Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States.
Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States; Arkansas College of Osteopathic Medicine, Arkansas Colleges of Health Education, Fort Smith, AR, United States.
J Cancer Policy. 2021 Mar;27:100268. doi: 10.1016/j.jcpo.2020.100268. Epub 2020 Dec 28.
While spin - i.e., a reporting practice that embellishes positive findings and understates negative ones - is prevalent in randomized controlled trials, it has yet to be investigated in the context of systematic reviews. Owing to their significant role in clinical decision making and patient outcomes, this study seeks to identify and evaluate the severity of spin in the abstracts of systematic reviews on breast cancer.
We searched MEDLINE and Embase for systematic reviews and meta-analyses focused on breast cancer treatment, screening, and post-treatment quality of life between 1987 and 2020. Investigators independently screened for study selection, extracted spin data, and appraised the methodological quality of reviews using AMSTAR 2. In this cross-sectional study, 11,717 articles were identified, of which 581 met inclusion criteria. Following randomization, the first 200 were evaluated and 21 % contained evidence of at least one of nine types of spin.
We identified spin types one, three, four, five, and six but not two, seven, eight, or nine. In particular, pharmacological (AOR 4.36, 95 % CI [1.18-16.01]) and surgical (AOR, 10.10 95 % CI [1.60-63.68]) intervention-type studies were highly associated with spin. There were no other associations between study characteristics and spin. While these results are significant, they contain a wide confidence interval and the reader should draw conclusions accordingly.
There is evidence of spin in meta-analyses and systematic reviews regarding breast cancer treatment and quality of life outcomes. Accordingly, readers of systematic review abstracts related to breast cancer could be misled by distorted presentation of findings.
This study aims to improve the standards of reporting in systematic reviews and meta-analyses related to cancer.
虽然在随机对照试验中，自旋——即一种夸大阳性结果、淡化阴性结果的报告做法——很普遍，但它在系统评价中尚未得到研究。由于系统评价在临床决策和患者结局中具有重要作用，本研究旨在识别和评估乳腺癌系统评价摘要中的自旋严重程度。
我们检索了 MEDLINE 和 Embase 中 1987 年至 2020 年间关于乳腺癌治疗、筛查和治疗后生活质量的系统评价和荟萃分析。调查人员独立进行研究筛选、提取自旋数据，并使用 AMSTAR 2 评估评价的方法学质量。在这项横断面研究中，共确定了 11717 篇文章，其中 581 篇符合纳入标准。在随机分组后，评估了前 200 篇，其中 21%的文章包含了至少九种自旋类型之一的证据。
我们确定了自旋类型一、三、四、五和六，但没有二、七、八或九。特别是，药理学（AOR 4.36，95%CI [1.18-16.01]）和外科干预型（AOR 10.10，95%CI [1.60-63.68]）研究与自旋高度相关。研究特征与自旋之间没有其他关联。虽然这些结果很显著，但它们的置信区间很宽，读者应相应地得出结论。
在乳腺癌治疗和生活质量结局的系统评价和荟萃分析中，存在自旋的证据。因此，与乳腺癌相关的系统评价摘要的读者可能会被扭曲的研究结果所误导。
本研究旨在提高与癌症相关的系统评价和荟萃分析的报告标准。
