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

Methods for assessing peri-implant marginal bone levels on digital periapical radiographs: a meta-research

OBJECTIVES

This meta-research assessed methodologies used for evaluating peri-implant marginal bone levels on digital periapical radiographs in randomized clinical trials published between 2019 and 2023.

METHODS

Articles were searched in four databases. Data on methods for assessing peri-implant marginal bone levels were extracted. Risk of bias assessment was performed.

RESULTS

During full-text reading, 108 out of 162 articles were excluded. Methodological issues accounted for these exclusions, including the absence of radiograph-type information, the lack of radiographic positioners, the missing anatomical references, and the use of panoramic radiographs or tomography. Fifty-four articles were included, most from Europe (70%) and university-based (74%). Radiographic positioners were specified in 54% of articles. Examiner calibration was unreported in 54%, with 69% lacking details. In 59%, no statistical measure assessed examiner agreement. Blinding was unreported or unused in 50%. Marginal bone level changes were the primary outcome of 61%. Most articles (59.3%) raised "some concerns" regarding bias, while 37% showed a high risk of bias, and only two articles (3.7%) demonstrated a low risk of bias.

CONCLUSIONS

Several limitations and areas for improvement were identified. Future studies should prioritize protocol registration, standardize radiographic acquisitions, specify examiner details, implement calibration and statistical measures for agreement, introduce blinding protocols, and maintain geometric calibration standards.

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.

Safety reporting in trials on glaucoma interventions registered in ClinicalTrials.gov and corresponding publications

Accurate, comprehensive, and consistent reporting of adverse events is of great importance for treatment decisions in clinical practice and patient safety. Aiming to evaluate the completeness and transparency of reported adverse events we conducted a retrospective analysis of completed clinical trials on glaucoma interventions registered in ClinicalTrials.gov from September 27, 2009, and updated and with results on or before November 1, 2023, as well as in corresponding journal publications. Any difference in completeness, number, or terminology/description of adverse events and all-cause mortality between ClinicalTrials.gov and the publication was categorized as inconsistent reporting of adverse events. All 79 trials with results both in the registry and a journal publication exhibited at least one inconsistency in reporting adverse events. In 19 publications (24%), the number of serious adverse events was smaller than in the registry. 69 (87%) trials reported more other adverse events in the registry than in the publication. Trials completed after the FDAA mandate for summary reporting of all-cause mortality more often reported this item in the registry but not in the publication. Trials on glaucoma interventions do not consistently report adverse events and thus introduce concerns about study credibility and potential harms of the interventions. Journals and other stakeholders in trial reporting must address this problem to ensure the safety of patients and trust in health interventions.

Effectiveness of vestibular incision subperiosteal tunnel access technique: A systematic review and meta-analysis

Vestibular Incision Subperiosteal Tunnel Access (VISTA) root coverage technique has experienced a surge in popularity in recent times. The methodology employed in this study is characterized by its minimally invasive nature, utilizing a single incision. The primary objective of this systematic review was to assess the effectiveness of the VISTA approach for achieving root coverage. The protocol was registered with PROSPERO and included randomized controlled clinical trials where gingival recessions were managed with VISTA technique or its modifications. Among the total of 416 records, a mere 14 studies were initially deemed eligible for consideration. Ultimately, only eight pieces of research were included in the final analysis. There were six studies that exhibited heterogeneity, while two studies showed homogeneity and were therefore included in the meta-analysis. All of the studies considered in the analysis exhibited a moderate to low risk of bias. The majority of the research included in the analysis focused on selective root coverage outcome indicators, while neglecting to incorporate patient-reported outcome measures and patient experienced outcome measures. The VISTA procedure is commonly acknowledged as the most efficacious approach for managing gingival recession. The current literature provides support for the recommendation of the procedure, with evidence of intermediate certainty. The findings of this systematic review indicates that the available data are restricted due to several methodological limitations observed in the included studies. These limitations include, small sample sizes, selective reporting of outcomes, and very short follow-up periods.

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.

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.

Why Pre-Registration of Research Must Be Taken More Seriously

The scientific method assumes that researchers use evidence generated from observational research to make predictions (hypotheses) that can be tested experimentally [...].