Spin in randomized controlled trials in obstetrics and gynecology: a systematic review

Abstract

Objectives Spin occurs when specific reporting strategies are used to distort the findings featuring the benefits of treatment. The objective of this study was to evaluate the nature and frequency of spin in randomized controlled trials (RCTs) in obstetrics and gynecology. Methods The top five journals in obstetrics and gynecology with thehighest impact factor were systematically searched for any RCTs with non-significant primary outcomes published between Jan1/2019 and Jun15/2020. Study selection, data extraction, spin assessment and risk of bias (ROB) assessment were conducted independently and in duplicate. Studies that recommended the use of intervention despite nonsignificant primary outcomes were considered high spin. Frequency of spin was compared by study characteristics with Fisher Exact tests where P Results Of 1170 articles identified, 51 articles fulfilled our selection criteria. Many articles involved obstetrics (n=30,59%), and less for gynecology (n=21,41%). Studies were funded by funding agencies (n=33,65%), industry (n=10,20%), or none stated (n=8,16%). No spin was detected in 27(53%) of articles, while three(6%) had one, 10(20%) had two, and 11(22%) had greater than two occurrences of spin. Compared to articles with no spin, spin was associated with Cochrane ROB domain pertaining to missing data and the overall ROB (p Conclusions The occurrence of spin was detected in nearly half of RCTs in obstetrics and gynecology, highlighting the need for caution in the reporting and interpretation of RCT findings.