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Background: With 14.4 million U.S. adults diagnosed with alcohol use disorder (AUD) annually, effective treatments for combatting this condition are essential. Clinicians are often guided by systematic reviews and meta-analyses - considered the gold standard of research. Spin, a biased way of reporting results, may lead to misinterpretation of research findings, resulting in suboptimal patient care.Objective: Our primary objective was to investigate the presence of spin in the abstracts of systematic reviews of AUD treatments.Methods: After systematically searching MEDLINE and Embase for systematic reviews of AUD treatments, abstracts were evaluated for the nine most severe types of spin. Additional article characteristics were concurrently extracted and study quality was evaluated. Descriptive statistics of spin were calculated and associations between spin and study characteristics were determined through Fisher's exact and logistic regression.Results: Among 79 included systematic reviews, 44 instances of spin were identified spanning 43% of our sample (34/79). Of the nine forms of spin, eight were found with a majority of instances being "selective reporting of or overemphasis on efficacy outcomes" (13/44, 29.5% of cases). The majority of articles were rated as critically low quality (51/79, 64.6%). No association was found between the presence of spin and extracted study characteristics.Conclusions: Spin was found in more than 40% of systematic review abstracts that evaluated pharmacotherapies in the treatment of AUD. Coupled with the finding that the majority of systematic reviews on the subject were of low quality, increased awareness of spin among physicians may be warranted.
RESUMO
BACKGROUND: The objective of this study was to assess the methodological quality and clarity of reporting of the systematic reviews (SRs) supporting clinical practice guideline (CPG) recommendations in the management of ST-elevation myocardial infarction (STEMI) across international CPGs. METHODS: We searched 13 guideline clearinghouses including the National Guideline Clearinghouse and Guidelines International Network (GIN). To meet inclusion criteria CPGs must be pertinent to the management of STEMI, endorsed by a governing body or national organization, and written in English. We retrieved SRs from the reference sections using a combination of keywords and hand searching. Two investigators scored eligible SRs using AMSTAR and PRISMA. RESULTS: We included four CPGs. We extracted 71 unique SRs. These SRs received AMSTAR scores ranging from 1 (low) to 9 (high) on an 11-point scale. All CPGs consistently underperformed in areas including disclosure of funding sources, risk of bias, and publication bias according to AMSTAR. PRISMA checklist completeness ranged from 44% to 96%. The PRISMA scores indicated that SRs did not provide a full search strategy, study protocol and registration, assessment of publication bias or report funding sources. Only one SR was referenced in all four CPGs. All CPGs omitted a large subset of available SRs cited by other guidelines. CONCLUSIONS: Our study demonstrates the variable quality of SRs used to establish recommendations within guidelines included in our sample. Although guideline developers have acknowledged this variability, it remains a significant finding that needs to be addressed further. FUNDING: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.