title: "Spin" in wound care research: the reporting and interpretation of randomized controlled trials with statistically non-significant primary outcome results or unspecified primary outcomes.
abstract: BACKGROUND
  Spin in the reporting of randomized controlled trials, where authors report research in a way that potentially misrepresents results and mislead readers, has been demonstrated in the broader medical literature. We investigated spin in wound care trials with (a) no statistically significant result for the primary outcome and (b) no clearly specified primary outcome.
  
  
  METHODS
  We searched the Cochrane Wounds Group Specialised Register of Trials for randomized controlled trials (RCTs). Eligible studies were: Parallel-group RCTs of interventions for foot, leg or pressure ulcers published in 2004 to 2009 (inclusive) with either a clearly identified primary outcome for which there was a statistically non-significant result (Cohort A) or studies that had no clear primary outcome (Cohort B).We extracted general study details. For both Cohorts A and B we then assessed for the presence of spin. For Cohort A we used a pre-defined process to assess reports for spin. For Cohort B we aimed to assess spin by recording the number of positive treatment effect claims made. We also compared the number of statistically significant and non-significant results reported in the main text and the abstract looking specifically for spin in the form of selective outcome reporting.
  
  
  RESULTS
  Of the 71 eligible studies, 28 were eligible for Cohort A; of these, 71% (20/28) contained spin. Cohort B contained 43 studies; of these, 86% (37/43) had abstracts that claimed a favorable treatment claim. Whilst 74% (32/43) of main text results in Cohort B included at least one statistically non-significant result, this was not reflected in the abstract where only 28% contained (12/43) at least one statistically non-significant result.
  
  
  CONCLUSIONS
  Spin is a frequent phenomenon in reports of RCTs of wound treatments. Studies without statistically significant results for the primary outcome used spin in 71% of cases. Furthermore, 33% (43/132) of reports of wound RCTs did not specify a primary outcome and there was evidence of spin and selective outcome reporting in the abstracts of these. Readers should be wary of only reading the abstracts of reports of RCTs of wound treatments since they are frequently misleading regarding treatment effects.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Lockyer
authors.forename: Rob
authors.initials: R
authors.lastname: Hodgson
authors.affiliation: School of Nursing, Midwifery & Social Work, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester M13 9PL, UK. jo.dumville@manchester.ac.uk.
authors.forename: Jo C
authors.initials: JC
authors.lastname: Dumville
authors.forename: Nicky
authors.initials: N
authors.lastname: Cullum
mesh_terms: D015982:Bias; D016265:Conflict of Interest; D003627:Data Interpretation, Statistical; D023381:Endpoint Determination; D019981:Health Care Sector / Q000191:economics; D006801:Humans; D007871:Leg Ulcer / Q000175:diagnosis / Q000628:therapy*; D003668:Pressure Ulcer / Q000175:diagnosis / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012107:Research Design / Q000706:statistics & numerical data; D012109:Research Support as Topic; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing