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Rosati P, Porzsolt F, Ricciotti G, Testa G, Inglese R, Giustini F, Fiscarelli E, Zazza M, Carlino C, Balassone V, Fiorito R, D'Amico R. Major discrepancies between what clinical trial registries record and paediatric randomised controlled trials publish. Trials 2016; 17:430. [PMID: 27659549 PMCID: PMC5034459 DOI: 10.1186/s13063-016-1551-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 08/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Whether information from clinical trial registries (CTRs) and published randomised controlled trial (RCTs) differs remains unknown. Knowing more about discrepancies should alert those who rely on RCTs for medical decision-making to possible dissemination or reporting bias. To provide help in critically appraising research relevant for clinical practice we sought possible discrepancies between what CTRs record and paediatric RCTs actually publish. For this purpose, after identifying six reporting domains including funding, design, and outcomes, we collected data from 20 consecutive RCTs published in a widely read peer-reviewed paediatric journal and cross-checked reported features with those in the corresponding CTRs. METHODS We collected data for 20 unselected, consecutive paediatric RCTs published in a widely read peer-reviewed journal from July to November 2013. To assess discrepancies, two reviewers identified and scored six reporting domains: funding and conflict of interests; sample size, inclusion and exclusion criteria or crossover; primary and secondary outcomes, early study completion, and main outcome reporting. After applying the Critical Appraisal Skills Programme (CASP) checklist, five reviewer pairs cross-checked CTRs and matching RCTs, then mapped and coded the reporting domains and scored combined discrepancy as low, medium and high. RESULTS The 20 RCTs were registered in five different CTRs. Even though the 20 RCTs fulfilled the CASP general criteria for assessing internal validity, 19 clinical trials had medium or high combined discrepancy scores for what the 20 RCTs reported and the matched five CTRs stated. All 20 RCTs selectively reported or failed to report main outcomes, 9 had discrepancies in declaring sponsorship, 8 discrepancies in the sample size, 9 failed to respect inclusion or exclusion criteria, 11 downgraded or modified primary outcome or upgraded secondary outcomes, and 13 completed early without justification. The CTRs for seven trials failed to index automatically the URL address or the RCT reference, and for 12 recorded RCT details, but the authors failed to report the results. CONCLUSIONS Major discrepancies between what CTRs record and paediatric RCTs publish raise concern about what clinical trials conclude. Our findings should make clinicians, who rely on RCT results for medical decision-making, aware of dissemination or reporting bias. Trialists need to bring CTR data and reported protocols into line with published data.
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Affiliation(s)
- Paola Rosati
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy. .,Unit of Clinical Epidemiology, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy.
| | - Franz Porzsolt
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy.,Health Care Research, General and Visceral Surgery, University Hospital Ulm, President Institute of Clinical Economics (ICE) e.V., Ulm, 89070, Germany
| | - Gabriella Ricciotti
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy
| | - Giuseppina Testa
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy
| | - Rita Inglese
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy
| | - Ferruccio Giustini
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy
| | - Ersilia Fiscarelli
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy
| | - Marco Zazza
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy
| | - Cecilia Carlino
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy.,Faculty of Medicine and Surgery, La Sapienza University, Rome, 00185, Italy
| | - Valerio Balassone
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy
| | - Roberto Fiorito
- General Surgery and Transplantation Department, University Tor Vergata, Rome, 00133, Italy
| | - Roberto D'Amico
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy.,Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, 41124, Italy
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