Jellison Samuel, Roberts Will, Bowers Aaron, Combs Tyler, Beaman Jason, Wayant Cole, Vassar Matt
College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.
Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.
BMJ Evid Based Med. 2019 Aug 5:178-181. doi: 10.1136/bmjebm-2019-111176.
We have identified 'spin' in abstracts of randomised controlled trials (RCTs) with nonsignificant primary endpoints in psychiatry and psychology journals. This is a cross-sectional review of clinical trials with nonsignificant primary endpoints published in psychiatry and psychology journals from January 2012 to December 2017. The main outcome was the frequency and manifestation of spin in the abstracts. We define spin as the 'use of specific reporting strategies, from whatever motive, to highlight that the experimental treatment is beneficial, despite a statistically nonsignificant difference for the primary outcome, or to distract the reader from statistically nonsignificant results'. We have also assessed the relationship between industry funding and spin. Of the 486 RCTs examined, 116 were included in our analysis of spin. Spin was identified in 56% (n=65) of those included. Spin was found in 2 (2%) titles, 24 (21%) abstract results sections and 57 (49.1%) abstract conclusion sections. Evidence of spin was simultaneously identified in both results and conclusions sections in 15% of RCTs (n=17). Twelve articles reported industry funding (10%). Industry funding was not associated with increased odds of spin in the abstract (unadjusted OR: 1.0; 95% CI: 0.3 to 3.2). We found no relationship between industry funding and spin in abstracts. These findings raise concerns about the effects spin may have on clinicians. Further steps could be taken to address spin, including inviting reviewers to comment on the presence of spin and updating Consolidated Standards of Reporting Trials guidelines to contain language discouraging spin.
我们在精神病学和心理学杂志中主要终点无统计学意义的随机对照试验(RCT)摘要中发现了“夸大”现象。这是一项对2012年1月至2017年12月在精神病学和心理学杂志上发表的主要终点无统计学意义的临床试验的横断面综述。主要结果是摘要中夸大现象的频率和表现形式。我们将夸大定义为“出于任何动机使用特定的报告策略,以突出实验性治疗是有益的,尽管主要结局在统计学上无显著差异,或者使读者忽略统计学上无显著意义的结果”。我们还评估了行业资助与夸大之间的关系。在所审查的486项随机对照试验中,116项纳入了我们对夸大现象的分析。在纳入分析的试验中,56%(n =65)被发现存在夸大现象。在2个(2%)标题、24个(21%)摘要结果部分和57个(49.1%)摘要结论部分发现了夸大现象。15%的随机对照试验(n =17)在结果和结论部分同时发现了夸大证据。12篇文章报告了行业资助情况(10%)。行业资助与摘要中夸大现象增加的几率无关(未调整的比值比:1.0;95%置信区间:0.3至3.2)。我们发现摘要中的行业资助与夸大现象之间没有关系。这些发现引发了对夸大现象可能对临床医生产生的影响的担忧。可以采取进一步措施来解决夸大问题,包括邀请审稿人对夸大现象的存在发表评论,并更新《报告试验的统一标准》指南,加入 discouraging spin的措辞。 (最后这个“discouraging spin”不太明确准确意思,可能表述有误,根据语境大致翻译为“抑制夸大”之类意思,但整体翻译可能因这个词的问题有些许瑕疵)