USC Epstein Family Center for Sports Medicine, Department of Orthopaedic Surgery, Keck Medicine of USC, Los Angeles, CA, USA.
Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, MD, USA.
J Shoulder Elbow Surg. 2022 Aug;31(8):1743-1750. doi: 10.1016/j.jse.2022.03.015. Epub 2022 Apr 25.
Small, preliminary studies and the systematic reviews on superior capsular reconstruction (SCR) that collate data are at increased risk spin. This study's primary objective was to identify, describe, and account for the incidence of spin in systematic reviews of SCR. This study's secondary objective was to characterize the studies in which spin was identified to determine whether identifiable patterns of characteristics exist among studies with spin.
This study was conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using a predetermined protocol. A search was conducted on the PubMed and Embase databases for systematic reviews and meta-analyses on SCR. Screening and data extraction were conducted independently by 2 authors. Each included study's abstract was assessed for the presence of the 15 most common types of spin, with full texts reviewed during cases of disagreement or for clarification. General data that were extracted included study title, authors, publication year, journal, level of evidence, study design, funding source, reported adherence to PRISMA guidelines, preregistration of the study protocol, and primary and secondary outcome measures. Full texts were used in the assessment of study quality per AMSTAR 2.
We identified 53 studies during our search, of which 17 met the inclusion criteria. At least 1 form of spin was observed in all 17 studies. The most common types of spin were type 5 ("The conclusion claims the beneficial effect of the experimental treatment despite a high risk of bias in primary studies") and type 9 ("Conclusion claims the beneficial effect of the experimental treatment despite reporting bias"), both of which were observed in 11 studies (11 of 17, 65%). A statistically significant association between lower level of evidence and type 5 ("The conclusion claims the beneficial effect of the experimental treatment despite a high risk of bias in primary studies") was observed (P = .0175). A statistically significant association was also found between more recent year of publication and the spin category misleading interpretation (P = .0398), and between lower AMSTAR 2 score and type 13 ("Failure to specify the direction of the effect when it favors the control intervention") (P = .0260). No other statistical associations between other study characteristics were observed.
Spin is highly prevalent in abstracts of SCR systematic reviews and meta-analyses. An association was found between the presence of spin and lower level of evidence, year of publication, and AMSTAR 2 ratings.
小型初步研究和对肩袖顶重建（SCR）的系统综述，对数据进行整理，存在着增加旋转风险。本研究的主要目的是确定、描述和说明 SCR 系统综述中旋转的发生率。本研究的次要目的是描述发现旋转的研究，以确定是否存在旋转研究之间存在可识别的特征模式。
本研究按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行，使用预定的方案。在 PubMed 和 Embase 数据库中对 SCR 的系统评价和荟萃分析进行了搜索。两名作者独立进行筛选和数据提取。对每个纳入研究的摘要进行了 15 种最常见类型旋转的评估，如果存在分歧或需要澄清，则对全文进行了审查。提取的一般数据包括研究标题、作者、出版年份、期刊、证据水平、研究设计、资金来源、报告对 PRISMA 指南的遵守情况、研究方案的预先登记以及主要和次要结局指标。根据 AMSTAR 2 评估研究质量时使用了全文。
我们在搜索中发现了 53 项研究，其中 17 项符合纳入标准。在所有 17 项研究中都观察到至少一种形式的旋转。最常见的旋转类型是类型 5（“结论声称实验性治疗有有益效果，尽管主要研究存在高偏倚风险”）和类型 9（“结论声称实验性治疗有有益效果，尽管存在报告偏倚”），这两种类型都在 11 项研究中观察到（17 项中的 11 项，65%）。观察到较低证据水平与类型 5（“结论声称实验性治疗有有益效果，尽管主要研究存在高偏倚风险”）之间存在统计学显著关联（P=0.0175）。还发现了较新的出版年份与旋转类别误导性解释之间存在统计学显著关联（P=0.0398），以及较低的 AMSTAR 2 评分与类型 13（“当控制干预有利于效果时，未能指定效果的方向”）之间存在统计学显著关联（P=0.0260）。未观察到其他研究特征之间存在其他统计学关联。
在 SCR 系统综述和荟萃分析的摘要中，旋转现象非常普遍。发现旋转的存在与较低的证据水平、出版年份和 AMSTAR 2 评分之间存在关联。
