Evaluation of Spin in the Abstracts of Emergency Medicine Randomized Controlled Trials

Victoria Reynolds-Vaughn; Jonathan Riddle; Jamin Brown; Michael Schiesel; Cole Wayant; Matt Vassar

doi:10.1016/j.annemergmed.2019.03.011

Evaluation of Spin in the Abstracts of Emergency Medicine Randomized Controlled Trials

Ann Emerg Med. 2019 May 14:423-431. doi: 10.1016/j.annemergmed.2019.03.011. Online ahead of print.

Authors

Victoria Reynolds-Vaughn¹, Jonathan Riddle², Jamin Brown³, Michael Schiesel³, Cole Wayant², Matt Vassar²

Affiliations

¹ Oklahoma State University Center for Health Sciences, Tulsa, OK. Electronic address: victoria.reynolds@okstate.edu.
² Oklahoma State University Center for Health Sciences, Tulsa, OK.
³ Department of Emergency Medicine, Oklahoma State University Medical Center, Tulsa, OK.

PMID: 31101371
DOI: 10.1016/j.annemergmed.2019.03.011

Abstract

Study objective: We aim to investigate spin in emergency medicine abstracts, using a sample of randomized controlled trials from high-impact-factor journals with statistically nonsignificant primary endpoints.

Methods: This study investigated spin in abstracts of emergency medicine randomized controlled trials from emergency medicine literature, with studies from 2013 to 2017 from the top 5 emergency medicine journals and general medical journals. Investigators screened records for inclusion and extracted data for spin. We considered evidence of spin if trial authors focused on statistically significant results, interpreted statistically nonsignificant results as equivalent or noninferior, used favorable rhetoric in the interpretation of nonsignificant results, or claimed benefit of an intervention despite statistically nonsignificant results.

Results: Of 772 abstracts screened, 114 randomized controlled trials reported statistically nonsignificant primary endpoints. Spin was found in 50 of 114 abstracts (44.3%). Industry-funded trials were more likely to have evidence of spin in the abstract (unadjusted odds ratio 3.4; 95% confidence interval 1.1 to 11.9). In the abstracts' results, evidence of spin was most often due to authors' emphasizing a statistically significant subgroup analysis (n=9). In the abstracts' conclusions, spin was most often due to authors' claiming they accomplished an objective that was not a prespecified endpoint (n=14).

Conclusion: Spin was prevalent in the selected randomized controlled trial, emergency medicine abstracts. Authors most commonly incorporated spin into their reports by focusing on statistically significant results for secondary outcomes or subgroup analyses when the primary outcome was statistically nonsignificant. Spin was more common in studies that had some component of industry funding.