Selective outcome reporting in root coverage randomized clinical trials

Adherence to Registration and Selective Outcome Reporting in Randomized Clinical Trials Published in Endodontic Journals Over the Past 5 Years: A Meta-Research Study

INTRODUCTION

Prospective registration of randomized clinical trials (RCTs) is highly recommended to ensure research transparency and prevent selective outcome reporting (SOR). This study aimed to evaluate the adherence to registration and the presence of SOR in RCTs published in endodontic journals over the past 5 years.

METHODS

Electronic searches were conducted in PubMed and the libraries of the Journal of Endodontics, International Endodontic Journal, European Endodontic Journal, and Australian Endodontic Journal. Two reviewers were involved in the study selection and evaluation. Publications were assessed for key methodological aspects, including the presence and timing of trial registration. RCT registries were examined to identify discrepancies between publication and registered protocols and the presence of SOR. Logistic regression was used to explore the effect of study variables on registration practices and SOR.

RESULTS

Of the 144 RCTs included, 104 (72.2%) were registered. Among those registered, only 19 (18.3%) adhered to prospective registration. Registration practice increased by 53% per year (OR 1.53; 95% CI: 1.34-2.08; P < .01). Discrepancies between publication and protocol were identified in 55.8% of studies, primarily related to sample size (33.7%). SOR was identified in 41 trials (39.4%), mainly due to discrepancies in the outcome time frame (18.3%). Studies evaluating multiple outcomes had 4.95 times higher odds of exhibiting SOR (OR 4.95; 95% CI: 1.63-12.95; P < .01). Furthermore, studies that were registered retrospectively or exhibited discrepancies between publication and protocol accounted for 6.10 times (OR 6.10; 95% CI: 1.81-18.96; P = .03) and 5.61 times (OR 5.61; 95% CI: 2.93-16.58; P < .01) higher odds of exhibiting SOR, respectively.

CONCLUSIONS

RCTs published in endodontic journals over the past 5 years presented low adherence to prospective trial registration and a high prevalence of SOR.

Selective outcome reporting concerning antibiotics and third molar surgery

OBJECTIVES

This study evaluates the selective outcome reporting (SOR) in clinical trials on antibiotic use in third molar surgeries. It explores how SOR may bias results and affect systematic reviews, potentially leading to misinterpretations of intervention efficacy.

MATERIALS AND METHODS

A search was conducted on "ClinicalTrials.gov", "Brazilian Registry of Clinical Trials", "International Clinical Trials Registry Platform" and "European Union Clinical Trials Register" using the terms "third molar" and "antibiotics" up to December 2024. Two independent researchers selected eligible clinical trials. Data were extracted from registered protocols and corresponding publications. Discrepancies were analyzed using established criteria, and the risk of bias of published articles was assessed with Risk of Bias2.

RESULTS

Discrepancies between protocols and publications were found in 87.5% of cases, affecting outcomes in 68.7% of studies. SOR significantly influenced results in studies with one or more discrepancies. 75% of studies assess pain post-antibiotic therapy; of those, 50% found significant results. Only 31,25% of studies showed significant reductions in trismus or edema with antibiotic use. The risk of bias varied significantly across studies.

CONCLUSIONS

The high rate of selective reporting stresses the need for transparent studies to clarify the role of antibiotics in the perioperative period. Researchers should adhere to best clinical practices, including protocol registration, accurate sample size calculations, and precision in reporting. Journals and reviewers must prioritize transparency to reduce bias and improve research quality.

CLINICAL RELEVANCE

This study emphasizes the impact of SOR in clinical trials using antibiotics in third molar surgery. Clinicians should be more cautious in reading evidence based on randomized clinical trials with SORs.

Selective outcome reporting among randomized controlled trials published in leading dental journals: A research-on-research study

OBJECTIVES

To study the prevalence and manifestation of selective outcome reporting (SOR) among randomized controlled trials (RCTs) published in leading dental journals, and to explore the association between SOR and potentially related factors.

METHODS

We hand-searched RCTs published in the leading dental journals between 2018 and 2023. RCTs with registrations and defined primary outcomes were included, and their relevant characteristics were extracted for analysis. Discrepancies between publication and corresponding registration were compared regarding primary outcome and other study characteristics. The generalized estimating equation model was applied to identify factors associated with SOR.

RESULTS

Two hundred and seventy trials were included. SOR was identified in 51.5% (n = 139) of the included RCTs with the discrepancy in the assessment timing of the primary outcome as the most common manifestation (n = 86, 31.9%). Substantial discrepancies were observed regarding sample size (n = 148, 54.8%) and source of funding (n = 105, 38.9%). Sample size [odds ratio (OR) 0.61, 95% confidence interval (CI) 0.40 to 0.92], timing of registration (OR 2.10, 95% CI 1.03 to 4.31), and discrepancy in follow-up length (OR 32.01, 95% CI 11.80 to 86.83) were identified as statistically significant factors associated with SOR.

CONCLUSIONS

SOR was prevalent among RCTs in leading dental journals. Researchers and other stakeholders should be aware of this reporting issue and make joint efforts to improve the outcome reporting quality.

CLINICAL SIGNIFICANCE

The findings of this research-on-research study indicate a substantial presence of SOR in the field of dentistry. Such bias can potentially mislead readers and distort the pooled effect estimates in evidence synthesis, ultimately influencing clinical decision-making.

Impact of selective reporting bias on stroke trials: potential compromise in evidence synthesis - A cross-sectional study

BACKGROUND

Accurate reporting of outcomes is crucial for interpreting the results of randomized controlled trials (RCTs). However, selectively reporting outcomes in publications to achieve researchers' anticipated results still occurs frequently. This study aims to investigate the prevalence of selective reporting of outcomes in RCTs on treating acute ischemic stroke (AIS), identify factors contributing to this issue, and assess its potential impact on the degree and direction of intervention effect.

METHODS

A search was conducted in MEDLINE, Embase, and the Cochrane Library to collect interventional RCTs on AIS published from 2020 to 2022. Full texts of RCTs were reviewed, and only those reporting International Clinical Trials Registry Platform primary registry numbers were included. Registration information of the RCTs was extracted from the registry platforms and compared with the publications' details to assess the selective reporting of outcomes. Bayesian multilevel logistic regression was used to analyze the reasons behind selective reporting.

RESULTS

Among the total of 159 AIS RCTs identified, 82 (51.6%) were ultimately included, as they reported registration numbers, which encompassed 819 outcomes. Among them, 72 RCTs (87.8%) and 497 outcomes (60.7%) exhibited selective reporting. Omission-type selective reporting (downgrading, omitting, or ambiguously reporting) accounted for 36.4%, while addition-type selective reporting (upgrading, adding, or altering the measurement scope of outcomes) comprised 63.6%. Omission-type selective reporting correlated with negative results (OR: 7.39; 95% CI: 4.08-13.44), whereas addition-type selective reporting correlated with positive results (OR: 2.07; 95% CI: 1.34-3.26) and publication in journals that are not in the top quartile of the Journal Citation Reports (OR: 2.48; 95% CI: 1.15-5.38).

CONCLUSIONS

Registered interventional AIS RCTs still face significant issues regarding selective reporting of outcomes. Therefore, it is necessary to further evaluate the influence of selective reporting bias on the positive results obtained from individual AIS RCTs and the systematic reviews based on these RCTs.

Selective outcome reporting in randomized clinical trials using the third molar surgery model

Selective outcome reporting (SOR) can threaten the validity of results found in clinical trials. Some studies in the literature have analyzed SOR in dentistry, but there is no study that has observed SOR in clinical trials in oral and maxillofacial surgery. Impacted third molar surgery is one of the most used models in clinical trials to study mainly analgesic and anti-inflammatory drug interventions. Our study aimed to evaluate the prevalence of SOR in publications employing the third molar extraction clinical trial model, and to verify whether there was an association between the statistical significance of outcomes and other characteristics that could lead to SOR. A systematic search was performed on the ClinicialTrials.gov platform for randomized clinical trial protocols, using the condition of third molar extraction. The corresponding published articles were sourced in PubMed, Scopus, and Embase databases, and compared with the registered protocols regarding the methodological data, in terms of: sample calculation, primary outcome identification, end-point periods, insertion of new outcomes in the publication, and results of outcomes. 358 protocol records were retrieved; 87 presented their corresponding articles. SOR was identified in 28.74% of the publications, and had a significant relationship with changes in the protocol, insertions of new outcomes, and discrepancies in the types of study. General risk of bias was found to be low. There were associations between SOR and the discrepancies in terms of the type of study, the choice of new outcome, and changes in the history of protocol records. The prevalence of SOR in clinical research using the third molar extraction surgery model is moderate. The quality of the scientific reporting of the results and, consequently, the certainty of evidence relating to the intervention tested can be overstated, increasing the chances of misinterpretation by health professionals.

Should informed consent and information related to patient recruitment in clinical trials be available to the reader of scientific articles? A case study in dentistry

Ethical aspects in research should be transparently reported. This study aimed to investigate whether informed consent and information related to patient recruitment in clinical studies are well reported in the scientific literature. Randomized clinical trials (RCTs) on root coverage procedures published between November 2016 and November 2021 were selected from the PubMed database. Items/questions were used to guide the extraction of data related to patient recruitment, with a focus on the detailed report of informed consent used to clarify the research to the patient. Data were extracted from the published article and the respective research protocol published in a public registry. Information related to potential selective outcome reporting (SOR) was also extracted. In total, 187 documents were initially screened and 74 reports of RCTs were included. No informed consent was published in the article. Only one research protocol provided a link to the informed consent. Deviations from reporting in the research protocol and published article were found, suggesting SOR. Informed consent and information related to patient recruitment in RCTs on root covering procedures are severely underreported. The present findings may stimulate further discussion and debate on the need for making this information publicly available.

Selective outcome reporting bias is highly prevalent in randomized clinical trials of nonsurgical periodontal therapy

Selective outcome reporting (SOR) is a type of bias that can compromise the validity of results and affect evidence-based practice. SOR can overestimate the effect of an intervention and lead to conclusions that a treatment is effective when it is not. This study aimed to investigate the prevalence of SOR in publications of RCTs on nonsurgical periodontal therapy (NSPT) and to verify associated factors. The protocols were searched and selected on the www.clinicaltrials.gov platform up to January 16, 2022. Corresponding publications were identified, and data extraction and discrepancy analysis were performed. The risk of bias was assessed according to the RoB2 tool. One hundred forty-five studies (174 publications) were included. The prevalence of SOR was 49.7% and was unclear in nearly one third of studies (27.6%). Only 31.7% of the primary outcomes were completely described in the publications. The overall risk of bias was high in 60% of the included studies. SOR was associated with statistical significance (p < .001), and multiple publications of the same study (p = .005). Our study demonstrated the high prevalence of SOR, highlighting the need to improve the quality of reporting of RCTs on NSPT studies.

Selective outcome reporting in paediatric dentistry restorative treatment randomised clinical trials-A meta-research

BACKGROUND

Selective outcome reporting (SOR) is a bias that occurs when the primary outcome of a randomised clinical trial (RCT) is omitted or changed.

AIM

To evaluate the prevalence of SOR in RCTs on restorative treatment in primary teeth.

DESIGN

We conducted an electronic search on ClinicalTrials.gov and the World Health Organization platform (International Clinical Trials Registry Platform) on 1^st of April 2021, with no registry time or language restrictions. We included RCT protocols that evaluated restorative treatments in primary teeth and excluded trials that did not have a complete publication in a scientific journal. The chi-squared test was used to identify the association between SOR and variables as a discrepancy in the follow-up period, the timing of registration, the type of sponsorship and the type of study design (α = 5%).

RESULTS

Of the 294 identified protocols, 30 were included in the study. 83.3% of trials were registered retrospectively. SOR was observed in 53.3% (n = 16) of the published trials and was significantly associated with a discrepancy in the follow-up period (p = .017).

CONCLUSIONS

The high prevalence of SOR in RCTs on restorative treatment proves that this is a prominent threat. A proper preregistered protocol, declaration of any protocol deviation and allowance of stakeholders to compare the protocol with that of the submitted papers will achieve transparency.

ASSESSMENT OF THE FREQUENCY OF REPORTING DENTAL PATIENT-REPORTED OUTCOMES (dPROs) IN A SAMPLE OF RANDOMIZED CONTROLLED TRIALS ON ROOT COVERAGE PROCEDURES

OBJECTIVE

Dental patient-reported outcomes (dPROs) are important for understanding the impact of proposed therapies on patients' oral health. The aims of the present study were to investigate the frequency of the reporting of dPROs in randomized controlled trials (RCTs) of root coverage procedures and to assess associations between the study/article characteristics and the reporting level of the dPROs.

METHODS

The PubMed database was searched for RCTs of root coverage procedures in March 16, 2022 and articles published up to March 2022 were included. Information on the types of outcomes and the characteristics of the studies/articles were extracted and reported as frequencies and percentages. Univariate and multivariate binary logistic regression analyses were performed to investigate the associations between the study/article characteristics and the reporting level of dPROs.

RESULTS

The search initially identified 387 articles, and after applying the eligibility criteria, 135 articles reporting 135 RCTs were included. A combination of dPROs and non-dPROs was reported in 61.5% of the selected trials, while 37.8% of the trials reported only non-dPROs. Pain or discomfort was the most frequently reported dPRO (n = 58, 43% of the RCTs). More recently published RCTs reported more dPROs. The country of the first author (odds ratio [OR]: 4.39; 95% CI: 1.76-10.95; P < .01), protocol registration (OR: 0.36; 95% CI: 0.16-0.83; P = .02), and RCT type (OR: 0.38; 95% CI: 0.17-0.83; P = .02) were significantly associated with the reporting level of the dPROs.

CONCLUSIONS

Researchers in recent years seem to be paying more attention to the importance of dPROs. RCTs in which the first authors were from developed countries, registered trials, and RCTs with a parallel design were more likely to report dPROs than RCTs with first authors from developing countries, unregistered trials, and RCTs with a split-mouth design.

Palatal mucosa thickness and palatal neurovascular bundle position evaluation by cone-beam computed tomography-retrospective study on relationships with palatal vault anatomy

Background

Measuring the thickness of the palatal mucosa at the planning of the surgical procedure is an important step in order to obtain the maximum width and thickness of the graft from the appropriate area. The aim of this study is to determine whether there is a relationship between palatal angle (PA) or palatal depth (PD) and palatal mucosa thickness (PMT) or palatal neurovascular bundle distance (PNBD).

Methods

PMT, PNBD, PD and PA were measured on cone-beam computed tomography (CBCT) images of maxillary posterior region of 200 male and 200 female patients. The mean of all parameters according to gender was compared and the significance of the difference detected between groups was evaluated. Potential relationship between PMT or PNBD and PA or PD was also evaluated.

Results

In females, the palatal mucosa was significantly thinner at all tooth regions (p < 0.005), and PNBD was lower only at the level of the second molar (p < 0.001). In addition, it was found that there was a significant inverse correlation between the palatal depth value and the palatal mucosal thickness, and palatal depth was correlated with the palatal neurovascular bundle distance (p ≤ 0.001).

Discussion

Consistent with previous studies, it was observed that the thickest mucosa in the palatal region was located in the region of the premolar teeth, and women had thinner palatal mucosa. In addition, in patients with a deeper palate vault, the palatal mucosa was thinner, but the palatal neurovascular bundle was more distant from the cemento-enamel junction.