe types of spin, i.e., the misrepresentation of study findings by exaggeration or omission, regardless of intentionality. Screening and data extraction occurred in a masked, triplicate fashion. Methodological quality was determined using A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2). RESULTS Spin was identified in 20 (out of 200, 10%) abstracts, with spin type 5 (claiming efficacy despite high risk of bias among primary studies) being most common (11/200, 5.5%). Spin types 2 and 7, both related to unsupported efficacy claims, were not found. No associations were found between spin and extracted study characteristics. The methodological quality of the sample was rated as follows: critically low (23.0%), low (13.5%), moderate (60.5%), and high (3%). CONCLUSIONS Although these findings demonstrate a low proportion of spin in the abstracts of systematic reviews for obesity treatment; increased preventive measures may further reduce its presence.
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Affiliation(s)
- Jantzen J Faulkner
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Connor Polson
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Andrew H Dodd
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Ryan Ottwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Wade Arthur
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Jenny Neff
- Department of Internal Medicine, Oklahoma State University Medical Center, Tulsa, Oklahoma, USA
| | - Justin Chronister
- Department of Internal Medicine, Oklahoma State University Medical Center, Tulsa, Oklahoma, USA
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Drew N Wright
- Samuel J. Wood Library & C. V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, New York, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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15
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Vorland CJ, Brown AW. Spin in the abstracts of systematic reviews and meta-analyses: How big is the problem in obesity? Obesity (Silver Spring) 2021; 29:1244-1245. [PMID: 34314109 PMCID: PMC8765550 DOI: 10.1002/oby.23230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 05/15/2021] [Indexed: 11/08/2022]
Affiliation(s)
- Colby J Vorland
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA
| | - Andrew W Brown
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA
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16
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Ottwell R, Esmond L, Rea W, Hartwell M, Som M, Harris R, Miao Z, Zhu L, Arthur W, Brachtenbach T, Wright DN, Vassar M. Spin Infrequently Occurs in Abstracts of Systematic Reviews For The Pharmacological Treatment of Type 2 Diabetes Mellitus. Diabet Med 2021; 38:e14653. [PMID: 34289158 DOI: 10.1111/dme.14653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 07/13/2021] [Indexed: 12/19/2022]
Abstract
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.
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Affiliation(s)
- Ryan Ottwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Department of Internal Medicine, University of Oklahoma, School of Community Medicine, Tulsa, OK, USA
- Samuel J. Wood Library & C.V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, NY, USA
| | - Lindy Esmond
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - William Rea
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Kansas City University of Medicine and Biosciences, Joplin, MO, USA
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Mousumi Som
- Department of Internal Medicine, Oklahoma State University Medical Center, Tulsa, OK, USA
| | - Rachael Harris
- Department of Internal Medicine, Oklahoma State University Medical Center, Tulsa, OK, USA
| | - Zhuqi Miao
- Spears School of Business, Oklahoma State University, Stillwater, OK, USA
| | - Lan Zhu
- Department of Statistics, Oklahoma State University, Stillwater, OK, USA
| | - Wade Arthur
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Travis Brachtenbach
- Department of Internal Medicine, Oklahoma State University Medical Center, Tulsa, OK, USA
| | - Drew N Wright
- Spears School of Business, Oklahoma State University, Stillwater, OK, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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17
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Corcoran A, Neale M, Arthur W, Ottwell R, Roberts W, Hartwell M, Cates S, Wright DN, Beaman J, Vassar M. Evaluating spin in the abstracts of systematic reviews and meta-analyses on cannabis use disorder. Subst Abus 2021; 43:1-9. [PMID: 34283700 DOI: 10.1080/08897077.2021.1944953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Clinicians rely upon abstracts to provide them quick synopses of research findings that may apply to their practice. Spin can exist within these abstracts that distorts or misrepresents the findings. Our goal was to evaluate the level of spin within systematic reviews (SRs) focused on the treatment of cannabis use disorder (CUD). Methods: A systematic search was conducted in May 2020. To meet inclusion criteria, publications had to be either an SR or meta-analysis related to the treatment of cannabis use. Screening and data extraction was performed in a duplicate and masked fashion. Study quality was assessed using AMSTAR-2 Results: 16/24 SRs (66.7%) contained at least one form of spin in the abstract. The most common forms of spin identified were type 3-selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention (45.8%)-and type 8-the review's findings from a surrogate marker or a specific outcome to the global improvement of the disease (37.5%). No significant association between spin and intervention type, PRISMA requirements, or funding source was identified. Weak positive correlations were found between the presence of spin and abstract word count (r =.217) and between spin and AMSTAR-2 rating (r = 0.143). "Moderate" was the most common AMSTAR-2 rating (9/24, 37.5%), followed by "low" (7/24, 29.2%) and "critically low" (7/24, 29.2%). One systematic review received an AMSTAR-2 rating of "high" (1/24, 4.2%). Conclusions: Spin was common among abstracts from the SRs focused on the treatments for CUD. Higher quality studies may help reduce the overall rate as well as standardizing treatment outcomes. To facilitate this, we encourage all authors, peer-reviewers, and editors to be more aware of the various types of spin as they can help reduce the overall amount of spin seen within the literature.
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Affiliation(s)
- Adam Corcoran
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Monika Neale
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
- College of Osteopathic Medicine, Kansas City University of Medicine and Biosciences, Kansas City, Missouri, USA
| | - Wade Arthur
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Ryan Ottwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Will Roberts
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Stephens Cates
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Drew N Wright
- Samuel J. Wood Library & C. V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, New York, USA
| | - Jason Beaman
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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18
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Garrett M, Koochin T, Ottwell R, Arthur W, Rogers TC, Hartwell M, Chen E, Ford A, Wright DN, Sealey M, Zhu L, Vassar M. Evaluation of spin in the abstracts of systematic reviews and meta-analyses of treatments and interventions for smoking cessation. Tob Prev Cessat 2021; 7:35. [PMID: 34046532 PMCID: PMC8135573 DOI: 10.18332/tpc/134238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 12/18/2022]
Abstract
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.
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Affiliation(s)
- Morgan Garrett
- Office of Medical Student Research, Center for Health Sciences, Oklahoma State University, Tulsa, United States
| | - Tremayne Koochin
- Office of Medical Student Research, Center for Health Sciences, Oklahoma State University, Tulsa, United States
- College of Osteopathic Medicine, Kansas City University of Medicine and Biosciences, Joplin, United States
| | - Ryan Ottwell
- Office of Medical Student Research, Center for Health Sciences, Oklahoma State University, Tulsa, United States
| | - Wade Arthur
- Office of Medical Student Research, Center for Health Sciences, Oklahoma State University, Tulsa, United States
| | - Taylor C. Rogers
- Office of Medical Student Research, Center for Health Sciences, Oklahoma State University, Tulsa, United States
| | - Micah Hartwell
- Office of Medical Student Research, Center for Health Sciences, Oklahoma State University, Tulsa, United States
- Department of Psychiatry and Behavioral Sciences, Center for Health Sciences, Oklahoma State University, Tulsa, United States
| | - Elizabeth Chen
- Department of Psychiatry and Behavioral Sciences, Center for Health Sciences, Oklahoma State University, Tulsa, United States
| | - Alicia Ford
- Department of Psychiatry and Behavioral Sciences, Center for Health Sciences, Oklahoma State University, Tulsa, United States
| | - Drew N. Wright
- Samuel J. Wood Library and C. V. Starr Biomedical Information Center, Weill Cornell Medical College, Cornell University, New York, United States
| | - Meghan Sealey
- Department of Statistics, Oklahoma State University, Stillwater, United States
| | - Lan Zhu
- Department of Statistics, Oklahoma State University, Stillwater, United States
| | - Matt Vassar
- Office of Medical Student Research, Center for Health Sciences, Oklahoma State University, Tulsa, United States
- Department of Psychiatry and Behavioral Sciences, Center for Health Sciences, Oklahoma State University, Tulsa, United States
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19
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Rucker B, Umbarger E, Ottwell R, Arthur W, Brame L, Woodson E, Wright DN, Hartwell M, Khojasteh J, Vassar M. Evaluation of Spin in the Abstracts of Systematic Reviews and Meta-Analyses Focused on Tinnitus. Otol Neurotol 2021; 42:1237-1244. [PMID: 33973954 DOI: 10.1097/mao.0000000000003178] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
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.
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Affiliation(s)
| | | | | | | | - Lacy Brame
- Office of Medical Student Research
- Department of Otolaryngology-Head and Neck Surgery, Oklahoma State University Medical Center
| | - Elena Woodson
- Department of Otolaryngology-Head and Neck Surgery, Oklahoma State University Medical Center
| | - Drew N Wright
- Samuel J. Wood Library & C.V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, New York
| | - Micah Hartwell
- Office of Medical Student Research
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences
| | - Jam Khojasteh
- School of Educational Foundations, Leadership and Aviation, Oklahoma State University, Tulsa, Oklahoma
| | - Matt Vassar
- Office of Medical Student Research
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences
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20
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Balcerak G, Shepard S, Ottwell R, Arthur W, Hartwell M, Beaman J, Lu K, Zhu L, Wright DN, Vassar M. Evaluation of spin in the abstracts of systematic reviews and meta-analyses of studies on opioid use disorder. Subst Abus 2021; 42:1-9. [PMID: 33848450 DOI: 10.1080/08897077.2021.1904092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
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.
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Affiliation(s)
- Greg Balcerak
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Samuel Shepard
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Ryan Ottwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Wade Arthur
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Jason Beaman
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Kaelyn Lu
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Lan Zhu
- Department of Statistics, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Drew N Wright
- Samuel J. Wood Library & C. V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, New York, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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21
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Nascimento DP, Ostelo RWJG, van Tulder MW, Gonzalez GZ, Araujo AC, Vanin AA, Costa LOP. Do not make clinical decisions based on abstracts of healthcare research: A systematic review. J Clin Epidemiol 2021; 135:136-157. [PMID: 33839242 DOI: 10.1016/j.jclinepi.2021.03.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 02/10/2021] [Accepted: 03/03/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To summarize the reporting quality of healthcare abstracts and inconsistencies between abstracts and full texts. STUDY DESIGN AND SETTING This systematic review included overviews of randomized controlled trials (RCTs) and systematic reviews (SRs) that summarized data of healthcare abstracts on reporting of abstracts and consistency of abstracts with the full text. Searches were performed in PubMed, CENTRAL, Cochrane Library and EMBASE databases from 1900 to February 2019. Two authors screened the overviews and extracted the data. All analyses were descriptive and divided into two main groups: abstracts' reporting quality and abstracts' consistency with the full text. Abstracts were considered poorly reported and inconsistent with the full text if more than 5% of abstracts' information was not fully reported or not consistent with the full text. RESULTS 27 overviews analyzing 5,194 RCTs and 866 SRs were retrieved for reporting quality of abstracts. A total of 22 overviews analyzing 2,025 RCTs and 551 SRs were included for consistency of abstracts with the full text. Abstracts across all healthcare areas presented poor reporting quality and were inconsistent with the full texts, with results and conclusions as the most inconsistent sections. CONCLUSION Abstracts of healthcare RCTs and SRs have shown a large room for improvement in reporting quality and consistency with the full text. Authors, journal editors and reviewers need to give the highest priority to this matter.
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Affiliation(s)
- Dafne P Nascimento
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil; Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Raymond W J G Ostelo
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, Amsterdam UMC, location VUmc and the Amsterdam Movement Sciences Research Institute, Amsterdam, The Netherlands
| | - Maurits W van Tulder
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Physiotherapy & Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark.
| | - Gabrielle Z Gonzalez
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | - Amanda C Araujo
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | - Adriane A Vanin
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | - Leonardo O P Costa
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
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22
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Demla S, Shinn E, Ottwell R, Arthur W, Khattab M, Hartwell M, Wright DN, Vassar M. Evaluation of spin in the abstracts of systematic reviews and meta-analyses focused on cataract therapies. Am J Ophthalmol 2021; 228:47-57. [PMID: 33823157 DOI: 10.1016/j.ajo.2021.03.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 03/04/2021] [Accepted: 03/18/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE Spin-the misrepresentation of study findings such that the beneficial effects of an intervention are magnified beyond what the results actually show-is a reporting practice that has been shown to influence perceptions of treatment efficacy and clinical decision making. We evaluated the extent of spin in the abstracts of systematic reviews of cataract surgery and its complications. We also evaluated whether particular study attributes were associated with spin. DESIGN Cross-sectional study. METHODS We searched MEDLINE and Embase for systematic reviews and meta-analyses relating to cataract treatment. From these search records, screening for eligible studies was done in duplicate. Using a previously developed classification system for spin, we assessed the systematic reviews that met our eligibility criteria for the occurrence of the 9 most severe forms of spin. We performed the evaluation of spin, extracted study characteristics, and appraised the methodological quality of each study using the 16-question AMSTAR-2 scale in duplicate. RESULTS Searches retrieved 2,059 studies, of which 110 were eligible for data extraction. We found at least 1 form of spin in 30.0% of included systematic reviews (33/110). Six of the 9 types of spin were identified in our sample, the most common being type 3 in 18.2% (20/110) of abstracts. We found no significant association between spin in abstracts, AMSTAR-2 appraisal, and any of the extracted study characteristics. CONCLUSION Spin was evident in approximately one-third of the abstracts of evaluated systematic reviews and meta-analyses of cataract surgery and associated complications.
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Affiliation(s)
- Simran Demla
- From the Office of Medical Student Research (S.D., E.S., R.O., W.A., M.K., M.H., M.V.), Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.
| | - Erin Shinn
- From the Office of Medical Student Research (S.D., E.S., R.O., W.A., M.K., M.H., M.V.), Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA; Arkansas College of Osteopathic Medicine (E.S.), Fort Smith, Arkansas, USA
| | - Ryan Ottwell
- From the Office of Medical Student Research (S.D., E.S., R.O., W.A., M.K., M.H., M.V.), Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Wade Arthur
- From the Office of Medical Student Research (S.D., E.S., R.O., W.A., M.K., M.H., M.V.), Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Mostafa Khattab
- From the Office of Medical Student Research (S.D., E.S., R.O., W.A., M.K., M.H., M.V.), Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Micah Hartwell
- From the Office of Medical Student Research (S.D., E.S., R.O., W.A., M.K., M.H., M.V.), Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA; Department of Psychiatry and Behavioral Sciences (M.H., M.V.), Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Drew N Wright
- Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.N.W.), Weill Cornell Medical College, New York, New York, USA
| | - Matt Vassar
- From the Office of Medical Student Research (S.D., E.S., R.O., W.A., M.K., M.H., M.V.), Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA; Department of Psychiatry and Behavioral Sciences (M.H., M.V.), Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
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23
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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: 8] [Impact Index Per Article: 2.7] [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.
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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
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24
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Heigle B, Kee M, Ottwell R, Arthur W, Brame L, Wright DN, Hartwell M, Khojasteh J, Vassar M. Spin the Abstracts of Systematic Reviews and Meta-Analyses Regarding the Treatment of Ménière's Disease. Ann Otol Rhinol Laryngol 2021; 130:34894211000493. [PMID: 33730925 DOI: 10.1177/00034894211000493] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
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.
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Affiliation(s)
- Benjamin Heigle
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Micah Kee
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Ryan Ottwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Wade Arthur
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Lacy Brame
- Department of Otolaryngology-Head and Neck Surgery, Oklahoma State University Medical Center, Tulsa, OK, USA
| | - Drew N Wright
- Samuel J. Wood Library & C. V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, NY, USA
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Department of Psychiatry and Behavioral Science, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Jam Khojasteh
- Research, Evaluation, Measurement and Statistics, Oklahoma State University, Tulsa, OK, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Department of Psychiatry and Behavioral Science, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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25
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Flores H, Kannan D, Ottwell R, Arthur W, Hartwell M, Patel N, Bowers A, Po W, Wright DN, Chen S, Miao Z, Vassar M. Evaluation of spin in the abstracts of systematic reviews and meta-analyses on breast cancer treatment, screening, and quality of life outcomes: A cross-sectional study. J Cancer Policy 2021; 27:100268. [DOI: 10.1016/j.jcpo.2020.100268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/13/2020] [Accepted: 12/14/2020] [Indexed: 01/23/2023]
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26
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Varady NH, Worsham CM, Jena AB. Analysis of institutional conflict of interest and bias in research findings and reporting. HEALTHCARE-THE JOURNAL OF DELIVERY SCIENCE AND INNOVATION 2021; 9:100515. [PMID: 33517178 DOI: 10.1016/j.hjdsi.2020.100515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 09/08/2020] [Accepted: 12/21/2020] [Indexed: 10/22/2022]
Affiliation(s)
| | - Christopher M Worsham
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Health Care Policy, Harvard Medical School, Department of Medicine, Massachusetts General Hospital, Both in Boston, MA, USA
| | - Anupam B Jena
- Department of Health Care Policy, Harvard Medical School, Department of Medicine, Massachusetts General Hospital, Both in Boston, MA, USA; National Bureau of Economic Research, Cambridge, MA, USA.
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27
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Jones C, Rulon Z, Arthur W, Ottwell R, Checketts J, Detweiler B, Calder M, Adil A, Hartwell M, Wright DN, Vassar M. Evaluation of spin in the abstracts of systematic reviews and meta-analyses related to the treatment of proximal humerus fractures. J Shoulder Elbow Surg 2021; 30:2197-2205. [PMID: 33482369 DOI: 10.1016/j.jse.2020.11.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/17/2020] [Accepted: 11/19/2020] [Indexed: 02/01/2023]
Abstract
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.
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Affiliation(s)
- Caleb Jones
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Zane Rulon
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Wade Arthur
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Ryan Ottwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA.
| | - Jake Checketts
- Department of Orthopedic Surgery, Oklahoma State University Center Medical Center, Tulsa, OK, USA
| | - Byron Detweiler
- Department of Orthopedic Surgery, Oklahoma State University Center Medical Center, Tulsa, OK, USA
| | - Mark Calder
- Orthopedic & Trauma Services of Oklahoma, Tulsa, OK, USA
| | - Abrar Adil
- Orthopedic & Trauma Services of Oklahoma, Tulsa, OK, USA
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA; Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Drew N Wright
- Samuel J. Wood Library and C. V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, NY, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA; Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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28
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Carr M, Dye D, Arthur W, Ottwell R, Detweiler B, Stotler W, Hawkins B, Wright DN, Hartwell M, Chen S, Miao Z, Vassar M. Evaluation of Spin in the Abstracts of Systematic Reviews and Meta-analyses Covering Treatments for Achilles Tendon Ruptures. FOOT & ANKLE ORTHOPAEDICS 2021; 6:24730114211000637. [PMID: 35097436 PMCID: PMC8702684 DOI: 10.1177/24730114211000637] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
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.
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Affiliation(s)
- Marvin Carr
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - David Dye
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA.,Kansas City University of Medicine and Biosciences-College of Osteopathic Medicine, Joplin, MO, USA
| | - Wade Arthur
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Ryan Ottwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Byron Detweiler
- Department of Orthopaedic Surgery, Oklahoma State University Center Medical Center, Tulsa, OK, USA
| | | | | | - Drew N Wright
- Samuel J. Wood Library & C.V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, NY, USA
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA.,Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Suhao Chen
- School of Industrial Engineering and Management, Oklahoma State University, Stillwater, OK, USA
| | - Zhuqi Miao
- Center for Health Systems Innovation, Oklahoma State University, Stillwater, OK, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA.,Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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29
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Okonya O, Lai E, Ottwell R, Khattab M, Arthur W, Khaimi MA, Wright DN, Hartwell M, Vassar M. Evaluation of Spin in the Abstracts of Systematic Reviews and Meta-analyses of Treatments for Glaucoma. J Glaucoma 2020; 30:235-241. [PMID: 33350656 DOI: 10.1097/ijg.0000000000001735] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Spin - the misrepresentation of the study's actual findings - carries the ability to distort a reader's perception of a treatments' full benefits and risks. Recent studies have suggested that spin is common in abstracts of randomized controlled trials and systematic reviews focused on treatments for a variety of medical disorders. Therefore, our primary objective was to evaluate the prevalence of spin in the abstracts of systematic reviews and meta-analyses related to glaucoma treatments. We further assessed whether specific study characteristics were associated with spin, including the methodological quality of a study. PATIENTS AND METHODS We used a cross-sectional study design searching MEDLINE and Embase databases all for systematic reviews and meta-analyses focused on glaucoma treatments. Each abstract was assessed for the nine most severe - severity determined by likelihood of distorting a reader's perception - types of spin that occur in systematic review abstracts. The screening and data extraction was performed in a duplicate, masked fashion. The methodological quality of each review was assessed using A MeaSurement Tool to Assess Systematic Reviews (AMSTAR-2) instrument. To evaluate relationships between spin, AMSTAR-2 appraisals, and other study characteristics, we used unadjusted odds ratios and Fisher's exact test. RESULTS Only three of the 102 abstracts contained spin, with spin type 5 being the most prevalent. No abstracts contained spin types 1, 2, 3, 4, 6, or 8, and no association was found between the presence of spin in an abstract and any particular study characteristic. Using the AMSTAR-2 quality appraisal instrument, 35 (34.3%) of the studies received a methodological quality rating as high, 42 (41.2%) as moderate, 11 (10.8%) as low, and 14 (13.7%) as critically low. CONCLUSIONS We found that's pin is present in only a small proportion of systematic reviews and meta-analyses covering the treatment of glaucoma. In comparison to studies in other fields of medicine, ophthalmology appears to be a leader in publishing systematic reviews and meta-analyses with low rates of spin occurring in the abstract.
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Affiliation(s)
| | - Elaine Lai
- Office of Medical Student Research
- Kansas City University of Medicine and Biosciences, College of Osteopathic Medicine, Joplin, MO
| | | | | | | | - Mahmoud A Khaimi
- Department of Ophthalmology Dean McGee Eye Institute, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Drew N Wright
- Samuel J. Wood Library & C. V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, NY
| | - Micah Hartwell
- Office of Medical Student Research
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa
| | - Matt Vassar
- Office of Medical Student Research
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa
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Reddy AK, Lulkovich K, Ottwell R, Arthur W, Bowers A, Al-Rifai S, Cook K, Wright DN, Hartwell M, Vassar M. 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. [PMID: 33291041 PMCID: PMC7930867 DOI: 10.1016/j.esxm.2020.10.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/09/2020] [Accepted: 10/22/2020] [Indexed: 12/17/2022] Open
Abstract
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.
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Affiliation(s)
- Arjun K Reddy
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA.
| | - Kaley Lulkovich
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Ryan Ottwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Wade Arthur
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Aaron Bowers
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Shafiq Al-Rifai
- Department of Internal Medicine, Oklahoma State University Medical Center, Tulsa, OK, USA
| | - Katherine Cook
- Department of Internal Medicine, Oklahoma State University Medical Center, Tulsa, OK, USA
| | - Drew N Wright
- Samuel J. Wood Library, Weill Cornell Medical College, New York, NY, USA
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA; Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA; Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Siex P, Nowlin W, Ottwell R, Arthur W, Checketts J, Thompson J, Small T, Reddick B, Wright DN, Hartwell M, Chen S, Miao Z, Vassar M. Evaluation of spin in the abstracts of systematic reviews and meta-analyses covering surgical management, or quality of life after surgical management, of osteoarthritis of the knee. OSTEOARTHRITIS AND CARTILAGE OPEN 2020; 2:100121. [DOI: 10.1016/j.ocarto.2020.100121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/04/2020] [Indexed: 02/06/2023] Open
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Dormire KD, Whitehead AJ, Wayant C, Bowers A, Vassar M. Evaluation of misrepresented findings in the abstracts of acute respiratory distress syndrome randomized trials with nonsignificant primary endpoints. THE CLINICAL RESPIRATORY JOURNAL 2020; 15:287-292. [PMID: 33080096 DOI: 10.1111/crj.13295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 10/08/2020] [Indexed: 11/30/2022]
Abstract
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.
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Affiliation(s)
- Kody D Dormire
- Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Aldon J Whitehead
- Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Cole Wayant
- Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Aaron Bowers
- Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Matt Vassar
- Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Cooper CM, Johnson A, Gray H, Vassar M. An Evaluation of the Presence of Spin in the Abstracts of Tonsillectomy Systematic Reviews. Laryngoscope 2020; 131:E727-E731. [PMID: 32880983 DOI: 10.1002/lary.29002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 07/10/2020] [Accepted: 07/18/2020] [Indexed: 01/10/2023]
Abstract
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.
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Affiliation(s)
- Craig M Cooper
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A
| | - Austin Johnson
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A
| | - Harrison Gray
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A
| | - Matt Vassar
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A
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Wu X, Yan Q, Fang X, Hua F, Shi B, Tu YK. Spin in the abstracts of randomized controlled trials in periodontology and oral implantology: A cross-sectional analysis. J Clin Periodontol 2020; 47:1079-1086. [PMID: 32618017 DOI: 10.1111/jcpe.13340] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/23/2020] [Indexed: 01/09/2023]
Abstract
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.
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Affiliation(s)
- Xinyu Wu
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qi Yan
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xiaolin Fang
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Bin Shi
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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Fang X, Hua F, Riley P, Chen F, Zhang L, Walsh T, Chen Z. Abstracts of published randomised controlled trials in Endodontics: Reporting quality and spin. Int Endod J 2020; 53:1050-1061. [PMID: 32333794 DOI: 10.1111/iej.13310] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/21/2020] [Indexed: 01/10/2023]
Abstract
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.
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Affiliation(s)
- X Fang
- Hubei-MOST KLOS & KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - F Hua
- Centre for Evidence-Based Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - P Riley
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - F Chen
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - L Zhang
- Hubei-MOST KLOS & KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - T Walsh
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Z Chen
- Hubei-MOST KLOS & KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
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Shaqman M, Al-Abedalla K, Wagner J, Swede H, Gunsolley JC, Ioannidou E. Reporting quality and spin in abstracts of randomized clinical trials of periodontal therapy and cardiovascular disease outcomes. PLoS One 2020; 15:e0230843. [PMID: 32302309 PMCID: PMC7164582 DOI: 10.1371/journal.pone.0230843] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/10/2020] [Indexed: 12/21/2022] Open
Abstract
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.
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Affiliation(s)
- Murad Shaqman
- Department of Oral Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Khadijeh Al-Abedalla
- Division of Periodontology, School of Dental Medicine, UCONN Health, Farmington, CT, United States of America
| | - Julie Wagner
- Division of Behavioral Science, School of Dental Medicine, UCONN Health, Farmington, CT, United States of America
| | - Helen Swede
- Department of Community Medicine, School of Medicine, UCONN Health, Farmington, CT, United States of America
| | - John Cart Gunsolley
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Effie Ioannidou
- Division of Periodontology, School of Dental Medicine, UCONN Health, Farmington, CT, United States of America
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Ottwell R, Rogers TC, Anderson JM, Johnson A, Vassar M. Evaluation of Spin in the Abstracts of Systematic Reviews and Meta-Analyses Focused on the Treatment of Acne Vulgaris: Cross-Sectional Analysis. JMIR DERMATOLOGY 2020. [DOI: 10.2196/16978] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
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.
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Vassar M, Jellison S, Wendelbo H, Wayant C, Gray H, Bibens M. Using the CONSORT statement to evaluate the completeness of reporting of addiction randomised trials: a cross-sectional review. BMJ Open 2019; 9:e032024. [PMID: 31494625 PMCID: PMC6731848 DOI: 10.1136/bmjopen-2019-032024] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/07/2019] [Accepted: 08/20/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Evaluate the completeness of reporting of addiction randomised controlled trials (RCTs) using the Consolidated Standards of Reporting Trials (CONSORT) statement. SETTING Not applicable. PARTICIPANTS RCTs identified using a PubMed search of 15 addiction journals and a 5-year cross-section. OUTCOME MEASURES Completeness of reporting. RESULTS Our analysis of 394 addiction RCTs found that the mean number of CONSORT items reported was 19.2 (SD 5.2), out of a possible 31. Twelve items were reported in <50% of RCTs; similarly, 12 items were reported in >75% of RCTs. Journal endorsement of CONSORT was found to improve the number of CONSORT items reported. CONCLUSIONS Poor reporting quality may prohibit readers from critically appraising the methodological quality of addiction trials. We recommend journal endorsement of CONSORT since our study and those previous have shown that CONSORT endorsement improves the quality of reporting.
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Affiliation(s)
- Matthew Vassar
- Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Sam Jellison
- Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Hannah Wendelbo
- Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Cole Wayant
- Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Harrison Gray
- Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Michael Bibens
- Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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Khan MS, Lateef N, Siddiqi TJ, Rehman KA, Alnaimat S, Khan SU, Riaz H, Murad MH, Mandrola J, Doukky R, Krasuski RA. Level and Prevalence of Spin in Published Cardiovascular Randomized Clinical Trial Reports With Statistically Nonsignificant Primary Outcomes: A Systematic Review. JAMA Netw Open 2019; 2:e192622. [PMID: 31050775 PMCID: PMC6503494 DOI: 10.1001/jamanetworkopen.2019.2622] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 03/01/2019] [Indexed: 12/28/2022] Open
Abstract
Importance Clinical researchers are obligated to present results objectively and accurately to ensure readers are not misled. In studies in which primary end points are not statistically significant, placing a spin, defined as the manipulation of language to potentially mislead readers from the likely truth of the results, can distract the reader and lead to misinterpretation and misapplication of the findings. Objective To determine the level and prevalence of spin in published reports of cardiovascular randomized clinical trial (RCT) reports. Data Source MEDLINE was searched from January 1, 2015, to December 31, 2017, using the Cochrane highly sensitive search strategy. Study Selection Inclusion criteria were parallel-group RCTs published from January 1, 2015, to December 31, 2017 in 1 of 6 high-impact journals (New England Journal of Medicine, The Lancet, JAMA, European Heart Journal, Circulation, and Journal of the American College of Cardiology) with primary outcomes that were not statistically significant were included in the analysis. Data Extraction and Synthesis Analysis began in August 2018. Data were extracted and verified by 2 independent investigators using a standard collection form. In cases of disagreement between the 2 investigators, a third investigators served as arbitrator. Main Outcomes and Measures The classifications of spin type, severity, and extent were determined according to predefined criteria. Primary clinical outcomes were divided into safety of treatment, efficacy of treatment, and both. Results Of 587 studies identified, 93 RCT reports (15.8%) met inclusion criteria. Spin was identified in 53 abstracts (57%; 95% CI, 47%-67%) and 62 main texts of published articles (67%; 95% CI, 57%-75%). Ten reports (11%; 95% CI, 6%-19%) had spin in the title, 35 reports (38%; 95% CI, 28%-48%) had spin in the results section, and 50 reports (54%; 95% CI, 44%-64%) had spin in the conclusions. Among the abstracts, spin was observed in 38 results sections (41%; 95% CI, 31%-51%) and 45 conclusions sections (48%; 95% CI, 38%-58%). Conclusions and Relevance This study suggests that in reports of cardiovascular RCTs with statistically nonsignificant primary outcomes, investigators often manipulate the language of the report to detract from the neutral primary outcomes. To best apply evidence to patient care, consumers of cardiovascular research should be aware that peer review does not always preclude the use of misleading language in scientific articles.
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Affiliation(s)
- Muhammad Shahzeb Khan
- Department of Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois
| | - Noman Lateef
- Department of Internal Medicine, Creighton University Medical Center, Omaha, Nebraska
| | - Tariq Jamal Siddiqi
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Karim Abdur Rehman
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Saed Alnaimat
- Department of Internal Medicine, University of Iowa, Iowa City
| | - Safi U. Khan
- Department of Internal Medicine, Robert Packer Hospital, Sayre, Pennsylvania
| | - Haris Riaz
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
| | - M. Hassan Murad
- Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota
| | - John Mandrola
- Department of Cardiovascular Medicine, Baptist Health Louisville, Louisville, Kentucky
| | - Rami Doukky
- Department of Cardiovascular Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois
| | - Richard A. Krasuski
- Department of Cardiovascular Medicine, Duke University Health System, Durham, North Carolina
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