Evaluation of “Spin” in the Abstracts of Randomized Controlled Trial Reports in Cardiology

Abstract

Context The misrepresentation and distortion of research findings, known as “spin,” has been shown to affect clinical decision making. Spin has been found in randomized controlled trials (RCTs) published in various fields of medicine. Objective To evaluate the abstracts of RCTs found in the cardiology literature for spin. Methods The authors searched PubMed using a specific string of keywords to identify previously published articles documenting RCTs of cardiovascular treatments in humans. To be included, a cardiology trial had to randomize humans to an intervention, statistically compare 2 or more groups, and have a nonsignificant primary endpoint. Records were excluded if they did not meet these criteria. Data extraction was double-blinded and done using a pilot-tested Google Form. Items extracted from each trial included the title, journal, funding source, comparator arm, primary endpoint, statistical analysis of the primary endpoint, secondary endpoints, statistical analysis of secondary endpoints, and trial registration number (if reported). The 2 authors who screened records for inclusion were then asked whether spin was present in the abstract of the randomized trial. Spin in the title, abstract results, abstract conclusions, and selection of reported endpoints were considered. Results Of the 651 PubMed citations retrieved by our search string, 194 RCTs with a clearly defined primary endpoint were identified. Of these 194 RCTs, 66 trials contained nonsignificant primary endpoints and were evaluated for spin. Of these trials, spin was identified in 18 of the 66 abstracts (27.3%). Conclusions Spin was present in our sample of cardiology RCTs. Spin may influence clinical decision making by creating false impressions of the true validity of a drug or intervention.

Consistency between trials presented at conferences, their subsequent publications and press releases

“…26 Another study identified spin in 34.5% of abstracts of systematic reviews and meta-analyses in emergency medicine. 27 Similarly, Roberts et al 28 evaluated spin in abstracts of cardiology trials and found evidence of spin in 27.3% of trial abstracts. 28 There were lower rates of consistent reporting among other trial characteristics between conference and publication abstracts, including sample sizes, follow-up periods and effect size estimates, which does not rule out the possibility of misreporting at conferences and/or their subsequent publications.…”

“…27 Similarly, Roberts et al 28 evaluated spin in abstracts of cardiology trials and found evidence of spin in 27.3% of trial abstracts. 28 There were lower rates of consistent reporting among other trial characteristics between conference and publication abstracts, including sample sizes, follow-up periods and effect size estimates, which does not rule out the possibility of misreporting at conferences and/or their subsequent publications. For instance, for sample size, safety endpoint and effect size reporting consistency, we found rates that ranged between 50% and 75%.…”

“… 26 Another study identified spin in 34.5% of abstracts of systematic reviews and meta-analyses in emergency medicine. 27 Similarly, Roberts et al 28 evaluated spin in abstracts of cardiology trials and found evidence of spin in 27.3% of trial abstracts. 28 …”

“… 27 Similarly, Roberts et al 28 evaluated spin in abstracts of cardiology trials and found evidence of spin in 27.3% of trial abstracts. 28 …”

The presence of spin in systematic reviews focused on diabetic neuropathy: A cross-sectional analysis

“…However, discrepancies have been found between specialties. For example, 70% of otolaryngology abstracts contain spin in comparison to 44.3% of emergency medicine abstracts, and 27.3% of cardiology abstracts [ 9 – 11 ]. Due to the variability in results of past research, further exploration is warranted to examine the presence of spin in additional fields.…”