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Level Of Confidence Of Randomized Controlled Trials In Arthroscopy And Sports Medicine – A Spin Based Assessment


Girinivasan Chellamuthu, MBBS, MS Ortho, FIOT, FASM
INDIA

Level Of Confidence Of Randomized Controlled Trials In Arthroscopy And Sports Medicine – A Spin Based Assessment

Girinivasan Chellamuthu, MBBS, MS Ortho, FIOT, FASM, INDIA Sathish Muthu, MS Ortho., DNB Ortho., MNAMS., , INDIA

Orthopaedic Research Group, Coimbatore, Tamil Nadu, INDIA

2021 Congress   Abstract Presentation   7 minutes   Not yet rated

 

Sports Medicine

Orthopaedic Sports Medicine Evidence Based Medicine

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Summary: We have performed an analysis of spin in the abstracts of RCTs published in top 5 journals of Arthroscopy and Sports Medicine using the LOC tool designed by Orthopaedic Research Group and found that only 50 percent of RCTs have high LOC

Purpose

Over the years pioneering works on the quality appraisal of RCTs have recognized and addressed most of the issues that affect the RCT quality but some issues are still to be sorted out. One such potential issue that hides in plain sight of the readers is the “Writers’ bias” or the so-called “Spin” in research articles. Spin, particularly in the abstracts, is a potential source of deception to the readers. Grading of studies based on spin will help readers to choose good articles. The main purpose of this study is to grade the RCTs of arthroscopy and sports medicine based on spin in their abstracts, analyze the prevalence of spin and the usefulness of this grading, and explore methods to prevent spin.

Methods

250 recent RCTs from the top 5 arthroscopy and sports medicine journals were selected. Baseline data of the articles were collected. Consort Adherence Score (CAS) based on the adherence of the abstracts of the RCTs to Consort checklist was calculated. The abstracts of the RCTs were graded using the Level Of Confidence (LOC) grading tool developed by the Orthopaedic Research Group. The association of the spin grade with other characteristics of the articles was analyzed.

Results

The median CAS for the included studies was 9 (IQR 8-10). It was found that only 49.6% (n=124) articles had high LOC with no or one non-critical spin in abstract. 20.8% (n=52) had Moderate LOC with more than one non-critical spin. 19.6% (n=49) had at least one critical spin and 10% (n=25) had more than one critical flaw making their results have Low and Critically Low LOC respectively. Of the ten variables analyzed in multivariate regression analysis, it was found that CAS was the only significant factor (ß=0.152, p=0.037) that determines the level of confidence in the abstract of RCTs

Conclusion

Spin is prevalent in abstracts of sports medicine and arthroscopy journals with 50.4% having some form of spin. LOC tool is the first of its kind grading tool for spin. Grading the LOC of the RCTs based on spin is the necessity of the day for the readers. Only 49.6% of the RCTs had high LOC. Upon exhaustive analysis of factors associated with spin, only the Consort Adherence Score had a significant correlation. Thus objective structuring of the abstracts will help eliminate spin in the future.

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