Do not make clinical decisions based on abstracts of healthcare research: A systematic review

Inconsistency between abstract and main text reporting is common in pilot randomized controlled trials of surgical interventions: A methodological survey

BACKGROUND

There is often inconsistency between abstract and main text reporting. While extensively demonstrated in randomized controlled trials, this inconsistency has never been explored in the setting of pilot and feasibility trials. We designed this methodological survey to assess the inconsistency between abstract and main text reporting in pilot and feasibility trials in surgery.

METHODS

Medline, Embase, and CENTRAL databases were searched from January 1, 2011 to December 31, 2011, and January 1, 2021 to December 31, 2021. Studies were included if they were pilot or feasibility randomized trials evaluating a surgical intervention. The primary outcome was the proportion of pilot and feasibility trials with inconsistency between abstract and main text reporting. Secondary outcomes included the association between research characteristics and inconsistent reporting. Inconsistent abstract reporting was defined as any of the following: (1) conclusions stronger than the main text; (2) omission of negative results found in the main text; (3) different outcomes than in the main text; (4) presence of outcomes/findings/claims not in the main text.

RESULTS

After screening 1991 citations, 38 studies from 2011 to 34 studies from 2021 were included. Fifty of the included pilot and feasibility trials (69.4 ​%, 95 ​% confidence interval [CI] 58.0-78.9 ​%) had inconsistencies between abstract and main text reporting. Fourteen trials (19.4 ​%, 95%CI 11.8-30.2 ​%) had stronger conclusions in their abstract than main text, 19 trials (26.4 ​%, 95%CI 17.5-37.6 ​%) omitted negative results from their abstracts, 27 trials (37.5 ​%, 95%CI 27.2-49.1 ​%) had different primary outcomes in their abstract and main text, and 35 trials (48.6 ​%, 95%CI 37.4-59.9 ​%) had outcomes, findings, and/or claims in their abstract that were not present in the main text.

CONCLUSION

(s): The majority of surgical pilot and feasibility trials have inconsistent reporting between their abstract and main text. Efforts from both authors and journals are required to improve the consistency of abstract reporting.

A cross-sectional study assessing visual abstracts of randomized trials revealed inadequate reporting and high prevalence of spin

OBJECTIVES

Visual abstracts (VAs) lack study-specific reporting guidelines and are increasingly used as stand-alone sources in medical research dissemination although not designed for this purpose. Therefore, our objectives were to describe 1) completeness of reporting in VAs and corresponding written abstracts (WAs) of randomized controlled trials (RCTs), and 2) the extent and type of spin (ie, any reporting pattern that could distort result interpretation and mislead readers) in VAs and WAs of RCTs with a statistically nonsignificant primary outcome.

STUDY DESIGN AND SETTING

We conducted a cross-sectional study evaluating VAs and WAs of RCTs published between January 1, 2021, and March 3, 2023. We searched MEDLINE via PubMed for reports of RCTs published in the 15 highest impact factor journals from six medical fields (among which 34 journals producing VAs of RCTs were identified). One reviewer identified primary reports of RCTs published with a VA and randomly selected a maximum of 10 reports from each journal to avoid overrepresentation. The completeness of reporting assessment was based on the Consolidated Standards of Reporting Trials extension for abstracts. Spin was explored using a standardized spin classification for RCTs with statistically nonsignificant primary outcome results. Both assessments were conducted in duplicate, with discussion until consensus in case of discrepancy.

RESULTS

A random sample of 253 reports from 34 journals was identified. The information provided in VAs was frequently incomplete: primary outcome identification, primary outcome results, and harms were respectively described or displayed in only 47% (n = 116/247), 30% (n = 75/247), and 35% (n = 88/253). Reporting was slightly better for some items in WAs, although still unsatisfactory. Among trials with nonsignificant primary outcome results (n = 101), 57% (n = 58) of the VAs and 55% (n = 56) of the WAs exhibited at least 1 type of spin. Posthoc analyses showed VAs produced by journal editors of high-impact general medical journals were more complete and more accurate than those produced by specialty journals or authors.

CONCLUSION

The information conveyed in VAs was frequently incomplete and inaccurate, highlighting the urgent need to refer to appropriate specific reporting guidelines to avoid misinterpretation by readers.

Exploring the Effects of Qigong, Tai Chi, and Yoga on Fatigue, Mental Health, and Sleep Quality in Chronic Fatigue and Post-COVID Syndromes: A Systematic Review with Meta-Analysis

Background/Objectives: Chronic fatigue syndrome (CFS) and post-COVID syndrome (PCS) pose a substantial socioeconomic burden. The aim of this systematic review was to assess current evidence regarding the effect of the most popular forms of movement-based mindful exercises, i.e., qigong, tai chi, and yoga, on fatigue and associated symptoms in CFS and PCS. Methods: CINAHL, Embase, PsycINFO, PubMed, Scopus, and the Cochrane Library were searched from inception to October 2023. Randomized controlled trials (RCTs) where qigong, tai chi, or yoga were compared with waitlist, no intervention, or active controls were included. Independent reviewers participated in data extraction, and evaluated risk of bias, spin of information, completeness of intervention description, and certainty of the evidence (GRADE). Meta-analyses were conducted. The primary outcome was the level of fatigue. Secondary measures were the severity of anxiety and depressive symptoms and sleep quality. Results were expressed as mean difference (MD) or standardized mean difference (SMD) with a 95% confidence interval (CI). Results: Thirteen RCTs with 661 participants were included, with most studies presenting a moderate or high risk of bias. Mindful exercises were more effective than control interventions to alleviate fatigue: SMD (95%CI) = -0.44 (-0.63 to -0.25), I2 = 48%, p < 0.0001. Positive effects were also observed for secondary outcomes. The certainty of the evidence was low or very low. Conclusions: Qigong, tai chi, and yoga may be effective to reduce fatigue and improve anxiety, depression, and sleep quality in adults with CFS or PCS. However, serious methodological concerns limit the clinical applicability of these findings.

Disciplinary Imbalances in Urology and Gynecology Research Publications within Functional Urology

(1) Background: This study aimed to quantify and evaluate the publication rate and discrepancies of functional urology abstracts from international conferences, and to explore the interdisciplinary contributions of urology and gynecology to the field. (2) Methods: A retrospective bibliometric and content analysis was conducted on abstracts presented between 2015 and 2019 at the EAU and ICS congresses, focusing on functional-urological keywords. A discrepancy scoring system ranging from 0 (minor discrepancies) to 3 (significant discrepancies) assessed the consistency between conference abstracts and full-text publications, and an in-depth analysis determined the disciplinary origin of these publications. (3) Results: Between 2015 and 2019, 53% of EAU and 57% of ICS congress abstracts were published as full-text articles, with minor discrepancies in 38% of EAU and 49% of ICS publications, and significant discrepancies in 17% from both. Urology departments dominated publications, contributing 68% at EAU and 55% at ICS, whereas gynecology contributed only 1% at EAU and 12% at ICS. (4) Conclusions: This study illuminates the need for improved reporting standards and interdisciplinary collaboration in functional urology, as well as increased gynecology research in functional urology-related fields, suggesting that addressing these issues is crucial for advancing the field and enhancing patient care.

Spin in dental publications: a scoping review

The aim of this review was to map the practice of spin in scientific publications in the dental field. After registering the review protocol (osf.io/kw5qv/), a search was conducted in MEDLINE via PubMed, CENTRAL, Embase, Scopus, LILACS, ClinicalTrials.gov, and OpenGrey databases in June 2023. Any study that evaluated the presence of spin in dentistry was eligible. Data were independently extracted in duplicate by two reviewers. After removing duplicates, 4888 records were screened and 38 were selected for full-text review. Thirteen studies met the eligibility criteria, all of which detected the presence of spin in the primary studies, with the prevalence of spin ranging from 30% to 86%. The most common types of spin assessed in systematic reviews were failure to mention adverse effects of interventions and to report the number of studies/patients contributing to the meta-analysis of main outcomes. In randomized controlled trials, there was a focus on statistically significant within-group and between-group comparisons for primary or secondary outcomes (in abstract results) and claiming equivalence/noninferiority/similarity for statistically nonsignificant results (in abstract conclusions). The practice of spin is widespread in dental scientific literature among different specialties, journals, and countries. Its impact, however, remains poorly investigated.

'Spin' among abstracts of randomised controlled trials in sleep medicine: A research-on-research study

STUDY OBJECTIVES

'Spin', using reporting strategies to distort study results, can mislead readers of medical research. This study aimed to evaluate the prevalence and characteristics of 'spin' among randomised controlled trial (RCT) abstracts published in sleep medicine journals, and to identify factors associated with its presence and severity.

METHODS

The search for RCTs published between 2010 and 2020 were conducted in seven reputable journals of sleep medicine. Abstracts of RCTs with statistically nonsignificant primary outcomes were included and analysed for 'spin', according to pre-determined 'spin' strategies. Chi-square tests or logistic regression analyses were performed to detect the association between characteristics of included abstracts and the presence and severity of 'spin'.

RESULTS

A total of 114 RCT abstracts were included in this study, of which 89 (78.1%) were identified as having at least one type of 'spin' strategy. Sixty-six abstracts (57.9%) had 'spin' in the Results section, 82 (71.9%) abstracts presented with 'spin' in the Conclusions section. The presence of 'spin' varied significantly among RCTs based on the different categories of research area (P=0.047) and the statistician involvement (P=0.045). Furthermore, research area (P=0.019) and funding status (P=0.033) were significant factors associated with the severity of 'spin'.

CONCLUSIONS

The prevalence of 'spin' is high among RCT abstracts in sleep medicine. This raise the need for researchers, editors and other stakeholders to be aware of the issue of 'spin' and make joint efforts to eliminate it in future publications.

How to peer review: practical advice for early career researchers

Practical tips and guidance on peer review are provided by three scientists in the respiratory field, to help early career researchers who may be invited to review papers for respiratory journals https://bit.ly/3EuWpoH.

Analysis of Spin in the Reporting of Studies on Electroanalgesia for Musculoskeletal Pain

OBJECTIVE

The purpose of this study was to analyze the quality of reporting and presence of spin in abstracts of randomized clinical trials (RCTs) on the use of electroanalgesia for musculoskeletal pain.

METHODS

The Physiotherapy Evidence Database (PEDro) was searched from 2010 to June 2021. Inclusion criteria were RCTs using electroanalgesia in individuals with musculoskeletal pain, written in any language, comparing 2 or more groups, and with pain as 1 of the outcomes. Two blinded, independent, and calibrated evaluators (Gwet's AC1 agreement analysis) performed eligibility and data extraction. General characteristics, report of outcomes, quality of reporting (Consolidated Standards of Reporting Trials for Abstracts [CONSORT-A]), and spin analysis (7-item spin checklist and spin analysis per section) were extracted from abstracts.

RESULTS

Of 989 studies selected, 173 abstracts were analyzed after screening and eligibility criteria. Mean risk of bias on the PEDro scale was 6.02 ± 1.6 points. Most abstracts did not report significant differences for primary (51.4%) and secondary (63%) outcomes. Mean quality of reporting was 5.10 ± 2.4 points in the CONSORT-A, and spin was 2.97 ± 1.7. Abstracts had at least 1 type of spin (93%), and the conclusion presented the greatest number of spin types. More than 50% of abstracts recommended an intervention without significant differences between groups.

CONCLUSION

This study found that the majority of RCT abstracts on electroanalgesia for musculoskeletal conditions in our sample had a moderate to high risk of bias, incomplete or missing information, and some type of spin. We recommend that health care providers who use electroanalgesia and the scientific community be aware of spin in published studies.

Reporting completeness in abstracts of systematic reviews of diagnostic test accuracy studies in cardiovascular diseases is suboptimal

OBJECTIVE

Journal abstracts are crucial for the identification and initial assessment of content of studies. We evaluated whether authors in the field of cardiovascular diseases (CVDs) reported Diagnostic Test Accuracy Systematic Reviews (DTA SRs) abstracts adequately, as defined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-DTA guidelines.

METHODS

SRs of DTA studies in CVDs published in general and specialized medical journals were identified in a MEDLINE search between 2010-2020. Adherence to 12 PRISMA-DTA for abstracts items was assessed independently by two reviewers and compared by journal's type. Moreover, the association of reporting completeness with different characteristics was investigated.

RESULTS

We included 72 abstracts. Studies published in general medical journals had higher mean reporting score than those in specialized journals (6.2 vs 5.3 out of 12 items; mean difference: 0.88; 95% confidence interval: 0.21, 1.55). PRISMA-DTA adherence was higher in journals that adopted this guideline and in articles with structured abstracts. However, number of participants analysed, funding and registration were the least-reported items in the identified abstracts.

CONCLUSION

The reporting of abstracts of DTA reports in CVDs is suboptimal according to PRISMA-DTA guidelines. Abstract reporting could be improved with the use of higher word count limits and the adoption of PRISMA-DTA guidelines especially in specialized journals.