Jones Caleb, Rulon Zane, Arthur Wade, Ottwell Ryan, Checketts Jake, Detweiler Byron, Calder Mark, Adil Abrar, Hartwell Micah, Wright Drew N, Vassar Matt
Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA.
Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA.
J Shoulder Elbow Surg. 2021 Jan 19:2197-2205. doi: 10.1016/j.jse.2020.11.026.
Research has shown that many physicians rely solely on abstracts to make clinical decisions. However, many abstracts have been shown to be misleading. The primary objective of this study was to identify the prevalence of spin - bias towards particular results - within the abstracts of systematic reviews and meta-analyses pertaining to the treatment of proximal humerus fractures, one of the most common osteoporotic fractures among elderly patients.
We systematically searched MEDLINE and Embase databases to identify systematic reviews and meta-analyses examining the treatment of proximal humerus fractures. Screening and data extraction occurred in a masked, duplicate fashion. The nine most severe types of spin that occur within abstracts were extracted along with study characteristics, including journal recommendations to adhere to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and year in which the review was performed, to identify potential associations. We subsequently explored the association between spin and the methodological quality of a systematic review using the revised A MeaSurement Tool to Assess systematic Reviews (AMSTAR 2) appraisal instrument.
Our search retrieved 505 articles, of which 73 systematic reviews met inclusion criteria. We found that 34.2% (25/73) of the included systematic reviews contained spin. Spin type 3 (selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention) was the most common type identified (12/73, 16.4%). Three spin types were not identified in any of the abstracts. Spin was 3.2 (OR 3.2; 95% CI, 1.02-10.02) times more likely to be present in systematic reviews published in journals recommending adherence to PRISMA. Furthermore, the odds of an abstract containing spin was 1.25 (OR 1.25; 95% CI, 1.02-1.52) times more likely to be present in systematic reviews for each year after 2000. No other study characteristics were associated with spin. The methodological quality of 24 studies were rated as "critically low" (32.9%), 14 were "low" (19.2%), 28 were "moderate" (38.4%), and 7 were "high" (9.6%), but these findings were not associated with spin.
Spin was present in systematic review abstracts regarding treatment of proximal humerus fractures. Measures such as education on the subject of spin and improved reporting standards should be implemented to increase awareness and reduce incidence of spin in abstracts.
Basic Science Study; Research Methodology.
研究表明，许多医生仅依靠摘要来做出临床决策。然而，许多摘要已被证明具有误导性。本研究的主要目的是确定在关于肱骨近端骨折治疗的系统评价和荟萃分析摘要中，对特定结果的倾向性偏倚的发生率，肱骨近端骨折是老年患者中最常见的骨质疏松性骨折之一。
我们系统检索了MEDLINE和Embase数据库，以识别有关肱骨近端骨折治疗的系统评价和荟萃分析。筛选和数据提取以盲法、重复的方式进行。提取摘要中出现的九种最严重的倾向性偏倚类型以及研究特征，包括期刊关于遵循系统评价和荟萃分析的首选报告项目（PRISMA）的建议以及进行评价的年份，以确定潜在关联。随后，我们使用修订后的评估系统评价测量工具（AMSTAR 2）评估工具，探讨了倾向性偏倚与系统评价方法学质量之间的关联。
我们的检索共获得505篇文章，其中73篇系统评价符合纳入标准。我们发现，纳入的系统评价中有34.2%（25/73）包含倾向性偏倚。倾向性偏倚类型3（选择性报告或过度强调疗效结果或分析偏向实验干预的有益效果）是最常见的类型（12/73，16.4%）。在任何摘要中均未发现三种倾向性偏倚类型。在建议遵循PRISMA的期刊上发表的系统评价中，出现倾向性偏倚的可能性高3.2倍（OR 3.2；95%CI，1.02 - 10.02）。此外，2000年后每年进行的系统评价中，摘要包含倾向性偏倚的几率高1.25倍（OR 1.25；95%CI，1.02 - 1.52）。没有其他研究特征与倾向性偏倚相关。24项研究的方法学质量被评为“极低”（32.9%），14项为“低”（19.2%），28项为“中等”（38.4%），7项为“高”（9.6%），但这些结果与倾向性偏倚无关。
关于肱骨近端骨折治疗的系统评价摘要中存在倾向性偏倚。应采取诸如开展关于倾向性偏倚主题的教育和提高报告标准等措施，以提高认识并减少摘要中倾向性偏倚的发生率。
基础科学研究；研究方法。
