Plast Reconstr Surg. 2022 Nov 29. doi: 10.1097/PRS.0000000000009937. Online ahead of print.
ABSTRACT
BACKGROUND: “Spin” refers to a manipulation of language that implies benefit for an intervention when none may exist. Randomized clinical trials (RCTs) in other fields have been demonstrated to employ spin, which can mislead clinicians to use ineffective or unsafe interventions. This study’s objective was to determine the strategies, severity, and extent of spin in plastic surgery RCTs with non-significant primary outcomes.
METHODS: A literature search of the top 15 plastic surgery journals using MEDLINE was performed (2000-2020). Parallel 1:1 RCTs with a clearly identified primary outcome showing statistically non-significant results (p ≥ .05) were included. Screening, data extraction, and spin analysis were performed by two independent reviewers. The spin analysis was then independently assessed in duplicate by two plastic surgery residents with graduate level training in clinical epidemiology.
RESULTS: From 3,497 studies identified, 92 RCTs were included in this study. Spin strategies were identified in 78 RCTs (85%), including 64 Abstracts (70%) and 77 Main Texts (84%). Severity of spin was rated moderate or high in 43 Abstract Conclusions (47%) and 42 Main Text Conclusions (46%). The most identified spin strategy in the Abstract was claiming equivalence for statistically non-significant results (26%), and in the Main Text was focusing on another objective (24%).
CONCLUSIONS: This study suggests that 85% of statistically non-significant RCTs in plastic surgery employ spin. Readers of plastic surgery research should be aware of strategies, whether intentional or unintentional, used to manipulate language in reports of statistically non-significant RCTs when applying research findings to clinical practice.
PMID:36442055 | DOI:10.1097/PRS.0000000000009937
