Physiology, Vitalism, and the Contest for Body and Soul in the Antebellum United States.

In the early nineteenth century, physiology became an increasingly popular and powerful science in the United States. Religious controversy over the nature of human vitality animated much of this interest. On one side of these debates stood Protestant apologists who wedded an immaterialist vitalism to their belief in an immaterial, immortal soul - and therefore to their dreams of a Christian republic. On the other side, religious skeptics argued for a materialist vitalism that excluded anything immaterial from human life, aspiring thereby to eliminate religious interference in the progress of science and society. Both sides hoped that by claiming physiology for their vision of human nature they might direct the future of religion in the US. Ultimately, they failed to realize these ambitions, but their contest posed a dilemma late nineteenth-century physiologists felt compelled to solve: how should they comprehend the relationship between life, body, and soul? Eager to undertake laboratory work and leave metaphysical questions behind, these researchers solved the problem by restricting their work to the body while leaving spiritual matters to preachers. In attempting to escape the vitalism and soul questions, late nineteenth-century Americans thus created a division of labor that shaped the history of medicine and religion for the following century.

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

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.

An Evaluation of Spin in Lower Extremity Joint Trials.

BACKGROUND: Spin is a specific type of reporting bias that misrepresents data and results within randomized controlled trials (RCTs). Because spin may provide a surgeon with an inaccurate representation of trial results, thus misconstruing the surgeons' interpretation thereof and possibly negatively affecting patient care, it is important that spin is identified within publications. The primary goal of our study was to determine the prevalence of spin found within the abstracts of lower extremity joint trials. METHODS: Using Google Scholar's H-5 index, we selected the top 20 journals in the orthopedic surgery category. We then conducted a PubMed search on July 2nd, 2018 using the advanced search feature, encompassing all RCTs published in these journals from January 1, 2016 to January 1, 2017. Spin was evaluated using a standardized protocol, using a previously published protocol on the Open Science Network. RESULTS: Our final sample consisted of 46 trials published in 9 of the top 20 orthopedic surgery journals. Spin was found in 27 (58.7%) of the 46 abstracts. Evidence of spin in the abstract results was found in 19 (41.3%) of the 46 articles, and spin in abstract conclusions was found in 15 (32.6%) of the 46 articles. CONCLUSIONS: Our study found that a significant number of lower extremity joint RCTs contain one or more form of spin in either their abstract results, conclusions, or both. In addition, our investigation revealed that a sizable portion of these lower extremity orthopedic joint RCTs are not registered or do not report their registration, and funding sources are also underreported.