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Evaluation of spin in the abstracts of systematic reviews regarding the treatment of acne vulgaris

Ottwell, Ryan
Rogers, T. Calli
Anderson, J. Michael
Johnson, Austin L.
Vassar, Matt
Background: Spin is the misrepresentation of study findings which may positively or negatively influence the reader's interpretation of the results. Little is known regarding the prevalence of spin in abstracts of systematic reviews — specifically systematic reviews pertaining to management and treatment for acne vulgaris.
Objective: Our primary objective was to characterize and determine the frequency of the most severe forms of spin in systematic review abstracts, and to evaluate whether various study characteristics were associated with spin.
Methods: Using a cross-sectional study design, we searched PubMed and Embase for systematic reviews focusing on the management and treatment of acne vulgaris. Our search returned 316 studies, of which 36 were included in our final sample. To be included, each systematic review must have addressed either pharmacologic or non-pharmacologic treatment of acne vulgaris. These studies were screened and data were extracted in duplicate by two blinded investigators. We analyzed systematic review abstracts for the 9 most severe types of spin.
Results: Spin was present in 11 of 36 abstracts (30.56%). Twelve examples of spin were identified in the 11 abstracts containing spin, with one abstract containing two instances of spin. The most common type of spin, selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention, was identified 5 times (5/12, 41.67%). Sixteen of the 36 (16/36, 44.44%) studies did not report a risk of bias assessment. Of the 11 abstracts containing spin, 6 did not report a risk of bias assessment or performed a risk of bias assessment but did not discuss it (6/11, 54.55%). Spin in abstracts was not significantly associated with a specific intervention type, the use of a medical writer, funding source, journal impact factor, or PRISMA/PRISMA-A journal requirements.
Conclusions: Abstracts with evidence of spin have the potential to influence clinical decision making. Therefore, further research is needed to evaluate what types of spin have the greatest influence on clinical practice. To help address the misrepresentation of study findings, we offer recommendations to better educate and improve peer-reviewers' and editors' awareness of, and ability to identify, spin in abstracts of systematic reviews.