Evaluation of spin in abstracts of papers in psychiatry and psychology journals, 2019, Jellison et al

Andy

Andy

Retired committee member
Introduction
Randomised controlled trials (RCTs) serve as the gold standard in psychiatry. Given the importance of such trials to clinical practice, it is imperative that results be reported objectively.

Researchers are encouraged to conduct studies and report findings according to the highest ethical standards.1 2 This standard means reporting results completely, in accordance with a protocol that outlines primary and secondary endpoints and prespecified subgroups and statistical analyses. However, authors are free to choose how to report or interpret study results. 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 summarise the findings of the study. When such a misrepresentation of study results occurs, there is said to be spin. Spin has been defined as, ‘the use of specific reporting strategies, from whatever motive, to highlight that the experimental treatment is beneficial, despite a statistically nonsignificant difference for the primary outcome, or to distract the reader from statistically nonsignificant results’.3 Many practices contribute to spin, including the selective reporting of outcomes,4 5 p-hacking,6 7 inappropriate application of statistical measures like relative risk8 and manipulation of figures or graphs.9 10

Spin in abstracts has recently been discussed in a systematic review.11 Evidence suggests that abstract information alone is capable of changing a majority of clinicians’ care decisions.12 For example, when unadjusted analyses or secondary outcomes are given undue attention in abstracts, readers’ overall appraisal of the contents of a manuscript is altered.13 Additionally, a previous systematic review showed there to be a higher rate of favourable conclusions in industry-funded studies compared with other sponsorships.14

We have evaluated the prevalence of spin in abstracts of RCTs with nonsignificant primary endpoints in the psychology and psychiatry literature and have explored the association between spin and industry funding.
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Open access at https://ebm.bmj.com/content/early/2019/07/04/bmjebm-2019-111176#T2
 
Conclusion
Over 50% of trials published in top psychiatry/psychology journals contain spin in the abstract. No association was found between spin and industry funded studies. Further research is needed to establish the effects of spin on clinical decision-making and the funding of future studies. 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.
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Standards are meaningless if they are not enforced. They clearly are not. On top of massive interpretation and allowing BS explanations to deviations from protocol, or "assurances" from researchers that those deviations did not impact outcome (then why deviate?) even when reanalysis shows it actually turned failure into "success" that is widely overhyped and misrepresented by the authors themselves.

Until research like PACE, which ignored all standards and just did WTF they wanted to do to achieve their results, then any discussion beyond basic adherence to standards is meaningless. It's not just a problem of interpretation, not even close.

And what about non-controlled trials? Another standard that can be arbitrarily waived off without any consequences. PACE is resoundly promoted as gold standard despite not being controlled.

Clean your house first, psychs. It's as dirty as the worst of hoarders out there.
 
I'm sure there is more to say on the subject of publishers and I don't know just how many there are but of two of the largest science publishers AAAS and Nature only one publishes a journal of psychiatry. Nature, based in the UK publishes Molecular Psychiatry. As far as I can tell the American (AAAS) does not.

This is a really minor but possibly interesting point.

I'm sure there is much more and other things to say about science papers and journals. What a morass this has become. I hope some viable solutions are found soon.
 
Snowdrop said:
I'm sure there is more to say on the subject of publishers and I don't know just how many there are but of two of the largest science publishers AAAS and Nature only one publishes a journal of psychiatry. Nature, based in the UK publishes Molecular Psychiatry. As far as I can tell the American (AAAS) does not.

This is a really minor but possibly interesting point.

I'm sure there is much more and other things to say about science papers and journals. What a morass this has become. I hope some viable solutions are found soon.
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The upcoming open research initiative should be a good step in that direction. I'm not entirely convinced PACE would have been published if they would have been forced to make the full raw data available for scrutiny. They clearly bet on being able to keep it secret long enough to have it take hold in people's imagination that even if forced to release some data the lies would already be too firmly entrenched. Good bet, paid off well for their careers. Not so much for the millions of lives destroyed but that's a sacrifice they were willing to make.

Same with trial pre-registration. The lies worked well because they did not report any of the massive deviations in the papers themselves.

I definitely predict a steep drop-off in the kind of garbage-quality churn that Crawley and Chalder are putting out these days. Maybe that even explains why there is so much of it lately, a kind of goodbye salvo before it becomes too embarrassing to publish.
 
Re amount of churned out papers this year
If only it represented a last gasp. I suspect
There's so much probably as it's been timed for NICE deliberation.

Having recently attended a SEN evening, psychological education seems to be the area to focus.

Whilst there were some positive aspects re understanding and advocating within the system ( largely for autism and dyslexia) , actual understanding and suggested support therapy was truly dire, as was ethics awareness.
 
Spin was identified in 56% (65/116) of included RCTs. Evidence of spin was found in 2 (2%) titles, 24 (21%) abstract results sections and 57 (49%) abstract conclusion sections. Evidence of spin was simultaneously identified in both results and conclusions sections in 17 RCTs (15%). Spin was identified more commonly in trials that used placebo or care-as-usual as the comparator arm (table
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Because the concept of spin is relatively new to the scientific community, there are few studies that have analysed the impact that spin has on clinical decision-making or the funding of subsequent trials. We have found only one. In that study, Boutron et al conducted an RCT in which they analysed the interpretation of abstract results by 300 oncologists. Each participant was given two abstracts to read, one with spin in the conclusions and one without, both with statistically nonsignificant results. For abstracts with spin, participants rated the experimental treatment as being more beneficial and were more interested to read the full text of the article.
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Researchers have an ethical obligation to honestly and clearly report the results of their research.22 Adding spin to the abstract of an article may mislead physicians who are attempting to draw conclusions about a treatment for patients. Most physicians read only the article abstract the majority of the time, while up to 25% of editorial decisions are based on the abstract alone.23–25 Those who write clinical trial manuscripts know that they have a limited amount of time and space in which to capture the attention of the reader. Positive results are more likely to be published,26 and many manuscript authors have turned to questionable reporting practices in order to beautify their results.13 Worst of all, Lazarus et al found that 15% of peer-reviewers asked authors to add spin to their manuscripts.
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Someone at the SMC has a very morbid sense of humor. And Sharpe is either completely clueless or enjoys hurting people and is happy to gloat about it. Regardless, anyone who thought this was a good idea needs to take a long hard look in the mirror.

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