Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK.
Department of Medical Oncology, Henri Mondor and Albert Chenevier Teaching Hospital, APHP, Créteil, France.
Br J Cancer. 2018 Nov;119(10):1288-1296. doi: 10.1038/s41416-018-0305-5. Epub 2018 Oct 24.
Cancer prognostic biomarkers have shown disappointing clinical applicability. The objective of this study was to classify and estimate how study results are overinterpreted and misreported in prognostic factor studies in oncology.
This systematic review focused on 17 oncology journals with an impact factor above 7. PubMed was searched for primary clinical studies published in 2015, evaluating prognostic factors. We developed a classification system, focusing on three domains: misleading reporting (selective, incomplete reporting, misreporting), misleading interpretation (unreliable statistical analysis, spin) and misleading extrapolation of the results (claiming irrelevant clinical applicability, ignoring uncertainty).
Our search identified 10,844 articles. The 98 studies included investigated a median of two prognostic factors (Q1-Q3, 1-7). The prognostic factors' effects were selectively and incompletely reported in 35/98 and 24/98 full texts, respectively. Twenty-nine articles used linguistic spin in the form of strong statements. Linguistic spin rejecting non-significant results was found in 34 full-text results and 15 abstract results sections. One in five articles had discussion and/or abstract conclusions that were inconsistent with the study findings. Sixteen reports had discrepancies between their full-text and abstract conclusions.
Our study provides evidence of frequent overinterpretation of findings of prognostic factor assessment in high-impact medical oncology journals.
癌症预后生物标志物的临床应用效果不尽人意。本研究旨在对肿瘤预后因素研究中过度解读和错误报告的情况进行分类和评估。
本系统评价重点关注了 17 种影响因子高于 7 的肿瘤学期刊。在 PubMed 上搜索了 2015 年发表的评估预后因素的主要临床研究的原始文章。我们开发了一个分类系统，重点关注三个领域：误导性报告（选择性报告、不完整报告、错误报告）、误导性解释（不可靠的统计分析、曲解）和结果的误导性外推（声称不相关的临床适用性、忽略不确定性）。
我们的搜索共确定了 10844 篇文章。纳入的 98 项研究平均评估了两种预后因素（Q1-Q3，1-7）。35/98 和 24/98 篇全文分别选择性和不完整地报告了预后因素的影响。29 篇文章使用了强烈陈述的语言曲解。在 34 篇全文和 15 篇摘要结果部分中发现了拒绝非显著性结果的语言曲解。五分之一的文章的讨论和/或摘要结论与研究结果不一致。16 份报告的全文和摘要结论存在差异。
本研究提供了证据，表明在高影响力的肿瘤学医学期刊中，对预后因素评估结果的过度解读较为频繁。
