Risk of Bias and Quality of Reporting in Colon and Rectal Cancer Systematic Reviews Cited by National Comprehensive Cancer Network Guidelines

INTRODUCTION

Given the changing landscape of colorectal cancer, systematic reviews are likely to play a key role in advancing the understanding of prevention, diagnosis, and treatment.

METHODS

We conducted a cross-sectional investigation of the risk of bias and reporting quality of systematic reviews referenced by colon and rectal cancer National Comprehensive Cancer Network (NCCN) guidelines. We used two widely accepted tools: Risk of Bias in Systematic reviews (ROBIS) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

RESULTS

Using ROBIS, only 3 (4.8%) systematic reviews were judged with low risk of bias, 35 (55.6%) systematic reviews were judged with unclear risk of bias, and 25 (39.7%) systematic reviews were judged with high risk of bias. Across all systematic reviews, the individual bias domains at the highest risk of bias were domains 1 (protocol and eligibility criteria) and 2 (methods to identify and select studies). Across all studies, the median adherence to PRISMA was 74.1% (IQR 69.2-80.0%), corresponding to approximately 20 of 27 items.

CONCLUSIONS

Systematic reviews cited in NCCN guidelines for colon and rectal cancer are frequently at unclear or high risk of bias and do not report key systematic review items that are important for the critical appraisal of results.

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.

Using the CONSORT statement to evaluate the completeness of reporting of addiction randomised trials: a cross-sectional review

OBJECTIVES

Evaluate the completeness of reporting of addiction randomised controlled trials (RCTs) using the Consolidated Standards of Reporting Trials (CONSORT) statement.

SETTING

Not applicable.

PARTICIPANTS

RCTs identified using a PubMed search of 15 addiction journals and a 5-year cross-section.

OUTCOME MEASURES

Completeness of reporting.

RESULTS

Our analysis of 394 addiction RCTs found that the mean number of CONSORT items reported was 19.2 (SD 5.2), out of a possible 31. Twelve items were reported in <50% of RCTs; similarly, 12 items were reported in >75% of RCTs. Journal endorsement of CONSORT was found to improve the number of CONSORT items reported.

CONCLUSIONS

Poor reporting quality may prohibit readers from critically appraising the methodological quality of addiction trials. We recommend journal endorsement of CONSORT since our study and those previous have shown that CONSORT endorsement improves the quality of reporting.

Using Google Trends to assess global public interest in osteoarthritis

To evaluate global public interest in osteoarthritis by assessing changes in Internet search popularity of the disease over a 10-year period. Google Trends was used to obtain search popularity scores for the word "osteoarthritis" (OA) between January 2004 and June 2018. We also analyzed changes in search volume relative to changes in search patterns for all health topics. Search interest in OA was high relative to all other health searches over the given timeframe. Overall, searches for OA steadily decreased between May 2004 and December 2012 and then steadily rose from January 2013 to April 2018. We also found consistent annual fluctuations over the pre-specified time range, with biannual peaks typically correlating with national and global awareness days. Biannual dips occurred with changes in seasonal patterns. Google searches for OA have steadily increased in recent years. Awareness initiatives, like World Arthritis Day, may be a reason for the public to search for information on OA. It may be helpful for physicians to search the Internet themselves for websites that provide accurate and high-quality information to recommend to their patients.