More than half of randomized controlled trials published in six top psychiatry/psychology journals over 5 years contained spin, mainly in the results and conclusion sections of the abstract, according to a survey published in BMJ Evidence-Based Medicine.
“In an abstract, authors may include only the results they want to highlight or the conclusions they wish to draw. These results and conclusions, however, may not accurately summarize the findings of the study. When such a misrepresentation of study results occurs, there is said to be spin,” Samuel Jellison, medical student at Oklahoma State University Center for Health Sciences, and colleagues wrote.
In their cross-sectional review, Jellison and colleagues examined the frequency and manifestation of spin in abstracts of randomized controlled trials (RCTs) with nonsignificant primary endpoints published in psychology and psychiatry journals from 2012 to 2017 as well as the connection between spin and industry funding.
Included journals were: British Journal of Psychiatry; Psychological Medicine; Journal of the American Academy of Child and Adolescent Psychiatry; JAMA Psychiatry; Journal of Child Psychology and Psychiatry; and American Journal of Psychiatry.
Overall, 116 papers with statistically nonsignificant results for the primary endpoints were included.
The investigators identified spin was in 65 RCTs (56%), mainly in the abstract results sections (n = 24; 21%) and the abstract conclusion sections (n = 57; 49%). They simultaneously found evidence of spin in both results and conclusions sections in 17 RCTs (15%).
The most common manifestation of spin in abstract results was emphasis on a statistically significant secondary endpoint while omitting one or more statistically nonsignificant primary endpoints (25%), whereas the most common manifestation in abstract conclusions was claiming benefit because of a statistically significant primary endpoint and ignoring statistically nonsignificant primary endpoints (32%), according to the results
In addition, Jellison and colleagues detected spin more often in trials that used placebo or care-as-usual as the comparator arm. They did not find an association between industry funding and increased risk for spin.
“Further research is needed to establish the effects of spin on clinical decision-making and the funding of future studies,” the researchers wrote. “We suggest future studies to assess the frequency of spin within other specialty journals, different study designs and its effect on lay people. Authors, journal editors and peer-reviewers should continue to be vigilant for spin to reduce the risk of biased reporting of trial results.” – by Savannah Demko
Disclosure: The authors report no relevant financial disclosures.