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Editorial
DOI: 10.1016/j.bjpt.2019.07.007
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Available online 2 August 2019
Spin of results in scientific articles might kill you
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Dafne Port Nascimento
Corresponding author
dafnepn@gmail.com

Corresponding author at: Rua Melo Peixoto, 1407 Tatuapé, São Paulo, SP 03070-000, Brazil.
, Leonardo Oliveira Pena Costa
Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
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That is a shocking title, right? This is actually a classic example of spin, which is an overenthusiastic and often misleading presentation of the results of a study.1 In fact, spin of results in scientific articles might kill the readers’ ability to interpret the results of a study by themselves. If clinicians only believe on every conclusion written by scientific articles, their patients might build false hope of recovering from a disease for example.2

Unfortunately, spin is very common.3 Spin can appear in the title, abstract or in the full text.4 Spin has been identified in several healthcare studies, such as in 98% of clinical trials abstracts of physical therapy interventions for low back pain5 and in 68% of abstracts from a wide range of medical fields.1

The most severe types of spin in abstracts are: recommendations of an intervention, or title suggesting a positive effect, that are not consistent with the study findings; selective reporting of positive and negative outcomes; safety based on non-statistically significant results; selective reporting of harm outcomes; and the conclusions are overstated to other interventions.6 Spin may lead clinicians to make poor clinical decisions.7 Moreover, misleading messages can be disseminated by press releases and news coverage8,9 leading to unpredictable consequences for patients and consumers or research in general. For example, a recent published randomized controlled trial10 evaluated three distinct exercise groups for treating patellofemoral pain in women, and found no statistically significant differences between the intervention groups for the primary outcome ‘pain intensity’. However, if the authors had focused only in the secondary outcome ‘strength’ in their conclusion section, that would have been a clear spin statement.

The responsibility of providing adequately, consistent and transparent information is given to the authors, journal editors and reviewers, especially because it is their obligation to follow the research code of conduct for research integrity11 and ethical principles on research.12 In order to improve the awareness of transparency and integrity of research healthcare abstracts and their dissemination to all stakeholders, we recommend the following actions to be taken by journal editorial policies:

  • 1.

    Mandatory use of reporting guidelines, not only for full text but also for abstracts,13,14 highlighted as one of the ‘instructions for authors’;

  • 2.

    Proper checking if authors have followed the adequate reporting guidelines for abstracts and full text, checking also for abstracts consistency of reporting and interpretation with the full text;

  • 3.

    Awareness of spin in the abstracts and full texts, with adequate interpretation of results and conclusions of trials and reviews;

  • 4.

    More flexibility with the abstract word count;

  • 5.

    Intensive training for journal editors and reviewers with regard to spin.

In order to present higher quality scientific articles published in healthcare research, we highly recommend that journal editors and reviewers follow these recommendations, which will also provide higher research credibility within all stakeholders. Furthermore, consumers of research should not rely only upon abstracts for decision making, when they should actually read and interpret the corresponding full texts by themselves. Again, critical appraisal skills training is urgently needed.

Conflicts of interest

The authors declare no conflicts of interest.

References
[1]
I. Boutron, S. Dutton, P. Ravaud, et al.
Reporting and interpretation of randomized controlled trials with statistically nonsignificant results for primary outcomes.
JAMA, 303 (2010), pp. 2058-2064
[2]
R. Haneef, C. Lazarus, P. Ravaud, et al.
Interpretation of results of studies evaluating an intervention highlighted in google health news: a cross-sectional study of news.
PLOS ONE, 10 (2015), pp. e0140889
[3]
K. Chiu, Q. Grundy, L. Bero.
‘Spin’ in published biomedical literature: a methodological systematic review.
[4]
G. Li, L.P.F. Abbade, I. Nwosu, et al.
A scoping review of comparisons between abstracts and full reports in primary biomedical research.
BMC Med Res Methodol, 17 (2017), pp. 181
[5]
D.P. Nascimento, L.O.P. Costa, G.Z. Gonzalez, et al.
Abstracts of low back pain trials are poorly reported and inconsistent with the full text: an overview study.
Arch Phys Med Rehabil (Epub ahead of print), (2019),
[6]
A. Yavchitz, P. Ravaud, D.G. Altman, et al.
A new classification of spin in systematic reviews and meta-analyses was developed and ranked according to the severity.
J Clin Epidemiol, 75 (2016), pp. 56-65
[7]
C.G. Maher, C. Sherrington, M. Elkins, et al.
Challenges for evidence-based physical therapy: accessing and interpreting high-quality evidence on therapy.
Phys Ther, 84 (2004), pp. 644-654
[8]
P. Sumner, S. Vivian-Griffiths, J. Boivin, et al.
The association between exaggeration in health related science news and academic press releases: retrospective observational study.
BMJ, 349 (2014), pp. g7015
[9]
A. Yavchitz, I. Boutron, A. Bafeta, et al.
Misrepresentation of randomized controlled trials in press releases and news coverage: a cohort study.
PLoS Med, 9 (2012), pp. e1001308
[10]
M.C. Saad, R.A. Vasconcelos, L.V.O. Mancinelli, et al.
Is hip strengthening the best treatment option for females with patellofemoral pain?. A randomized controlled trial of three different types of exercises.
Braz J Phys Ther, 22 (2018), pp. 408-416
[11]
European Science Foundation.
Fostering Research Integrity in Europe.
(2010),
[12]
World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects.
JAMA, 310 (2013), pp. 2191-2194
[13]
E.M. Beller, P.P. Glasziou, D.G. Altman, et al.
PRISMA for Abstracts: reporting systematic reviews in journal and conference abstracts.
PLoS Med, 10 (2013), pp. e1001419
[14]
S. Hopewell, M. Clarke, D. Moher, et al.
CONSORT for reporting randomised trials in journal and conference abstracts.
Lancet, 371 (2008), pp. 281-283
Copyright © 2019. Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia
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Brazilian Journal of Physical Therapy

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