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Review
. 2024 Jan 1:2112-2120.
doi: 10.1016/j.arthro.2023.12.018. Online ahead of print.

Reporting Bias in the Form of Positive Spin Is Highly Prevalent in Abstracts of Systematic Reviews on Primary Repair of the Anterior Cruciate Ligament

N Mina Hwang  1 , Justin T Samuel  2 , Ashley A Thompson  1 , Cory K Mayfield  1 , Maya S Abu-Zahra  1 , Jacob L Kotlier  1 , Frank A Petrigliano  3 , Joseph N Liu  1
Affiliations
Review

Reporting Bias in the Form of Positive Spin Is Highly Prevalent in Abstracts of Systematic Reviews on Primary Repair of the Anterior Cruciate Ligament

N Mina Hwang et al. Arthroscopy. .

Abstract

Purpose: To analyze reporting bias in the form of spin present in systematic reviews and meta-analyses on the topic of primary anterior cruciate ligament (ACL) repair.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed throughout this study. Peer-reviewed systematic reviews were collected from 3 databases (PubMed, Scopus, and SPORTDiscus), and their abstracts were assessed for the 15 most common types of spin. Articles were excluded if they were not published in English, had no evidence, were retracted, were published without an abstract, did not have full text available, or included cadaveric or nonhuman subjects. Full text quality was assessed using AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews Version 2). Fisher exact tests were used to examine associations between the different types of spin and other study characteristics such as AMSTAR 2 confidence rating, study design, and level of evidence.

Results: Spin was present in the abstracts of 13 of 15 articles (86.7%). There were significant associations between PRISMA adherence and lower incidences of spin types 3, 6, and 8 (P = .029 for each). A critically low AMSTAR 2 confidence rating was significantly associated with an increased incidence of spin type 9 (P = .01), and a higher AMSTAR 2 score was significantly associated with decreased spin type 4 and type 5 (P = .039 and P = .048, respectively). A more recent year of publication was correlated with a lower incidence of spin type 14 (P = .044).

Conclusions: Spin is present in most systematic reviews and meta-analyses regarding primary repair of the ACL, with two-thirds of abstracts spinning evidence in favor of ACL repair. Standardized guidelines including the PRISMA guidelines and the AMSTAR 2 assessment tool were negatively correlated with spin. More recently published articles were found to contain significantly less spin, as were articles published in journals with higher Clarivate Impact Factors and Scopus CiteScores.

Level of evidence: Level V, systematic review of Level III through V studies.

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Conflict of interest statement

Disclosures The authors report the following potential conflicts of interest or sources of funding: F.A.P. reports consultancy for Stryker, Smith & Nephew, Exatech, Micromed, Zimmer Biomet, Flexion Therapeutics, and DePuy, outside the submitted work. J.N.L. reports board membership in American Shoulder and Elbow Surgeons and Arthroscopy Association of North America and consultancy for Stryker, Smith & Nephew, Merz North America, and Neuracrine Biosciences, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.

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