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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 the management and treatment of acne vulgaris.
The primary objective of this study 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.
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 nonpharmacologic 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 nine most severe types of spin.
Spin was present in 31% (11/36) of abstracts. A total of 12 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,
Spin is present in the abstracts of systematic reviews and meta-analyses covering the treatment of acne vulgaris. This paper raises awareness of spin in abstracts and emphasizes the importance of its recognition, which may lead to fewer incidences of spin in future studies.
Acne vulgaris is one of the most common medical diagnoses made by dermatologists each year, with over 50 million Americans affected by this condition [
Systematic reviews offer valuable insights to clinicians about current treatments [
Spin has been demonstrated to be prevalent in the abstracts of randomized controlled trials [
This study was performed in accordance with a previously written protocol available publicly on Open Science Framework (OSF) [
Before screening, training was conducted, which included face-to-face training sessions for the authors RO and CR. Author MV led the training sessions as his studies regarding the presence of spin in randomized controlled trials have previously been published. During these training sessions, the authors (RO and CR) received instruction and education using example abstracts and full studies from different areas of medicine. During this training, the most severe types of spin described by Yavchitz et al [
Data extraction was performed in duplicate fashion using the Google form, and the investigators were blinded during the extraction process. After data extraction was completed, the investigators were unblinded and met to discuss any inconsistency until agreement was reached. On items for which agreement could not be reached, a third investigator was available for adjudication. The process of dual extraction of data was used to substantiate the work of each individual investigator. The items extracted on the Google form included the study title, journal title, number of studies included, number of subjects included, types of studies included, types of interventions, when the review was performed, databases searched, funding source, and if the review/primary outcome was significant. Furthermore, we evaluated whether the article contained any of the nine most severe examples of spin in abstracts [
To characterize and determine the frequency of spin in the abstracts of systematic reviews on the topic of the treatment of acne vulgaris, we employed the classification system previously developed by Yavchitz et al [
Frequency of each type of spin (N=12).
Type of spin | Value, n (%)a |
Conclusion contains recommendations for clinical practice not supported by the findings. | 0 (0) |
Title claims or suggests a beneficial effect of the experimental intervention not supported by the findings. | 0 (0) |
Selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention. | 5 (42) |
Conclusion claims safety based on nonstatistically significant results with a wide confidence interval. | 0 (0) |
Conclusion claims the beneficial effect of the experimental treatment despite a high risk of bias in primary studies. | 4 (33) |
Selective reporting of or overemphasis on harm outcomes or analysis favoring the safety of the experimental intervention. | 1 (83) |
Conclusion extrapolates the review’s findings to a different intervention (ie, claiming efficacy of a specific intervention although the review covers a class of several interventions). | 2 (17) |
Conclusion extrapolates the review’s findings from a surrogate marker or a specific outcome to the global improvement of the disease. | 0 (0) |
Conclusion claims the beneficial effect of the experimental treatment despite reporting bias. | 0 (0) |
aMore than one type of spin may have been present in the same systematic review.
To evaluate the most common forms of spin within systematic review abstracts, we calculated frequencies and percentages. To evaluate particular study characteristics associated with spin in systematic review abstracts, we planned in our protocol,
Our search string retrieved 316 studies, of which 58 studies were deleted as duplicates and 204 studies were excluded by the title and abstract. The studies excluded from this study are mentioned in
Flow diagram of study selection.
Characteristics of included studies (N=36).
Characteristics | Total (N=36), n (%) | With spin (n=11), n (%) | |
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Public | 12 (33) | 3 (27) |
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Industry | 6 (17) | 2 (18) |
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Not funded | 6 (17) | 3 (27) |
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Funding not mentioned | 12 (33) | 3 (27) |
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Pharmacologic | 23 (64) | 8 (73) |
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Nonpharmacologic | 11 (31) | 3 (27) |
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Combined | 2 (6) | 0 (0) |
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Yes | 21 (58) | 7 (64) |
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No | 15 (42) | 4 (36) |
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Yes | 0 (0) | 0 (0) |
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No | 0 (0) | 0 (0) |
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Yes | 2 (6) | 1 (9) |
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No | 34 (94) | 0 (0) |
For the primary outcome, interrater reliability was assessed using Gwet’s AC1, which was 0.68 (95% CI 0.44-0.92). Each discrepancy was subsequently resolved by group discussion, achieving an agreement of 100%. Spin was determined to be present in 31% (11/36) of abstracts in this study’s sample. A total of 12 separate instances of spin were identified in the 11 abstracts containing spin, with one of the abstracts containing two examples of spin. The most common type of spin identified was type 3,
Although we found no instances of spin type number 4 regarding safety (
Spin is prevalent in the abstracts of systematic reviews and meta-analyses focused on the treatment of acne vulgaris. We identified spin in nearly one-third of the included studies in this study’s sample. The most common type of spin found was type 3,
We were limited in our assessment of spin type 5,
To our knowledge, we are the first to investigate the presence of spin in the abstracts of systematic reviews and meta-analyses focused on acne vulgaris treatment options. In the field of dermatology, Motosko et al [
The PRISMA Statement [
This study has several strengths and limitations. Regarding strengths, investigators underwent extensive training to ensure the understanding of the concept of spin in publications. A group consensus was reached on the definition of each of the nine types of spin in an effort to ensure standardized responses. We fostered an atmosphere of reproducibility by posting the full study protocol on OSF before extraction. Each data extractor was blinded during the screening and data extraction process. Data were then extracted in duplicate fashion in accordance with the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions [
In conclusion, a sizable amount of spin was found in the abstracts of systematic reviews focused on the treatment of acne vulgaris. Moving forward, we recommend that peer reviewers and editors should be educated about the identification of spin. We also recommend the development of strict reporting guidelines for abstracts. Further research is needed to evaluate the types of spin that most significantly affect clinical decision making, which was outside of the purview of this study. We recommend future studies to assess the frequency of spin in other specialties.
Medical Literature Analysis and Retrieval System Online
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Abstracts
Open Science Framework
All authors of this study had access to all data. This study was not funded by any institution or sponsor.
RO and TR contributed equally to this paper. RO contributed to data extraction, manuscript writing, manuscript editing, and project design. TR contributed to data extraction, manuscript writing, manuscript editing, and project design. MA contributed to manuscript editing, data collection, analysis, and project design. AJ contributed to data analysis, manuscript editing, and approval. CC contributed to project design, training, and project oversight. MV contributed to project design, manuscript editing, project oversight, and training.
None declared.