Summary

Spin bias is present in the majority of meta-analyses and systematic reviews pertaining to hip labrum reconstruction.

Abstract

Introduction

Hip labral reconstruction is an evolving technique to treat labral pathology. There continues to be debate of the short-term and long-term outcomes of acetabular labral reconstruction. Spin is a recent concept that is defined as a reporting bias that misrepresents research. Spin bias can affect clinical decision making and patient care. The purpose of this study is to identify the prevalence of spin in meta-analysis and systematic reviews regarding the efficacy of acetabular labral reconstruction.

Methods

Electronic libraries (MEDLINE, Embase, Web of Science, Google Scholar) were searched for meta-analyses and systematic reviews regarding hip labrum reconstruction. The inclusion criteria for final review was that each article needed to be a systematic review or meta-analysis regarding labral reconstruction that was written in English or included an English translation. The nine most severe types of spin commonly found in abstracts were used as an evaluation tool to assess the articles. Other variables evaluated included number of citations, journal impact factor, reported conflicts of interest, adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and methodologic quality according to A Measurement Tool to Assess Systematic Reviews (AMSTAR-2). Statistical analysis was done in RStudio and the Fisher exact test, t-test, and/or Wilcoxon rank sum test was used to evaluate associations between presence of spin and study characteristics.

Results

The electronic database search resulted in 1,148 articles, of which 10 met our inclusion criteria. Of these 10 articles, 70% (7/10) were found to have at least one form of spin present. The most prevalent types of spin were type 3 (“selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention”), type 5 (“claims the beneficial effect of the experimental treatment despite high risk of bias in the primary studies”), and type 8 (“extrapolates the review’s findings from a surrogate marker or a specific outcome to the global improvement of the disease”), which each were found in 30% (3/10) of articles. No significant associations were found between the presence of spin and number of citations, journal impact factor, reported conflicts of interest, adherence to PRISMA guidelines, or AMSTAR-2 rating.

Conclusion

Spin was present in the majority of meta-analyses and systematic reviews pertaining to hip labrum reconstruction. Therefore, education and recognition of spin is crucial for orthopedic surgeons when making clinical decisions based on review of literature. Furthermore, improved guidelines should be considered to reduce the prevalence of spin in orthopedic literature.