Evaluation of selective outcome reporting and trial registration practices among addiction clinical trials

Assessment of Rehabilitation Journal Requirements for the Use of Reporting Guidelines and Clinical Trial Registration

OBJECTIVE

To assess reporting guideline and clinical trial registration requirements in rehabilitation journals.

DESIGN

We examined rehabilitation journals with 5-year impact factors exceeding 1.00 from the 2021 Scopus CiteScore tool, alongside the 28 journals included in the 2014 rehabilitation and disability quality improvement initiative. Journals outside the traditional rehabilitation scope were excluded.

SETTING

A publicly-funded academic health center in the United States.

PARTICIPANTS AND INTERVENTIONS

N/A.

MAIN OUTCOME MEASURE(S)

The proportion of journals requiring/recommending reporting guideline use and clinical trial registration.

RESULTS

Over 90% (57/63) of journals required/recommended clinical trial reporting guidelines, while 68% (39/57) specified guideline requirements for systematic review/meta-analysis protocols. The 2014 collaborative initiative journals demonstrated higher rates of requiring/recommending reporting guidelines for clinical trials (24/26; 92.3%), systematic reviews/meta-analyses (23/26; 88.5%), observational studies in epidemiology (22/25; 88%), and diagnostic accuracy studies (20/24; 83.3%). Conversely, the 2021 Scopus CiteScore journals displayed higher rates for the remaining study designs. Overall, 52/63 (82.5%) journals required/recommended trial registration. Trial registration policies were comparable, with a slight advantage favoring the 2021 Scopus CiteScore journals.

CONCLUSION

Rehabilitation journals variably promoted reporting guideline use and clinical trial registration. Common study designs like clinical trials, observational studies in epidemiology, and diagnostic accuracy studies demonstrated robust requirement/recommendation rates, while less common designs like economic evaluations and animal research had suboptimal rates. Journals can enhance reporting guideline use and trial registration by directing authors to the EQUATOR Network, requiring adherence to registration and reporting standards, and clarifying language in author instructions.

Unveiling Bias: Examining the Influence of Positive Results on Ergogenic Aids in Published Sports Science Studies

We investigated the potential for publication bias in the field of sports science regarding studies on ergogenic aids and their effects on exercise performance. We found evidence to suggest that journals tend to prioritize studies with positive results (76%) while neglecting those with negative outcomes (2.7%). Worryingly, this could lead to a discrepancy between reported conclusions and actual study outcomes. We also identified inconsistencies between reported outcomes and actual performance variable outcomes. Taken together, these data highlight the need for future research to reduce bias and encourage the publication of studies with both positive and negative results to improve the reliability of scientific evidence in this field.

Ranking of addiction journals in eight widely used impact metrics

Background and aims

Journal metrics assess impact upon the research literature, and are now used to assess individual researchers in hiring and promotion decisions. This study compared the ranking of addiction journals according to eight widely used metrics; assessed the correlations between journal rankings; and assessed changes over time in metric scores.

Methods

Data pertaining to the 2020 scores on eight metrics for 43 journals were obtained and the top 20 ranking in each compared and the correlations between rankings assessed. The Impact Factor was employed to assess changes over time.

Results

Ignoring the two categorization systems used by some metrics, 31 journals appeared in at least one metric top 20 and 11 in all eight. The top rank in each was occupied by one of three journals. Three-quarters of the correlations between rankings were above 6.0. The number of journals with an Impact Factor rose from 23 in 1997 to 38 in 2020, and the journals added tended to focus on addictions other than alcohol and drugs or have a specific focus.

Conclusions and discussion

The results indicate a concentration of journals at the top of the metrics and moderate to strong agreement between them, but almost three-quarters of journals appeared in at least one metric. The longitudinal data reflect both a broadening and specialization of the addiction field. The study limitations include exclusion of some journals and metrics.

A comparison of registered and published primary outcomes in clinical trials of opioid use disorder: ACTTION review and recommendations

BACKGROUND AND AIMS

Prospective trial registration can increase research integrity. This Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) review was designed to compare the primary outcomes (PO) reported in registries with associated publications for opioid use disorder (OUD) clinical trials.

DESIGN

The World Health Organization's International Clinical Trials Registry Platform (ICTRP) was searched for completed trials (2010 through 2019). Associated publications were identified and paired with trial registry data based on the publication date.

MEASUREMENTS

Reviewers independently rated the occurrence of discrepancies between the POs in the registry compared to the publication. An analysis of prospective versus retrospective registration was also completed.

FINDINGS

One-hundred and forty trials were identified in the search, and 43 registry-publication pairs evaluated. Only 34 of the 43 pairs could be examined for discrepancies because nine did not report a PO in registry and publication. Of the 34 pairs, only four met rigorous criteria for prospective trial registration and had an exact match of POs. In contrast, the majority of the 34 trials, or 80%, had inconsistent POs (e.g., registered secondary outcomes published as primary; the timing of PO not specified) and/or were retrospectively registered.

CONCLUSIONS

Many clinical trials focused on OUD have not met the standards of trial registration, such as consistent reporting of POs and prospective registration. Failure to properly register trial characteristics undermines the validity of research findings and can delay the development of life-saving treatments. Recommendations for improving prospective trial reporting practices are provided.

Tonsillar-related pathologies: An analysis of the evidence underpinning management recommendations

OBJECTIVE

Evidence-based decision making is crucial in reducing the health and economic burdens imposed by tonsillar-related pathologies. Clinical practice guidelines are used to guide these decisions; however, uptake of recommendations in these guidelines is low. Systematic reviews are the highest level of evidence used to influence guideline recommendations; therefore, improving the reporting and methodological quality of systematic reviews related to tonsillar-related pathologies may improve guideline uptake and patient care.

METHODS

We used PubMed to search for all clinical practice guidelines related to tonsillar-related pathologies from 2010 to 2020. Included guidelines were then searched for all systematic reviews and meta-analyses. Study characteristics were extracted from each cited systematic review/meta-analysis before being evaluated using the PRISMA (Preferred Reporting Instrument for Systematic Reviews and Meta-Analyses) and AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews 2) instruments. We then compared systematic reviews conducted by a Cochrane systematic review group with non-Cochrane systematic reviews.

RESULTS

Seven clinical practice guidelines were included in our study and within these guidelines 98 SRs/MAs were cited, 80 of which were unique and included. Systematic reviews composed 9.1% (98/1082) of all guideline citations. Guideline PRISMA scores ranged from 0.47 to 0.83 with a mean score of 0.71 (n = 80) and guideline AMSTAR-2 scores ranged from 0.52 to 0.83 with a mean of 0.56 (7.29/13) and 0.75 (11.94/16) (n = 80). Cochrane systematic reviews displayed greater PRISMA (0.88 vs. 0.64: p < 0.001) and AMSTAR-2 (0.90 vs. 0.57; p < 0.001) scores compared to the non-Cochrane studies. We found PRISMA and AMSTAR-2 scores were positively correlated across guidelines (r = 0.93).

CONCLUSION

Wide variation exists in adherence to PRISMA and AMSTAR-2 guidelines among systematic reviews cited in clinical practice guidelines for tonsillar-related pathologies. Prior registration and adequate risk of bias assessment are two areas where improvements may be needed. Given the importance of guideline uptake, careful considerations to improve the methodological and reporting quality of evidence supporting tonsillar-related pathology recommendations are necessary.

Evaluation of Risks of Bias in Addiction Medicine Randomized Controlled Trials

AIMS

Perhaps the most important step when designing and conducting randomized controlled trials (RCTs) in addiction is to put methodological safeguards in place to minimize the likelihood for bias to affect trial outcomes. In this study, we applied the revised Cochrane risk of bias tool (ROB 2) to RCTs of drug, alcohol or tobacco interventions.

METHODS

We searched for trials published in 15 addiction medicine journals over a 7-year period. Our primary endpoint is the risk of bias of included studies. We conducted a sensitivity analysis of publicly funded trials.

RESULTS

Overall, included RCTs were most often at high risk of bias per our judgments (244/487, 50.1%). However, significant proportions of included RCTs were at low risk of bias (123/487, 25.3%) or some concerns for bias (120/497, 24.6%). RCTs with behavioral modification interventions (19/44, 43.2%) and alcohol interventions (80/150, 53.3%) had the highest proportion of high-risk judgments. In a sensitivity analysis of publicly funded RCTs), 195/386 (50.5%) were at high risk of bias.

CONCLUSIONS

Approximately half of included drug, alcohol or tobacco RCTs in our sample were judged to be at high risk of bias with the most common reason being a lack of proper blinding or proper description of blinding. Key action items to reduce bias in future addiction RCTs include adequate randomization, blinding and inclusion of a trial registry number and protocol.

An Evaluation of Reporting Guidelines and Clinical Trial Registry Requirements Among Addiction Medicine Journals

Context

Robust methodology and ethical reporting are paramount for quality scientific research, but recently, that quality in addiction research has been questioned. Avenues to improve such research quality include adherence to reporting guidelines and proper usage of clinical trial registries. Reporting guidelines and clinical trial registries have been shown to lead researchers to more ethical and transparent methodology.

Objectives

To investigate the reporting guideline and clinical trial registration policies of addiction research journals and identify areas of improvement.

Methods

We used Google Scholar Metrics' h-5 index to identify the top 20 addiction research journals. We then examined the instructions for authors from each journal to identify whether they required, recommended, or made no mention of trial registration and reporting guidelines, including the Consolidated Standards of Reporting Trials (CONSORT), Meta-Analysis of Observational Studies in Epidemiology (MOOSE), Quality of Reporting of Meta-analyses (QUOROM), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), Standards for Reporting Diagnostic Accuracy Studies (STARD), Strengthening the Reporting of Observational Studies in Epidemiology (STROBE), Animal Research: Reporting of In Vivo Experiments (ARRIVE), Case Reports (CARE), Consolidated Health Economic Evaluation Reporting Standards (CHEERS), Standards for Reporting Qualitative Research (SRQR), Standards for Quality Improvement Reporting Excellence (SQUIRE), Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT), Consolidated Criteria for Reporting Qualitative Research (COREQ), Transparent Reporting of a Multivariate Prediction Model for Individual Prognosis or Diagnosis (TRIPOD), Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P), and the International Committee of Medical Journal Editors (ICMJE) guidelines. We performed the same analysis regarding requirements for clinical trial registration.

Results

Of the 20 journals included in this study, 10 journals (50%) did not require adherence to any reporting guidelines. Trial registration followed a similar trend; 15 journals (75%) did not mention any form of trial or systematic review registration, and ClinicalTrials.gov was only recommended by only 1 journal (5%).

Conclusions

Among top addiction medicine journals, required adherence to reporting guidelines and clinical trial registry policies remains substandard. A step toward fulfilling the National Institute on Drug Abuses' call for improvement in transparency and reproducibility within addiction research should include all journals adopting a strict reporting guideline and clinical trial registry adherence policy.

Evaluation of selective outcome reporting and trial registration practices among addiction clinical trials

BACKGROUND AND AIMS

Selective outcome reporting occurs when trialists pre-specify primary and secondary outcomes during trial planning but alter the definitions in the published report. Here, we investigate selective outcome reporting in published addiction randomized controlled trials (RCTs) and evaluate whether particular funding sources are associated with an increased likelihood of selective outcome reporting.

DESIGN

We conducted a cross-sectional study of published addiction clinical trials. A PubMed search was performed to identify RCTs in addiction journals from 2013 to 2017. Included studies used a randomized design to address one of the following topics: (1) drug, alcohol and tobacco addiction prevention, (2) stabilization following excessive use of a substance, (3) relapse prevention or (4) recovery maintenance.

SETTING

Single-center, medical research institution.

PARTICIPANTS

Our sample included 162 RCTs that were prospectively registered with a clearly defined primary outcome.

MEASUREMENT

We extracted the following items from addiction RCTs: journal, funding source, trial registry number (if included), sample size, dates of subject enrollment, whether primary and secondary outcomes were denoted, all published outcomes, P-value for all outcomes and whether authors mentioned any deviations from the trial protocol as it related to RCT outcomes.

FINDINGS

In total, 47 of 162 RCTs (29.0%) had at least one major discrepancy between the trial registry and published RCT. Overall, these 47 RCTs included 54 major discrepancies. The most common major discrepancy was demotion of a primary registered outcome (19/54, 35.2%). The majority of RCTs (132/162, 81.5%) were funded from public sources. Additionally, 166 RCTs were excluded from our sample because registration could not be confirmed.

CONCLUSIONS

There is evidence suggestive of selective outcome reporting in addiction randomized controlled trials (RCTs). The most common major discrepancies pertained to the primary outcome.