1st Department of Internal Medicine and Infectious Diseases, "Sotiria" General and Chest Diseases Hospital of Athens, 152, Mesogion St., Athens, 115 27 Greece.
J Clin Epidemiol. 2021 Aug;136:55-63. doi: 10.1016/j.jclinepi.2021.03.020. Epub 2021 Mar 26.
To investigate the presence of white hat bias in Covid-19 treatment research by evaluating the effects of citation and reporting bias.
Citation bias was investigated by assessing the degree of agreement between evidence provided by a remdesivir randomized controlled trial and its citing articles. The dissimilarity of outcomes derived from nonrandomized and randomized studies was tested by a meta-analysis of hydroxychloroquine effects on mortality. The differential influence of studies with beneficial over those with neutral results was evaluated by a bibliometric analysis.
The articles citing the ACTT-1 remdesivir trial preferentially presented its positive outcomes in 55.83% and its negative outcomes in 6.43% of cases. The hydroxychloroquine indicated no significant effect by randomized studies, but a significant survival benefit by nonrandomized ones. Citation mapping revealed that the study reporting survival benefit from the hydroxychloroquine-azithromycin combination was the most influential, despite subsequent studies reporting potential harmful effects.
The present study raises concerns about citation bias and a predilection of reporting beneficial over harmful effects in the Covid-19 treatment research, potentially in the context of white hat bias. Preregistration, data sharing and avoidance of selective reporting are crucial to ensure the credibility of future research.
通过评估引用和报告偏倚的影响，调查新冠病毒治疗研究中是否存在“白帽子”偏倚。
通过评估瑞德西韦随机对照试验与其引用文章之间证据的一致性，来研究引用偏倚。通过对羟氯喹对死亡率影响的荟萃分析，检验非随机和随机研究得出的结果的差异。通过文献计量学分析，评估具有有益结果的研究与中性结果的研究的不同影响。
引用 ACTT-1 瑞德西韦试验的文章在 55.83%的情况下优先呈现其阳性结果，在 6.43%的情况下呈现其阴性结果。随机研究表明羟氯喹没有显著效果，但非随机研究表明其有显著的生存获益。引文图谱显示，尽管随后的研究报告了潜在的有害影响，但报告羟氯喹-阿奇霉素联合用药有生存获益的研究最具影响力。
本研究对新冠病毒治疗研究中存在的引用偏倚和对有益影响的报告偏好提出了担忧，这可能涉及到“白帽子”偏倚。预先注册、数据共享和避免选择性报告对于确保未来研究的可信度至关重要。
