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Bashrum BS, Hwang NM, Thompson AA, Mayfield CK, Abu-Zahra M, Bolia IK, Biedermann BM, Petrigliano FA, Liu JN. Evaluation of spin in systematic reviews on the use of tendon transfer for massive irreparable rotator cuff tears. J Shoulder Elbow Surg 2024; 33:e377-e383. [PMID: 38122887 DOI: 10.1016/j.jse.2023.10.036] [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] [Received: 07/18/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE To identify, describe and account for the incidence of spin in systematic reviews and meta-analyses of tendon transfer for the treatment of massive, irreparable rotator cuff tears. The secondary objective was to characterize the studies in which spin was identified and to determine whether identifiable patterns exist among studies with spin. METHODS This study was conducted per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Each abstract was assessed for the presence of the 15 most common types of spin derived from a previously established methodology. General data that were extracted included study title, authors, publication year, journal, level of evidence, study design, funding source, reported adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, preregistration of the study protocol, and methodologic quality per A Measurement Tool to Assess Systematic Reviews Version 2 (AMSTAR 2). RESULTS The search yielded 53 articles, of which 13 were included in the final analysis. Articles were excluded if they were not published in a peer reviewed journal, not written in English, utilized cadaveric or nonhuman models, or lacked an abstract with accessible full text. 53.8% (7/13) of the included studies contained at least 1 type of spin in the abstract. Type 5 spin ("The conclusion claims beneficial effect of the experimental treatment despite a high risk of bias in primary studies") was the most common, appearing in 23.1% (3/13) of included abstracts. Nine of the spin categories did not appear in any of the included abstracts. A lower AMSTAR 2 score was significantly associated with the presence of spin in the abstract (P < .006). CONCLUSION Spin is highly prevalent in the abstracts of systematic reviews and meta-analyses concerning tendon transfer for massive rotator cuff tears. A lower overall AMSTAR 2 rating was associated with a higher incidence of spin. Future studies should continue to explore the prevalence of spin in orthopedic literature and identify any factors that may contribute to its presence.
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Affiliation(s)
- Bryan S Bashrum
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA
| | - N Mina Hwang
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA
| | - Ashley A Thompson
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA
| | - Cory K Mayfield
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA
| | - Maya Abu-Zahra
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA
| | - Ioanna K Bolia
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA
| | - Brett M Biedermann
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA
| | - Frank A Petrigliano
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA
| | - Joseph N Liu
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA.
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Shirafkan H, Moher D, Mirabi P. The reporting quality and spin of randomized controlled trials of endometriosis pain: Methodological study based on CONSORT extension on abstracts. PLoS One 2024; 19:e0302108. [PMID: 38696383 PMCID: PMC11065215 DOI: 10.1371/journal.pone.0302108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 03/27/2024] [Indexed: 05/04/2024] Open
Abstract
OBJECTIVE To assess the reporting quality of published RCT abstracts regarding patients with endometriosis pelvic pain and investigate the prevalence and characteristics of spin in these abstracts. METHODS PubMed and Scopus were searched for RCT abstracts addressing endometriosis pelvic pain published from January 1st, 2010 to December 1st, 2023.The reporting quality of RCT abstracts was assessed using the CONSORT statement for abstracts. Additionally, spin was evaluated in the results and conclusions section of the abstracts, defined as the misleading reporting of study findings to emphasize the perceived benefits of an intervention or to confound readers from statistically non-significant results. Assessing factors affecting the reporting quality and spin existence, linear and logistic regression was used, respectively. RESULTS A total of 47 RCT abstracts were included. Out of 16 checklist items, only three items including objective, intervention and conclusions were sufficiently reported in the most abstracts (more than 95%), and none of the abstracts presented precise data as required by the CONSORT-A guidelines. In the reporting quality of material and method section, trial design, type of randomization, the generation of random allocation sequences, the allocation concealment and blinding were most items identified that were suboptimal. The total score for the quality varied between 5 and 15 (mean: 9.59, SD: 3.03, median: 9, IQR: 5). Word count (beta = 0.015, p-value = 0.005) and publishing in open-accessed journals (beta = 2.023, p-value = 0.023) were the significant factors that affecting the reporting quality. Evaluating spin within each included paper, we found that 18 (51.43%) papers had statistically non-significant results. From these studies, 12 (66.66%) had spin in both results and conclusion sections. Furthermore, the spin intensity increased during 2010-2023 and 38.29% of abstracts had spin in both results and conclusion sections. CONCLUSION Overall poor adherence to CONSORT-A was observed, with spin detected in several RCTs featuring non-significant primary endpoints in obstetrics and gynecology literature.
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Affiliation(s)
- Hoda Shirafkan
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - David Moher
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Parvaneh Mirabi
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Sinopoulou V, Gordon M, Moran GW, Egiz AMAM, Phlananthachai S, Rane A, Al-Tameemi AHA. Prepublication abstract-only reports compared with full-text manuscripts for randomised controlled trials in inflammatory bowel disease: a systematic review. BMJ Open Gastroenterol 2024; 11:e001334. [PMID: 38453251 PMCID: PMC10921483 DOI: 10.1136/bmjgast-2023-001334] [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] [Received: 12/22/2023] [Accepted: 02/16/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION Randomised controlled trials (RCTs) of key therapies in inflammatory bowel disease (IBD) are often presented and available as abstracts for significant periods of time prior to full publication, often being employed to make strategic and clinical prescribing decisions. We compared the concordance of prepublication abstract-only reports and their respective full-text manuscripts. METHODS Pairs of full-text manuscripts and their respective prepublication abstract-only reports for the same RCT outcomes, at the same time point of analysis were included. The RCTs were on treatments for IBD with full-text manuscripts published between 2010 and 2023. RESULTS We found 77 pairs of full-text manuscripts and their prepublication abstract-only reports. There were significant mismatches in the reporting of stated planned outcomes (65/77 matched, p<0.001) and primary outcomes reported in their results sections (67/77, p<0.001); trial registrations (34/65, p<0.001); the number of randomised participants (49/77, p=0.18); participants reaching end of study (21/71, p<0.001) and primary outcome data (40/73, p<0.001). Authors conclusions matched (75/77, p=0.157). Authors did not provide explicit or implied justifications for the absence or non-concordance for any of the above items. CONCLUSIONS Abstract-only reports have consistent issues with both limited reporting of key information and significant differences in data when compared with their later full-text publications. These are not related to further recruitment of patients or word count limitations and are never explained. As abstracts are often used in guidelines, reviews and stakeholder decision-making on prescribing, caution in their use is strongly suggested. Further work is needed to enhance minimum reporting standards in abstract-only works and ensure consistency with final published papers.
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Affiliation(s)
| | - Morris Gordon
- BEST Unit, University of Central Lancashire, Preston, UK
| | | | | | | | - Aditi Rane
- University of Central Lancashire, Preston, UK
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Hwang NM, Samuel JT, Thompson AA, Mayfield CK, Abu-Zahra MS, Kotlier JL, Petrigliano FA, Liu JN. Reporting Bias in the Form of Positive Spin Is Highly Prevalent in Abstracts of Systematic Reviews on Primary Repair of the Anterior Cruciate Ligament. Arthroscopy 2024; 40:2112-2120. [PMID: 38171422 DOI: 10.1016/j.arthro.2023.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/04/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE To analyze reporting bias in the form of spin present in systematic reviews and meta-analyses on the topic of primary anterior cruciate ligament (ACL) repair. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed throughout this study. Peer-reviewed systematic reviews were collected from 3 databases (PubMed, Scopus, and SPORTDiscus), and their abstracts were assessed for the 15 most common types of spin. Articles were excluded if they were not published in English, had no evidence, were retracted, were published without an abstract, did not have full text available, or included cadaveric or nonhuman subjects. Full text quality was assessed using AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews Version 2). Fisher exact tests were used to examine associations between the different types of spin and other study characteristics such as AMSTAR 2 confidence rating, study design, and level of evidence. RESULTS Spin was present in the abstracts of 13 of 15 articles (86.7%). There were significant associations between PRISMA adherence and lower incidences of spin types 3, 6, and 8 (P = .029 for each). A critically low AMSTAR 2 confidence rating was significantly associated with an increased incidence of spin type 9 (P = .01), and a higher AMSTAR 2 score was significantly associated with decreased spin type 4 and type 5 (P = .039 and P = .048, respectively). A more recent year of publication was correlated with a lower incidence of spin type 14 (P = .044). CONCLUSIONS Spin is present in most systematic reviews and meta-analyses regarding primary repair of the ACL, with two-thirds of abstracts spinning evidence in favor of ACL repair. Standardized guidelines including the PRISMA guidelines and the AMSTAR 2 assessment tool were negatively correlated with spin. More recently published articles were found to contain significantly less spin, as were articles published in journals with higher Clarivate Impact Factors and Scopus CiteScores. LEVEL OF EVIDENCE Level V, systematic review of Level III through V studies.
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Affiliation(s)
- N Mina Hwang
- University of Southern California Epstein Family Center for Sports Medicine at Keck Medicine of University of Southern California, Los Angeles, California, U.S.A
| | - Justin T Samuel
- City University of New York School of Medicine, New York, New York, U.S.A
| | - Ashley A Thompson
- University of Southern California Epstein Family Center for Sports Medicine at Keck Medicine of University of Southern California, Los Angeles, California, U.S.A
| | - Cory K Mayfield
- University of Southern California Epstein Family Center for Sports Medicine at Keck Medicine of University of Southern California, Los Angeles, California, U.S.A
| | - Maya S Abu-Zahra
- University of Southern California Epstein Family Center for Sports Medicine at Keck Medicine of University of Southern California, Los Angeles, California, U.S.A
| | - Jacob L Kotlier
- University of Southern California Epstein Family Center for Sports Medicine at Keck Medicine of University of Southern California, Los Angeles, California, U.S.A
| | - Frank A Petrigliano
- University of Southern California Epstein Family Center for Sports Medicine at Keck Medicine of University of Southern California, Los Angeles, California, U.S.A..
| | - Joseph N Liu
- University of Southern California Epstein Family Center for Sports Medicine at Keck Medicine of University of Southern California, Los Angeles, California, U.S.A
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He Y, Zhang R, Shan W, Yin Y, Zhang X, Zhang Y, Wang X. Evaluating the completeness of the reporting of abstracts since the publication of the CONSORT extension for abstracts: an evaluation of randomized controlled trial in ten nursing journals. Trials 2023; 24:423. [PMID: 37349754 DOI: 10.1186/s13063-023-07419-5] [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: 12/06/2022] [Accepted: 05/27/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND As a practice-oriented discipline, strict adherence to reporting guidelines is particularly important in randomized controlled trial (RCT) abstracts of the nursing area. However, whether abstract reports after 2010 have complied with the Consolidated Standards of Reporting Trials for Abstracts (CONSORT-A) guideline is unclear. This study aimed to evaluate whether the publication of CONSORT-A has improved abstract reporting in nursing and explores the factors associated with better adherence to the guidelines. METHODS We searched the Web of Science for 200 RCTs randomly selected from ten nursing journals. We used a data extraction form based on CONSORT-A, including 16 items, to analyze the reporting adherence to the guidelines, and the reporting rate of each item and the total score for each abstract were used to indicate adherence and overall quality score (OQS, range 0-16). A comparison of the total mean score between the two periods was made, and affecting factors were analyzed. RESULTS In the studies we included, 48 abstracts were published pre-CONSORT-A whereas 152 post-CONSORT-A. The overall mean score for reporting adherence to 16 items was 7.41 ± 2.78 and 9.16 ± 2.76 for pre- and post-CONSORT-A, respectively (total score: 16). The most poorly reported items are "harms (0%)," "outcomes in method (8.5%)," "randomization (25%)," and "blinding (6.5%)." Items including the year of publication, impact factor, multiple center trial, word count, and structured abstract are significantly associated with higher adherence. CONCLUSIONS The adherence to abstract reporting in nursing literature has improved since the CONSORT-A era, but the overall completeness of RCT abstracts remained low. A joint effort by authors, editors, and journals is necessary to improve reporting quality of RCT abstracts.
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Affiliation(s)
- Yan He
- Health Human Resources Service Center, Health Commission of Gansu Province, Lanzhou, Gansu, 730000, China
| | - Rong Zhang
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, 730000, Gansu, China
| | - Wenjing Shan
- Oncology Department, Nursing, Xi'an International Medical Center, Xi'an, 710000, Shaanxi, China
| | - Yuhuan Yin
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, 730000, Gansu, China
| | - Xiaoli Zhang
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, 730000, Gansu, China
| | - Yiyin Zhang
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, 730000, Gansu, China
| | - Xiaoping Wang
- Urological Examination Room, Gansu Provincial Hospital, Lanzhou, 730000, Gansu, China.
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Modi J, Magee T, Rucker B, Flores H, Wise A, Kee M, Garrett M, Roberts W, Vassar M. An analysis of harms reporting in systematic reviews regarding ketorolac for management of perioperative pain. Br J Anaesth 2022; 129:767-775. [PMID: 36175184 DOI: 10.1016/j.bja.2022.08.007] [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: 06/27/2022] [Revised: 08/01/2022] [Accepted: 08/10/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Owing to the frequent perioperative use of ketorolac tromethamine and its ability to minimise postoperative opioid requirements, it is important to continually reassess harms associated with its use. Our primary objective was to investigate the extent of harms reporting in systematic reviews (SRs) on ketorolac for perioperative pain. METHODS In May 2022, we conducted a search of major databases, MEDLINE (PubMed and Ovid), Embase, Epistemonikos, and the Cochrane Database of Systematic Reviews to identify eligible SRs on ketorolac for perioperative pain. Screening and data extraction were performed in masked, duplicate fashion. A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) was used to appraise the methodological quality of included SRs. Corrected covered area (CCA) was calculated to determine overlap of primary studies between SR dyads. RESULTS A total of 28 SRs evaluating 630 primary studies met the inclusion criteria. Seven SRs (7/28, 25%) reported no harms and 17 SRs (17/28, 60.7%) reported ≤50% of harms items. A significant association was found between completeness of harms reporting and whether harms were specified as a primary outcome (P<0.001). No other associations were statistically significant. Regarding methodological quality, 22 SRs were appraised as 'critically low' (22/28, 78.6%), 5 as 'low' (5/28, 17.9%), and 1 as 'high' (1/28, 3.6%). One SR dyad had a CCA >50% but neither reported harms. CONCLUSIONS The extent of harms reporting in systematic reviews was inadequate. Given the importance that systematic reviews have on guiding perioperative decision-making, it is essential to improve the completeness of harms reporting.
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Affiliation(s)
- Jay Modi
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA.
| | - Trevor Magee
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Brayden Rucker
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Holly Flores
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Audrey Wise
- 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
| | - Morgan Garrett
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Will Roberts
- Department of Anesthesiology, Oklahoma State University Medical Center, 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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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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Kim MS, Hasan LK, Fathi A, Hasan SK, Haratian A, Bolia IK, Petrigliano FA, Weber AE, Gamradt SC, Liu JN. Evaluation of spin in systematic reviews and meta-analyses of superior capsular reconstruction. J Shoulder Elbow Surg 2022; 31:1743-1750. [PMID: 35472573 DOI: 10.1016/j.jse.2022.03.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Small, preliminary studies and the systematic reviews on superior capsular reconstruction (SCR) that collate data are at increased risk spin. This study's primary objective was to identify, describe, and account for the incidence of spin in systematic reviews of SCR. This study's secondary objective was to characterize the studies in which spin was identified to determine whether identifiable patterns of characteristics exist among studies with spin. METHODS This study was conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using a predetermined protocol. A search was conducted on the PubMed and Embase databases for systematic reviews and meta-analyses on SCR. Screening and data extraction were conducted independently by 2 authors. Each included study's abstract was assessed for the presence of the 15 most common types of spin, with full texts reviewed during cases of disagreement or for clarification. General data that were extracted included study title, authors, publication year, journal, level of evidence, study design, funding source, reported adherence to PRISMA guidelines, preregistration of the study protocol, and primary and secondary outcome measures. Full texts were used in the assessment of study quality per AMSTAR 2. RESULTS We identified 53 studies during our search, of which 17 met the inclusion criteria. At least 1 form of spin was observed in all 17 studies. The most common types of spin were type 5 ("The conclusion claims the beneficial effect of the experimental treatment despite a high risk of bias in primary studies") and type 9 ("Conclusion claims the beneficial effect of the experimental treatment despite reporting bias"), both of which were observed in 11 studies (11 of 17, 65%). A statistically significant association between lower level of evidence and type 5 ("The conclusion claims the beneficial effect of the experimental treatment despite a high risk of bias in primary studies") was observed (P = .0175). A statistically significant association was also found between more recent year of publication and the spin category misleading interpretation (P = .0398), and between lower AMSTAR 2 score and type 13 ("Failure to specify the direction of the effect when it favors the control intervention") (P = .0260). No other statistical associations between other study characteristics were observed. CONCLUSION Spin is highly prevalent in abstracts of SCR systematic reviews and meta-analyses. An association was found between the presence of spin and lower level of evidence, year of publication, and AMSTAR 2 ratings.
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Affiliation(s)
- Michael S Kim
- USC Epstein Family Center for Sports Medicine, Department of Orthopaedic Surgery, Keck Medicine of USC, Los Angeles, CA, USA
| | - Laith K Hasan
- USC Epstein Family Center for Sports Medicine, Department of Orthopaedic Surgery, Keck Medicine of USC, Los Angeles, CA, USA
| | - Amir Fathi
- USC Epstein Family Center for Sports Medicine, Department of Orthopaedic Surgery, Keck Medicine of USC, Los Angeles, CA, USA
| | - Shurooq K Hasan
- Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, MD, USA
| | - Aryan Haratian
- USC Epstein Family Center for Sports Medicine, Department of Orthopaedic Surgery, Keck Medicine of USC, Los Angeles, CA, USA
| | - Ioanna K Bolia
- USC Epstein Family Center for Sports Medicine, Department of Orthopaedic Surgery, Keck Medicine of USC, Los Angeles, CA, USA
| | - Frank A Petrigliano
- USC Epstein Family Center for Sports Medicine, Department of Orthopaedic Surgery, Keck Medicine of USC, Los Angeles, CA, USA
| | - Alexander E Weber
- USC Epstein Family Center for Sports Medicine, Department of Orthopaedic Surgery, Keck Medicine of USC, Los Angeles, CA, USA
| | - Seth C Gamradt
- USC Epstein Family Center for Sports Medicine, Department of Orthopaedic Surgery, Keck Medicine of USC, Los Angeles, CA, USA
| | - Joseph N Liu
- USC Epstein Family Center for Sports Medicine, Department of Orthopaedic Surgery, Keck Medicine of USC, Los Angeles, CA, USA.
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Nowlin R, Wirtz A, Wenger D, Ottwell R, Cook C, Arthur W, Sallee B, Levin J, Hartwell M, Wright D, Sealey M, Zhu L, Vassar M. Spin in Abstracts of Systematic Reviews and Meta-analyses of Melanoma Therapies: Cross-sectional Analysis. JMIR DERMATOLOGY 2022; 5:e33996. [PMID: 37632865 PMCID: PMC10334896 DOI: 10.2196/33996] [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: 10/05/2021] [Revised: 01/01/2022] [Accepted: 01/03/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Spin is defined as the misrepresentation of a study's results, which may lead to misperceptions or misinterpretation of the findings. Spin has previously been found in randomized controlled trials and systematic reviews of acne vulgaris treatments and treatments of various nondermatological conditions. OBJECTIVE The purpose of this study was to quantify the presence of spin in abstracts of systematic reviews and meta-analyses of melanoma therapies and identify any related secondary characteristics of these articles. METHODS We used a cross-sectional approach on June 2, 2020, to search the MEDLINE and Embase databases from their inception. To meet inclusion criteria, a study was required to be a systematic review or meta-analysis pertaining to the treatment of melanoma in human subjects, and reported in English. We used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) definition of systematic reviews and meta-analyses. Data were extracted in a masked, duplicate fashion. We conducted a powered bivariate linear regression and calculated odds ratios for each study characteristic. RESULTS A total of 200 systematic reviews met the inclusion criteria. We identified spin in 38% (n=76) of the abstracts. The most common type of spin found was type 3 (selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention), occurring 40 times; the least common was type 2 (title claims or suggests a beneficial effect of the experimental intervention not supported by the findings), which was not present in any included abstracts. We found that abstracts pertaining to pharmacologic interventions were 3.84 times more likely to contain spin. The likelihood of an article containing spin has decreased annually (adjusted odds ratio 0.91, 95% CI 0.84-0.99). No significant correlation between funding source or other study characteristics and the presence of spin was identified. CONCLUSIONS We have found that spin is fairly common in the abstracts of systematic reviews of melanoma treatments, but the prevalence of spin in these abstracts has been declining from 1992-2020.
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Affiliation(s)
- Ross Nowlin
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Alexis Wirtz
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - David Wenger
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Ryan Ottwell
- Department of Internal Medicine, University of Oklahoma College of Community Medicine, Tulsa, OK, United States
- Department of Dermatology, St. Joseph Mercy Hospital, Ann Arbor, MI, United States
| | - Courtney Cook
- Department of Dermatology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Wade Arthur
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Fayetteville, AR, United States
| | - Brigitte Sallee
- Department of Dermatology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Jarad Levin
- Department of Dermatology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Drew Wright
- Samuel J. Wood Library and C.V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, NY, United States
| | - Meghan Sealey
- Department of Statistics, Oklahoma State University, Stillwater, OK, United States
| | - Lan Zhu
- Department of Statistics, Oklahoma State University, Stillwater, OK, United States
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
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10
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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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11
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Yin Y, Gao J, Zhang Y, Zhang X, Ye J, Zhang J. Evaluation of reporting quality of abstracts of randomized controlled trials regarding patients with COVID-19 using the CONSORT statement for abstracts. Int J Infect Dis 2022; 116:122-129. [PMID: 34999245 PMCID: PMC8736283 DOI: 10.1016/j.ijid.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 12/13/2021] [Accepted: 01/03/2022] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To evaluate the reporting quality of randomized controlled trial (RCT) abstracts regarding patients with coronavirus disease 2019 (COVID-19) and to analyze the factors influencing the quality. METHODS The PubMed, Embase, Web of Science, and Cochrane Library databases were searched to collect RCTs on patients with COVID-19. The retrieval time was from inception to December 1, 2020. The CONSORT statement for abstracts was used to evaluate the reporting quality of RCT abstracts. RESULTS A total of 53 RCT abstracts were included. The CONSORT statement for abstracts showed that the average reporting rate of all items was 50.2%. The items with a lower reporting quality were mainly the trial design and the details of randomization and blinding (<10%). The mean overall adherence score across all studies was 8.68 ± 2.69 (range 4-13.5). Multivariate linear regression analysis showed that the higher reporting scores were associated with higher journal impact factor (P < 0.01), international collaboration (P = 0.04), and structured abstract format (P < 0.01). CONCLUSIONS Although many RCTs on patients with COVID-19 have been published in different journals, the overall quality of reporting in the included RCT abstracts was suboptimal, thus diminishing their potential usefulness, and this may mislead clinical decision-making. In order to improve the reporting quality, it is necessary to promote and actively apply the CONSORT statement for abstracts.
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Affiliation(s)
- Yuhuan Yin
- Clinical Educational Department, Gansu Provincial Hospital, Lanzhou, Gansu, China, 730000; School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China, 730000
| | - Jiangxia Gao
- Department of Otolaryngology, Gansu Provincial Hospital, Lanzhou, Gansu, China, 730000
| | - Yiyin Zhang
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China, 730000
| | - Xiaoli Zhang
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China, 730000
| | - Jianying Ye
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China, 730000
| | - Juxia Zhang
- Clinical Educational Department, Gansu Provincial Hospital, Lanzhou, Gansu, China, 730000.
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12
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Lee CY, Jenq CC, Chandratilake M, Chen J, Chen MM, Nishigori H, Wajid G, Yang PH, Yusoff MSB, Monrouxe L. A scoping review of clinical reasoning research with Asian healthcare professionals. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:1555-1579. [PMID: 34254202 PMCID: PMC8610955 DOI: 10.1007/s10459-021-10060-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 06/26/2021] [Indexed: 05/05/2023]
Abstract
Clinical reasoning is the thought process that guides practice. Although a plethora of clinical reasoning studies in healthcare professionals exists, the majority appear to originate from Western cultures. A scoping review was undertaken to examine clinical reasoning related research across Asian cultures. PubMed, SciVerse Scopus, Web of Science and Airiti Library databases were searched. Inclusion criteria included full-text articles published in Asian countries (2007 to 2019). Search terms included clinical reasoning, thinking process, differential diagnosis, decision making, problem-based learning, critical thinking, healthcare profession, institution, medical students and nursing students. After applying exclusion criteria, n = 240 were included in the review. The number of publications increased in 2012 (from 5%, n = 13 in 2011 to 9%, n = 22) with a steady increase onwards to 12% (n = 29) in 2016. South Korea published the most articles (19%, n = 46) followed by Iran (17%, n = 41). Nurse Education Today published 11% of the articles (n = 26), followed by BMC Medical Education (5%, n = 13). Nursing and Medical students account for the largest population groups studied. Analysis of the articles resulted in seven themes: Evaluation of existing courses (30%, n = 73) being the most frequently identified theme. Only seven comparative articles showed cultural implications, but none provided direct evidence of the impact of culture on clinical reasoning. We illuminate the potential necessity of further research in clinical reasoning, specifically with a focus on how clinical reasoning is affected by national culture. A better understanding of current clinical reasoning research in Asian cultures may assist curricula developers in establishing a culturally appropriate learning environment.
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Affiliation(s)
- Ching-Yi Lee
- Department of Neurosurgery, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Medical Education Research Center, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chang-Chyi Jenq
- Medical Education Research Center, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Department of Nephrology, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Madawa Chandratilake
- Department of Medical Education, Faculty of Medicine, University of Kelaniya, Kelaniya, Taiwan
| | - Julie Chen
- Department of Family Medicine and Primary Care (FMPC) and Bau Institute of Medical and Health Sciences Education (BIMHSE), The University of Hong Kong, Hong Kong, China
| | - Mi-Mi Chen
- Medical Education Research Center, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hiroshi Nishigori
- Center for Medical Education, Graduate School of Medicine, Nagoya University, Nagoya, China
| | - Gohar Wajid
- World Health Organization, Geneva, Switzerland
| | - Pai-Hsuang Yang
- Medical Education Research Center, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | | | - Lynn Monrouxe
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Level 7, Susan Wakil Health Building D18, Sydney, NSW, 2006, Australia.
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13
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Reddy AK, Shepard S, Ottwell R, Thompson J, Price CM, Arthur W, Hanson C, Ebert A, Wright DN, Hartwell M, Vassar M. Over 30% of Systematic Reviews and Meta-analyses Focused on Rotator Cuff Tear Treatments Contained Spin in the Abstract. Arthroscopy 2021; 37:2953-2959. [PMID: 33887409 DOI: 10.1016/j.arthro.2021.03.066] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 03/26/2021] [Accepted: 03/29/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this study is to determine the prevalence of spin in the abstracts of systematic reviews and meta-analyses on treatments for rotator cuff tears and whether various study and publishing journal characteristics were associated with the presence of spin. METHODS A search strategy was developed for Ovid MEDLINE and Ovid Embase to retrieve systematic reviews focused on treatments for rotator cuff tears. For an article to be included, it must meet the following criteria: (1) the article must be a systematic review with or without a meta-analysis, (2) the article must pertain to the treatment of rotator cuff tears, (3) the article must only contain human subjects, and (4) the article must be accessible in English. Systematic reviews were analyzed for spin using a previously developed classification scheme in a masked, duplicate manner. Binary logistic regression was used to examine independent associations via unadjusted odds ratios and 95% confidence intervals between the presence of spin and study characteristics. RESULTS Search queries returned 932 articles, of which 121 systematic reviews and meta-analyses were eligible. A total of 36.4% (44/121) of systematic reviews contained spin. Among the general characteristics evaluated, there were no correlations with spin. CONCLUSIONS Spin was present in more than one-third of systematic reviews and meta-analyses covering rotator cuff tear treatments. Spin was not associated with any general study or journal characteristics, which indicates that clinicians must be aware of the potential presence of spin in all such abstracts. CLINICAL RELEVANCE Clinicians rely on systematic reviews and meta-analyses, especially abstracts of these articles, to provide succinct guidance on best practices in patient care. The presence of spin could adversely affect patient care; thus, steps should be taken to improve the reporting quality of abstracts on rotator cuff tear treatment.
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Affiliation(s)
- Arjun K Reddy
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A..
| | - Samuel Shepard
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A
| | - Ryan Ottwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A
| | - Jay Thompson
- Department of Orthopedic Surgery, Oklahoma State University Medical Center, Tulsa, Oklahoma, U.S.A
| | - Christopher M Price
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A
| | - Wade Arthur
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A
| | - Chad Hanson
- Department of Orthopedic Surgery, Oklahoma State University Medical Center, Tulsa, Oklahoma, U.S.A
| | - Andrew Ebert
- Department of Orthopedic Surgery, Oklahoma State University Medical Center, Tulsa, Oklahoma, U.S.A
| | - Drew N Wright
- Samuel J. Wood Library & C. V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, New York, U.S.A
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A.; Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A.; Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A
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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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15
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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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16
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Cole WT, Wittl P, Arthur W, Ottwell R, Greiner B, Koshy G, Chronister J, Hartwell M, Staheli J, Wright DN, Sealey M, Zhu L, Vassar M. Spin in the abstracts of systematic reviews and metaanalyses focused on percutaneous coronary intervention. J Osteopath Med 2021; 121:723-731. [PMID: 34213843 DOI: 10.1515/jom-2021-0085] [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] [Received: 03/12/2021] [Accepted: 05/25/2021] [Indexed: 01/10/2023]
Abstract
CONTEXT "Spin" is a form of bias that involves highlighting study results in a way that presents the conclusions about benefit or efficacy beyond the scope of the data. Spin in the abstract of published studies has the potential to affect patient care, making investigations about its presence and prevalence important for readers. OBJECTIVES To evaluate the most severe types of spin in the abstracts of systematic reviews and metaanalyses focused on percutaneous coronary intervention. METHODS Using a cross sectional study design, the authors searched MEDLINE and Embase with the terms "percutaneous coronary intervention," "percutaneous coronary revascularization," "PCI," "systematic review," "meta analysis," and "meta-analysis." To be considered for this study, the article must have (1) focused on PCI; (2) had either a systematic review or metaanalysis study design; (3) been conducted on human subjects; and (4) been available in English. Reviews were excluded if these criteria were not met. Each included article was assessed for the nine most severe types of spin as defined in a previously published article, as well as other study characteristics (type of intervention being compared, date the review was received, adherence of systematic review and/or meta-analysis to Preferred Reporting for Systematic Reviews or Metanalyses (PRISMA) guidelines, requirement of PRISMA guidelines by the publishing journal, the publishing journal's five-year impact factor, and sources of funding). RESULTS Our database search retrieved 7,038 records; 2,190 duplicates were removed. Initial title and abstract screening led to the exclusion of 4,367 records, and an additional 281 records were excluded during full text screening. An arbitrary limit of 200 articles was applied for this analysis; five additional articles were excluded for ineligible study design, so 195 were included in our final analysis. Spin was present in the abstracts of 43 studies from that pool (22.1%). Spin type 3-selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention-occurred most frequently (29; 14.8%). The presence of spin was not associated with any of the extracted study characteristics. CONCLUSIONS Our data showed that spin occurred in more than one in every five systematic reviews or metaanalyses of PCI. Spin has the potential to distort a reader's ability to translate the true findings of a study; therefore, efforts are needed to prevent spin from appearing in article summaries.
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Affiliation(s)
- Wesley Tanner Cole
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Peter Wittl
- 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
| | - Benjamin Greiner
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Gershon Koshy
- Department of Internal Medicine, Oklahoma State University Medical Center, Tulsa, OK, USA
| | - Justin Chronister
- Department of Internal Medicine, Oklahoma State University Medical Center, 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
| | - Jonathan Staheli
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Drew N Wright
- Samuel J. Wood Library & C. V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, NY, USA
| | - Meghan Sealey
- Department of Statistics, Oklahoma State University, Stillwater, OK, USA
| | - Lan Zhu
- Department of Statistics, 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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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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18
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Shepard S, Checketts J, Eash C, Austin J, Arthur W, Wayant C, Johnson M, Norris B, Vassar M. Evaluation of spin in the abstracts of orthopedic trauma literature: A cross-sectional review. Injury 2021; 52:1709-1714. [PMID: 34020782 DOI: 10.1016/j.injury.2021.04.060] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/18/2021] [Accepted: 04/24/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES A cross-sectional analysis of orthopedic trauma randomized controlled trial (RCT) abstracts to assess the frequency and manifestations of spin, the misrepresentation or distortion of research findings, in orthopedic trauma clinical trials. METHODS The top 5 orthopedic trauma journals were searched from January 1, 2012, to December 31, 2017. RCTs with nonsignificant endpoints (p > .05) were analyzed for spin in the abstract. The primary endpoint of our investigation was the frequency and type of spin. The secondary endpoint was to assess whether funding source was associated with the presence of spin. Due to the low reporting of funding sources no statistics were able to be computed for this outcome. RESULTS Our PubMed search yielded 517 articles. Primary screening excluded 303 articles, and full text evaluation excluded an additional 161. Overall, 53 articles were included. Spin was identified in 35 of the 53 (66.0%) abstracts analyzed. Evidence of spin was found in 21 (39.6%) abstract results sections and 22 (41.5%) abstract conclusion sections. Of the 21 RCTs reporting a clinical trial registry, 3 (14.3%) had evidence of selective reporting bias. CONCLUSIONS Orthopedic trauma RCTs from highly ranked journals with nonsignificant endpoints published from 2012 to 2017 frequently have spin in their abstracts. Abstracts with evidence of spin may influence a reader's perception of new drugs or procedures. In orthopedic trauma, the implications of spin may affect the treatment of patients with orthopedic trauma, so efforts to mitigate spin in RCT abstracts must be prioritized.
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Affiliation(s)
- Samuel Shepard
- Oklahoma State University, Center for Health Sciences, 1111 W. 17th St, Tulsa, OK, 74107 USA
| | - Jake Checketts
- Oklahoma State University, Center for Health Sciences, 1111 W. 17th St, Tulsa, OK, 74107 USA
| | - Colin Eash
- Oklahoma State University, Center for Health Sciences, 1111 W. 17th St, Tulsa, OK, 74107 USA
| | - Jennifer Austin
- Oklahoma State University, Center for Health Sciences, 1111 W. 17th St, Tulsa, OK, 74107 USA
| | - Wade Arthur
- Oklahoma State University, Center for Health Sciences, 1111 W. 17th St, Tulsa, OK, 74107 USA
| | - Cole Wayant
- Oklahoma State University, Center for Health Sciences, 1111 W. 17th St, Tulsa, OK, 74107 USA
| | - Mark Johnson
- Oklahoma State University Medical Center - Department of Orthopaedics USA
| | - Brent Norris
- Oklahoma State University Medical Center - Department of Orthopaedics USA; Orthopaedic & Trauma Services of Oklahoma USA
| | - Matt Vassar
- Oklahoma State University, Center for Health Sciences, 1111 W. 17th St, Tulsa, OK, 74107 USA
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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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Romli MH, Cheema MS, Mehat MZ, Md Hashim NF, Abdul Hamid H. Exploring the effectiveness of technology-based learning on the educational outcomes of undergraduate healthcare students: an overview of systematic reviews protocol. BMJ Open 2020; 10:e041153. [PMID: 33234650 PMCID: PMC7684815 DOI: 10.1136/bmjopen-2020-041153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/03/2020] [Accepted: 10/30/2020] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Rapid technology development due to the introduction of Industrial Revolution 4.0 and Internet of Things has created a demand and gradual transition from traditional teaching and learning to technology-based learning in higher education, including healthcare education. The COVID-19 pandemic has accelerated this process, with educators now required to quickly adapt to and adopt such changes. The abundance of available systematic reviews has made the effectiveness of such approaches ambiguous especially in healthcare education. Therefore, a protocol of the overview of systematic reviews (OoSR) is planned to extrapolate the effectiveness of technology-based learning in undergraduate healthcare education. METHODS AND ANALYSIS Scopus, CINAHL, Academic Search Complete, Cochrane Library, MEDLINE and Psychology and Behavioral Sciences Collection databases were selected. Screening was conducted independently by at least two authors and the decision for inclusion was done through discussion or involvement of an arbiter against a predetermined criteria. Included articles will be evaluated for quality using A MeaSurement Tool to Assess systematic Reviews and Risk of Bias in Systematic Review tools, while primary systematic review articles will be cross-checked and reported for any overlapping using the 'corrected covered area' method. Only narrative synthesis will be employed according to the predefined themes into two major dimensions-theory and knowledge generation (focusing on cognitive taxonomy due to its ability to be generalised across disciplines), and clinical-based competence (focusing on psychomotor and affective taxonomies due to discipline-specific influence). The type of technology used will be identified and extracted. ETHICS AND DISSEMINATION The OoSR involves analysis of secondary data from published literature, thus ethical approval is not required. The findings will provide a valuable insight for policymakers, stakeholders, and researchers in terms of technology-based learning implementation and gaps identification. The findings will be published in several reports due to the extensiveness of the topic and will be disseminated through peer-reviewed publications and conferences. PROSPERO REGISTRATION NUMBER CRD4202017974.
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Affiliation(s)
- Muhammad Hibatullah Romli
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
- Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
| | - Manraj Singh Cheema
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
| | - Muhammad Zulfadli Mehat
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
| | - Nur Fariesha Md Hashim
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
| | - Hafizah Abdul Hamid
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
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21
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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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22
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Roberts WB, Cooper CM, Khattab M, Neff P, Wildes D, Wayant C, Vassar M. Evaluation of "Spin" in the Abstracts of Randomized Controlled Trial Reports in Cardiology. J Osteopath Med 2020; 120:732-739. [PMID: 32961554 DOI: 10.7556/jaoa.2020.133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
CONTEXT The misrepresentation and distortion of research findings, known as "spin," has been shown to affect clinical decision making. Spin has been found in randomized controlled trials (RCTs) published in various fields of medicine. OBJECTIVE To evaluate the abstracts of RCTs found in the cardiology literature for spin. METHODS The authors searched PubMed using a specific string of keywords to identify previously published articles documenting RCTs of cardiovascular treatments in humans. To be included, a cardiology trial had to randomize humans to an intervention, statistically compare 2 or more groups, and have a nonsignificant primary endpoint. Records were excluded if they did not meet these criteria. Data extraction was double-blinded and done using a pilot-tested Google Form. Items extracted from each trial included the title, journal, funding source, comparator arm, primary endpoint, statistical analysis of the primary endpoint, secondary endpoints, statistical analysis of secondary endpoints, and trial registration number (if reported). The 2 authors who screened records for inclusion were then asked whether spin was present in the abstract of the randomized trial. Spin in the title, abstract results, abstract conclusions, and selection of reported endpoints were considered. RESULTS Of the 651 PubMed citations retrieved by our search string, 194 RCTs with a clearly defined primary endpoint were identified. Of these 194 RCTs, 66 trials contained nonsignificant primary endpoints and were evaluated for spin. Of these trials, spin was identified in 18 of the 66 abstracts (27.3%). CONCLUSIONS Spin was present in our sample of cardiology RCTs. Spin may influence clinical decision making by creating false impressions of the true validity of a drug or intervention.
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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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Ekong I, Esan O, Chukwu E, Kawu M. eHealth Adoption on Patients' Pre-Consultation Waiting Time. INTERNATIONAL JOURNAL OF INFORMATION TECHNOLOGY AND WEB ENGINEERING 2020. [DOI: 10.4018/ijitwe.2020040105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Evidence to support widespread adoption of digital health tools in hospitals is still lacking, and proof of their acceptance within the health system is largely missing. This study compared patient's pre-consultation waiting time (time spent at the pay-point, registration, and nursing-station prior to consultation) in two hospitals, one using paper based registration system and the other using an electronic (eHealth) registration system. Structured questionnaires were administered to both patients and health workers to determine and compare factors affecting care delivery wait times and how the use or non-use of eHealth in patient's registration process influence it. In addition, patient wait times were measured in both hospitals at these care points. Overall aggregate waiting time was observed to be longer in Maitama District Hospital (MDH) using the electronic hospital information system. This variance was found to be statistically significant as can be seen (t= 58.405, p=0.024). Inspite of this, wait times at registration and pay-point was significantly lower for MDH.
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Affiliation(s)
- Iniobong Ekong
- Department of Health Planning, Research and Statistics, FCT Health and Human Services Secretariat, Abuja, Nigeria
| | - Oluwaseun Esan
- Department of Community Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Emeka Chukwu
- Department of Computer Information System, University of Malta, Msida, Malta
| | - Mohammed Kawu
- Department of Health Planning,Research and Statistics, FCT Health and Human Services Secretariat, Abuja, Nigeria
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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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Arthur W, Zaaza Z, Checketts JX, Johnson AL, Middlemist K, Basener C, Jellison S, Wayant C, Vassar M. Analyzing Spin in Abstracts of Orthopaedic Randomized Controlled Trials with Statistically Insignificant Primary Endpoints. Arthroscopy 2020; 36:1443-1450.e1. [PMID: 31954806 DOI: 10.1016/j.arthro.2019.12.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 12/12/2019] [Accepted: 12/13/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE Our primary aim of our study is to evaluate the prevalence of spin among abstracts in orthopaedic randomized controlled trials (RCTs) with nonsignificant primary endpoints. METHODS This study was conducted in accordance with a previously written protocol publicly available via the Open Science Framework. PubMed (which includes Medline) was searched for RCTs in orthopaedic surgery. The articles that were identified were then uploaded to Rayyan, and the abstracts were screened for inclusion. To be included, a trial had to have randomized the patients for intervention, statistically compare multiple groups, and had a primary endpoint that was not significant. Odds ratios and summary statistics (frequencies and proportions) were then calculated for spin in the abstracts. RESULTS Of the 780 articles retrieved from our search string, 250 articles met the inclusion criteria. Analysis resulted in 112/250 (44.80%; [95% CI, 38.64-50.96]) RCTs that containing spin within the abstract. Of the 112 RCTs, 52 (46.43%; [95% CI, 37.19-55.66]) had spin in the results, and 89 (79.46%; [95% CI, 71.98-86.95]) had spin in the conclusion of the abstract. The Journal of Bone and Joint Surgery was found to have the highest prevalence of spin (21/37, 56.76% [95% CI, 40.79%-72.72%]) while Arthroscopy: The Journal of Arthroscopic & Related Surgery had the lowest prevalence of spin (5/15, 33.33% [95% CI, 9.48%-57.19%]). No correlation was found between industry funding and increased odds of spin in the abstract (uOR, 1.10; 95% CI, 0.45-2.63). Discrepancies for our primary endpoint, prevalence of spin among abstracts, were analyzed with Gwet's AC1 inter-rater statistic and found to be 81% [95% CI, 0.75-0.87]. CONCLUSION Spin was found in 44.8% of the abstracts within our sample of orthopaedic RCTs. Nonsignificant primary data were often represented to seem significant, many orthopaedic RCTs did not indicate primary endpoints, and orthopaedic RCTs infrequently reported trial registration.
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Affiliation(s)
- Wade Arthur
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A
| | - Zachariah Zaaza
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A
| | - Jake X Checketts
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A
| | - Austin L Johnson
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A..
| | - Kevin Middlemist
- Oklahoma State University Medical Center, Tulsa, Oklahoma, U.S.A
| | - Clint Basener
- Oklahoma State University Medical Center, Tulsa, Oklahoma, U.S.A
| | - Sam Jellison
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A
| | - Cole Wayant
- 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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Wayant C, Margalski D, Vaughn K, Vassar M. Evaluation of spin in oncology clinical trials. Crit Rev Oncol Hematol 2019; 144:102821. [DOI: 10.1016/j.critrevonc.2019.102821] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 10/08/2019] [Accepted: 10/14/2019] [Indexed: 11/30/2022] Open
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Checketts JX, Riddle J, Zaaza Z, Boose MA, Whitener JH, Vassar MB. An Evaluation of Spin in Lower Extremity Joint Trials. J Arthroplasty 2019; 34:1008-1012. [PMID: 30733070 DOI: 10.1016/j.arth.2019.01.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 12/20/2018] [Accepted: 01/08/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Spin is a specific type of reporting bias that misrepresents data and results within randomized controlled trials (RCTs). Because spin may provide a surgeon with an inaccurate representation of trial results, thus misconstruing the surgeons' interpretation thereof and possibly negatively affecting patient care, it is important that spin is identified within publications. The primary goal of our study was to determine the prevalence of spin found within the abstracts of lower extremity joint trials. METHODS Using Google Scholar's H-5 index, we selected the top 20 journals in the orthopedic surgery category. We then conducted a PubMed search on July 2nd, 2018 using the advanced search feature, encompassing all RCTs published in these journals from January 1, 2016 to January 1, 2017. Spin was evaluated using a standardized protocol, using a previously published protocol on the Open Science Network. RESULTS Our final sample consisted of 46 trials published in 9 of the top 20 orthopedic surgery journals. Spin was found in 27 (58.7%) of the 46 abstracts. Evidence of spin in the abstract results was found in 19 (41.3%) of the 46 articles, and spin in abstract conclusions was found in 15 (32.6%) of the 46 articles. CONCLUSIONS Our study found that a significant number of lower extremity joint RCTs contain one or more form of spin in either their abstract results, conclusions, or both. In addition, our investigation revealed that a sizable portion of these lower extremity orthopedic joint RCTs are not registered or do not report their registration, and funding sources are also underreported.
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Affiliation(s)
| | - Jonathan Riddle
- Oklahoma State University Center for Health Sciences, Tulsa, OK
| | - Zach Zaaza
- Oklahoma State University Center for Health Sciences, Tulsa, OK
| | - Marshall A Boose
- Department of Orthopaedic Surgery, Oklahoma State University Medical Center, Tulsa, OK
| | - Jake H Whitener
- Department of Orthopaedic Surgery, Oklahoma State University Medical Center, Tulsa, OK
| | - Matt B Vassar
- Oklahoma State University Center for Health Sciences, Tulsa, OK
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Austin J, Smith C, Natarajan K, Som M, Wayant C, Vassar M. Evaluation of spin within abstracts in obesity randomized clinical trials: A cross-sectional review. Clin Obes 2019; 9:e12292. [PMID: 30576083 DOI: 10.1111/cob.12292] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/30/2018] [Accepted: 11/23/2018] [Indexed: 01/25/2023]
Abstract
This is a cross-sectional analysis of spin in randomized controlled trial (RCT) abstracts published in top-ranked obesity and general medicine journals. The top seven obesity and four general medicine journals were searched from 1 January 2016 to 31 December 2017. To be included in this study, a trial must be an RCT with non-significant primary endpoint (P > 0.05), exclusively randomize subjects with overweight or obesity or have a primary endpoint of weight loss. These studies were analysed by two reviewers for spin in the abstract. The primary endpoint of our investigation was the frequency and type of spin. The secondary endpoint was to assess whether funding source was associated with the presence of spin. Our PubMed search yielded 1143 articles. Primary screening excluded 992 articles, and full-text evaluation excluded an additional 106. Overall, 45 articles were included. Spin was identified in 21 of the 45 (46.7%) abstracts analysed. Evidence of spin was found in 17 (37.8%) abstract result sections and 11 (24.4%) abstract conclusion sections. Of the 39 RCTs reporting a clinical trial registry, 6 (15.4%) had evidence of selective reporting bias. Our study found that obesity medicine RCTs from top-ranked journals with non-significant primary endpoints published in 2016 and 2017 frequently have spin in their abstracts. Abstracts with evidence of spin may influence a reader's perception of new drugs or procedures. These results warrant a careful review of future RCTs, but may not be generalizable to RCTs published in lower-ranked journals.
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Affiliation(s)
- J Austin
- Department of Psychiatry, Oklahoma State University-Center for Health Sciences, Tulsa, OK, USA
| | - C Smith
- Internal Medicine, Oklahoma State University, Stillwater, OK, USA
| | - K Natarajan
- Oklahoma State University Medical Center, Tulsa, OK, USA
| | - M Som
- Oklahoma State University Medical Center, Tulsa, OK, USA
| | - C Wayant
- Department of Psychiatry, Oklahoma State University-Center for Health Sciences, Tulsa, OK, USA
| | - M Vassar
- Department of Psychiatry, Oklahoma State University-Center for Health Sciences, Tulsa, OK, USA
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Romli MH, Wan Yunus F, Mackenzie L. Overview of reviews of standardised occupation-based instruments for use in occupational therapy practice. Aust Occup Ther J 2019; 66:428-445. [PMID: 30821362 DOI: 10.1111/1440-1630.12572] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Using standardised instruments is one approach to support evidence-based practice. Referring to systematic reviews is an option to identify suitable instruments. However, with an abundance of systematic reviews available, therapists are challenged to identify an appropriate instrument to use. Therefore, this overview of reviews aimed to summarise relevant systematic review findings about standardised occupation-based instruments relevant for occupational therapy practice. METHODS An overview of reviews was conducted. A systematic search was performed on four databases up to March 2018. Included systematic reviews were analysed for quality using A MeaSurement Tool to Assess systematic Reviews (AMSTAR). RESULTS A total of 2187 articles were identified after removing duplicates. Ultimately, 58 systematic reviews were identified that yielded 641 instruments. From those, 45 instruments were selected for appraisal as they met the inclusion criteria of being developed mainly by occupational therapists and were recommended in the summarised findings from the systematic reviews. The instruments were classified according to the following occupation domains: (i) multidimensional, (ii) activities of daily living, (iii) productivity, (iv) social, (v) sleep/rest, (vi) sexuality and (vii) spirituality. No systematic review was identified that specifically focussed on occupations related to school/education, leisure and play. DISCUSSION Certain occupation domains such as activities of daily living, social and sleep/rest received high attention amongst researchers. There is a need for systematic reviews of instruments to measure education/school, play and leisure. Limited numbers of instruments were developed by occupational therapists outside the occupation domain of activities of daily living, and in areas of practice other than children and older people. Nevertheless, this overview can give some guidance for occupational therapists in selecting a suitable occupational therapy instrument for practice.
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Affiliation(s)
- Muhammad Hibatullah Romli
- Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.,Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Farahiyah Wan Yunus
- Occupational Therapy Programme, Faculty of Health Sciences, Centre for Rehabilitation and Special Needs, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus, University of Sydney, Lidcombe, New South Wales, Australia
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Hassanipour S, Ghaem H, Arab-Zozani M, Seif M, Fararouei M, Abdzadeh E, Sabetian G, Paydar S. Comparison of artificial neural network and logistic regression models for prediction of outcomes in trauma patients: A systematic review and meta-analysis. Injury 2019; 50:244-250. [PMID: 30660332 DOI: 10.1016/j.injury.2019.01.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/10/2018] [Accepted: 01/10/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Currently, two models of artificial neural network (ANN) and logistic regression (LR) are known as models that extensively used in medical sciences. The aim of this study was to compare the ANN and LR models in prediction of Health-related outcomes in traumatic patients using a systematic review. METHODS The study was planned and conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. A literature search of published studies was conducted using PubMed, Embase, Web of knowledge, Scopus, and Google Scholar in May 2018. Joanna Briggs Institute (JBI) checklists was used for assessing the quality of the included articles. RESULTS The literature searches yielded 326 potentially relevant studies from the primary searches. Overall, the review included 10 unique studies. The results of this study showed that the area under curve (AUC) for the ANN was 0.91, (95% CI 0.89-0.83) and 0.89, (95% CI 0.87-90) for the LR in random effect model. The accuracy rate for ANN and LR in random effect models were 90.5, (95% CI, 87.6-94.2) and 83.2, (95% CI 75.1-91.2), respectively. CONCLUSION The results of our study showed that ANN has better performance than LR in predicting the terminal outcomes of traumatic patients in both the AUC and accuracy rate. Using an ANN to predict the final implications of trauma patients can provide more accurate clinical decisions.
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Affiliation(s)
- Soheil Hassanipour
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Haleh Ghaem
- Research Center for Health Sciences, Institute of Health, Epidemiology Department, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Morteza Arab-Zozani
- Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mozhgan Seif
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Fararouei
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elham Abdzadeh
- Department of Biology, Faculty of Science, University of Guilan, Rasht, Iran
| | - Golnar Sabetian
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahram Paydar
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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Presence of ‘spin’ in the abstracts and titles of anaesthesiology randomised controlled trials. Br J Anaesth 2019; 122:e13-e14. [DOI: 10.1016/j.bja.2018.10.023] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 09/28/2018] [Accepted: 10/15/2018] [Indexed: 11/18/2022] Open
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Cooper CM, Gray HM, Ross AE, Hamilton TA, Bea Downs J, Wayant C, Vassar M. Evaluation of spin in the abstracts of otolaryngology randomized controlled trials. Laryngoscope 2018; 129:2036-2040. [PMID: 30578543 DOI: 10.1002/lary.27750] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Spin, the misrepresentation and distortion of research findings, has been shown to affect clinical decision making. Spin has been found in randomized controlled trials (RCTs) published in various fields of medicine, but no study has tested for the presence of spin in otolaryngology RCTs. The purpose of this study is to evaluate the abstracts of RCTs found in the otolaryngology literature for spin. METHODS In this cross-sectional analysis, we analyzed the abstracts of RCTs for spin using a pilot-tested form. Double data extraction was performed by two blinded authors, and discrepancies were resolved using mutual discussion. RESULTS Out of the 534 PubMed citations retrieved by our search string, 162 parallel-group RCTs with clearly defined primary and secondary endpoints were identified. Further analysis identified 47 trials with nonsignificant primary outcomes, which were then evaluated for spin. Spin was identified in 33 of the 47 (70%) abstracts. Spin was found in the results sections of 25 (53%) of the included abstracts and was found in the conclusion section of 27 (57%) of the abstracts. Spin was not present in the titles of any of the included studies. CONCLUSION Spin was common in our sample of otolaryngology RCTs. Spin may potentially create false impressions about the true validity of a drug or intervention. Further research needs to test for potential clinical implications of spin in the otolaryngology literature. LEVEL OF EVIDENCE NA. Laryngoscope, 2018.
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Affiliation(s)
- Craig M Cooper
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A
| | - Harrison M Gray
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A
| | - Andrew E Ross
- Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, U.S.A
| | - Tom A Hamilton
- Department of Otolaryngology, Oklahoma State University Medical Center, Tulsa, Oklahoma, U.S.A
| | - Jaye Bea Downs
- Department of Otolaryngology, Oklahoma State University Medical Center, Tulsa, Oklahoma, U.S.A
| | - Cole Wayant
- 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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Gartrell K, Brennan CW, Wallen GR, Liu F, Smith KG, Fontelo P. Clinicians' perceptions of usefulness of the PubMed4Hh mobile device application for clinical decision making at the point of care: a pilot study. BMC Med Inform Decis Mak 2018; 18:27. [PMID: 29739392 PMCID: PMC5941474 DOI: 10.1186/s12911-018-0607-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 04/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although evidence-based practice in healthcare has been facilitated by Internet access through wireless mobile devices, research on the effectiveness of clinical decision support for clinicians at the point of care is lacking. This study examined how evidence as abstracts and the bottom-line summaries, accessed with PubMed4Hh mobile devices, affected clinicians' decision making at the point of care. METHODS Three iterative steps were taken to evaluate the usefulness of PubMed4Hh tools at the NIH Clinical Center. First, feasibility testing was conducted using data collected from a librarian. Next, usability testing was carried out by a postdoctoral research fellow shadowing clinicians during rounds for one month in the inpatient setting. Then, a pilot study was conducted from February, 2016 to January, 2017, with clinicians using a mobile version of PubMed4Hh. Invitations were sent via e-mail lists to clinicians (physicians, physician assistants and nurse practitioners) along with periodic reminders. Participants rated the usefulness of retrieved bottom-line summaries and abstracts and indicated their usefulness on a 7-point Likert scale. They also indicated location of use (office, rounds, etc.). RESULTS Of the 166 responses collected in the feasibility phase, more than half of questions (57%, n = 94) were answerable by both the librarian using various resources and by the postdoctoral research fellow using PubMed4Hh. Sixty-six questions were collected during usability testing. More than half of questions (60.6%) were related to information about medication or treatment, while 21% were questions regarding diagnosis, and 12% were specific to disease entities. During the pilot study, participants reviewed 34 abstracts and 40 bottom-line summaries. The abstracts' usefulness mean scores were higher (95% CI [6.12, 6.64) than the scores of the bottom-line summaries (95% CI [5.25, 6.10]). The most frequent reason given was that it confirmed current or tentative diagnostic or treatment plan. The bottom-line summaries were used more in the office (79.3%), and abstracts were used more at point of care (51.9%). CONCLUSIONS Clinicians reported that retrieving relevant health information from biomedical literature using the PubMed4Hh was useful at the point of care and in the office.
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Affiliation(s)
- Kyungsook Gartrell
- Department of Nursing, Towson University, Linthicum Hall Room 201J, 8000 York Road, Towson, MD 21252 USA
| | - Caitlin W. Brennan
- National Institutes of Health Clinical Center Nursing Department, 10 Center Drive, Bldg. 10/6-3523, Bethesda, MD 20892-1151 USA
| | - Gwenyth R. Wallen
- National Institutes of Health Clinical Center Nursing Department, 10 Center Drive, 6-1484, Bethesda, MD 20892 USA
| | - Fang Liu
- National Library of Medicine, Lister Hill National Center for Biomedical Communications, B1N30N, 38A, 8600 Rockville Pike, Bethesda, MD 20894 USA
| | - Karen G. Smith
- National Institutes of Health/Library, 10 Center Drive, Bethesda, MD 20892 USA
| | - Paul Fontelo
- National Library of Medicine, Lister Hill National Center for Biomedical Communications, B1N30L, 38A, 8600 Rockville Pike, Bethesda, MD 20894 USA
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Assem Y, Adie S, Tang J, Harris IA. The over-representation of significant p values in abstracts compared to corresponding full texts: A systematic review of surgical randomized trials. Contemp Clin Trials Commun 2017; 7:194-199. [PMID: 29696186 PMCID: PMC5898552 DOI: 10.1016/j.conctc.2017.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 07/02/2017] [Accepted: 07/20/2017] [Indexed: 11/06/2022] Open
Abstract
Background Abstracts are often the only read summaries of research findings, and it is essential that they accurately represent of the contents of the full text of the randomised control trial (RCT). We investigated whether outcomes in surgical trials were selectively reported in abstracts based on their statistical significance. Objective To compare the proportion of significant p-values reported in abstracts to their corresponding full texts in surgical RCTs. Method A Meta-analysis of 350 full text RCTs conducted on humans that compared a surgical intervention to any other intervention. An electronic search of MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) was conducted. All outcomes were extracted from the abstract and the full text. Frequency histograms were used to plot the distribution of numerically reported p-values across the statistical significance spectrum. For each RCT, a 2 × 2 table was populated with that trial's outcomes and whether the outcome was statistically significant (p < 0.05). From each 2 × 2 table, an odds ratio (OR) was calculated describing the association between statistical significance, and reporting in the abstract. ORs were pooled in random effects meta-analysis for an overall estimate of the association. Results A total of 8258 reported outcomes were included. Outcomes reported in a surgical RCT abstract had three times the odds of being significant when compared to the corresponding full text (OR = 3.0, 95% confidence interval 2.5–3.6, p < 0.001). This finding was consistent and not subject to heterogeneity (I2 = 0%). Both histograms demonstrated a large drop in the frequency of reported p values between 0.04 and 0.05, and after the 0.06 thresholds. Conclusions Data presented in abstracts is biased to statistically significant outcomes. Clinicians and policy makers should do not rely solely on information presented in abstracts for their decision-making.
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Affiliation(s)
- Yusuf Assem
- University of New South Wales, South Western Sydney Clinical School, Liverpool Hospital, Liverpool, Australia.,South West Sydney Local Health District, Liverpool Hospital, Liverpool, Australia
| | - Sam Adie
- University of New South Wales, South Western Sydney Clinical School, Liverpool Hospital, Liverpool, Australia.,Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool, Australia.,South West Sydney Local Health District, Liverpool Hospital, Liverpool, Australia
| | - Jason Tang
- University of New South Wales, South Western Sydney Clinical School, Liverpool Hospital, Liverpool, Australia.,South West Sydney Local Health District, Liverpool Hospital, Liverpool, Australia
| | - Ian A Harris
- University of New South Wales, South Western Sydney Clinical School, Liverpool Hospital, Liverpool, Australia.,Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool, Australia.,South West Sydney Local Health District, Liverpool Hospital, Liverpool, Australia
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Kim JM, Zimmerman RM, Jones CM, Muhit AA, Higgins JP, Means Jr KR. The quality of randomised controlled trials involving surgery from the hand to the elbow. Bone Joint J 2017; 99-B:94-99. [DOI: 10.1302/0301-620x.99b1.bjj-2016-0400.r1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 09/09/2016] [Indexed: 11/05/2022]
Abstract
Aims Our purpose was to determine the quality of current randomised controlled trials (RCTs) in hand surgery using standardised metrics. Materials and Methods Based on five-year mean impact factors, we selected the six journals that routinely publish studies of upper extremity surgery. Using a journal-specific search query, 62 RCTs met our inclusion criteria. Then three blinded reviewers used the Jadad and revised Coleman Methodology Score (RCMS) to assess the quality of the manuscripts. Results Based on the Jadad scale, 28 studies were of high quality and 34 were of low quality. Methodological deficiencies in poorly scoring trials included the absence of rate of enrolment, no power analysis, no description of withdrawal or dropout, and a failure to use validated outcomes assessments with an independent investigator. Conclusion A large number of RCTs in hand, wrist, and elbow surgery were of suboptimal quality when judged against the RCMS and Jadad scales. Even with a high level of evidence, study design and execution of RCTs should be critically assessed. Methodological deficiencies may introduce bias and lead to statistically underpowered studies. Cite this article: Bone Joint J 2017;99-B:94–9.
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Affiliation(s)
- J. M. Kim
- MedStar Union Memorial Hospital, 3333
North Calvert Street, JPB 200, Baltimore, Maryland, USA
| | - R. M. Zimmerman
- MedStar Union Memorial Hospital, 3333
North Calvert Street, JPB 200, Baltimore, Maryland, USA
| | - C. M. Jones
- MedStar Union Memorial Hospital, 3333
North Calvert Street, JPB 200, Baltimore, Maryland, USA
| | - A. Al Muhit
- MedStar Union Memorial Hospital, 3333
North Calvert Street, JPB 200, Baltimore, Maryland, USA
| | - J. P. Higgins
- MedStar Union Memorial Hospital, 3333
North Calvert Street, JPB 200, Baltimore, Maryland, USA
| | - K. R. Means Jr
- MedStar Union Memorial Hospital, 3333
North Calvert Street, JPB 200, Baltimore, Maryland, USA
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Trial Designs and Characteristics in Laser Studies in Dermatology: A Systematic Review. Dermatol Surg 2016; 43:198-203. [PMID: 27805958 DOI: 10.1097/dss.0000000000000884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lasers are increasingly used in Dermatology. Clinical studies are among the best means to assess their efficacy. OBJECTIVE To obtain an overview of therapeutic laser studies in the field of Dermatology, the authors conducted a systematic review to describe the types of study published over the past 25 years, and their reporting in the abstracts. METHODS The authors selected interventional studies that evaluated laser treatment on human subjects with skin diseases. Reviews or single-case reports were excluded. Journal characteristics, study design, and trial characteristics were recorded and analyzed according to trends over time and journal impact factor ratings. RESULTS Of the 681 studies included, 57% were comparative, of which 46% were randomized, controlled studies. Trial duration was clearly mentioned in 63% of the abstracts. Trial duration was generally under 6 months (78%). Some parameters were rarely mentioned as follows: the number of patients lost to follow-up (only 12%), blinding (21%), and a clearly stated main outcome (36%). Over the 25 years, there was a significant trend toward an increased proportion of randomized, controlled trials, from 15% between 1990 and 2000 to 41% between 2010 and 2015 (p < .001). CONCLUSION This systematic review highlights areas for improvement in laser studies in Dermatology.
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The Quality of Reporting of Abstracts in Physical Therapy Literature is Suboptimal. Am J Phys Med Rehabil 2016; 95:673-84. [DOI: 10.1097/phm.0000000000000467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fontelo P, Liu F, Uy RC. How does evidence affect clinical decision-making? ACTA ACUST UNITED AC 2015; 20:156-61. [PMID: 26337628 DOI: 10.1136/ebmed-2015-110250] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Paul Fontelo
- National Library of Medicine, Bethesda, Maryland, USA
| | - Fang Liu
- National Library of Medicine, Bethesda, Maryland, USA
| | - Raymonde C Uy
- National Library of Medicine, Bethesda, Maryland, USA
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Uy RC, Sarmiento RF, Gavino A, Fontelo P. Confidence and Information Access in Clinical Decision-Making: An Examination of the Cognitive Processes that affect the Information-seeking Behavior of Physicians. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2014; 2014:1134-1140. [PMID: 25954424 PMCID: PMC4419936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Clinical decision-making involves the interplay between cognitive processes and physicians' perceptions of confidence in the context of their information-seeking behavior. The objectives of the study are: to examine how these concepts interact, to determine whether physician confidence, defined in relation to information need, affects clinical decision-making, and if information access improves decision accuracy. We analyzed previously collected data about resident physicians' perceptions of information need from a study comparing abstracts and full-text articles in clinical decision accuracy. We found that there is a significant relation between confidence and accuracy (φ=0.164, p<0.01). We also found various differences in the alignment of confidence and accuracy, demonstrating the concepts of underconfidence and overconfidence across years of clinical experience. Access to online literature also has a significant effect on accuracy (p<0.001). These results highlight possible CDSS strategies to reduce medical errors.
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Affiliation(s)
| | | | - Alex Gavino
- National Library of Medicine, Bethesda, MD 20894
| | - Paul Fontelo
- National Library of Medicine, Bethesda, MD 20894
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Pastori MM, Sarti M, Pons M, Barazzoni F. Assessing the impact of bibliographical support on the quality of medical care in patients admitted to an internal medicine service: a prospective clinical, open, randomised two-arm parallel study. ACTA ACUST UNITED AC 2014; 19:163-8. [DOI: 10.1136/ebmed-2014-110021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Miller JB, Schoenberg MR, Bilder RM. Consolidated Standards of Reporting Trials (CONSORT): Considerations for Neuropsychological Research. Clin Neuropsychol 2014; 28:575-99. [DOI: 10.1080/13854046.2014.907445] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Gavino AI, Ho BLC, Wee PAA, Marcelo AB, Fontelo P. Information-seeking trends of medical professionals and students from middle-income countries: a focus on the Philippines. Health Info Libr J 2013; 30:303-17. [PMID: 24251892 DOI: 10.1111/hir.12032] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Accepted: 04/29/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Increased emphasis has been given to the practice of evidence-based medicine (EBM) worldwide. Access to quality health information is essential to the practice of EBM in developing countries. OBJECTIVES To understand the information needs and sources of information of physicians from low- and middle-income countries (LMICs). METHODS Medical doctors and students participated in an 18-question online or paper study. RESULTS Of the 156 respondents from six LMICs, 146 (94%) came from the Philippines. Eighty-eight per cent encountered at least one clinical question daily, while 58% were very likely to search for answers. A basic mobile phone was the most used device at home (94%) and at work (82%). More than half had Internet connectivity at home (62%) and just under half at work (46%). In decreasing order, short messaging services (SMS), email, instant messaging and multimedia messaging services (MMS) were the most commonly used messaging tools at home and at work. The primary source for medication questions was a formulary, but for diagnostic dilemmas, colleagues were consulted first. PubMed use was high for therapy and management questions. CONCLUSION The use of health information from the Internet through mobile devices may be increasing. Access to health information was higher at home than at work. These results may be useful when planning resources for healthcare givers in resource-poor settings.
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