title: Major discrepancies between what clinical trial registries record and paediatric randomised controlled trials publish.
abstract: BACKGROUND
  Whether information from clinical trial registries (CTRs) and published randomised controlled trial (RCTs) differs remains unknown. Knowing more about discrepancies should alert those who rely on RCTs for medical decision-making to possible dissemination or reporting bias. To provide help in critically appraising research relevant for clinical practice we sought possible discrepancies between what CTRs record and paediatric RCTs actually publish. For this purpose, after identifying six reporting domains including funding, design, and outcomes, we collected data from 20 consecutive RCTs published in a widely read peer-reviewed paediatric journal and cross-checked reported features with those in the corresponding CTRs.
  
  
  METHODS
  We collected data for 20 unselected, consecutive paediatric RCTs published in a widely read peer-reviewed journal from July to November 2013. To assess discrepancies, two reviewers identified and scored six reporting domains: funding and conflict of interests; sample size, inclusion and exclusion criteria or crossover; primary and secondary outcomes, early study completion, and main outcome reporting. After applying the Critical Appraisal Skills Programme (CASP) checklist, five reviewer pairs cross-checked CTRs and matching RCTs, then mapped and coded the reporting domains and scored combined discrepancy as low, medium and high.
  
  
  RESULTS
  The 20 RCTs were registered in five different CTRs. Even though the 20 RCTs fulfilled the CASP general criteria for assessing internal validity, 19 clinical trials had medium or high combined discrepancy scores for what the 20 RCTs reported and the matched five CTRs stated. All 20 RCTs selectively reported or failed to report main outcomes, 9 had discrepancies in declaring sponsorship, 8 discrepancies in the sample size, 9 failed to respect inclusion or exclusion criteria, 11 downgraded or modified primary outcome or upgraded secondary outcomes, and 13 completed early without justification. The CTRs for seven trials failed to index automatically the URL address or the RCT reference, and for 12 recorded RCT details, but the authors failed to report the results.
  
  
  CONCLUSIONS
  Major discrepancies between what CTRs record and paediatric RCTs publish raise concern about what clinical trials conclude. Our findings should make clinicians, who rely on RCT results for medical decision-making, aware of dissemination or reporting bias. Trialists need to bring CTR data and reported protocols into line with published data.
authors.affiliation: G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy. paola.rosati@opbg.net.|Unit of Clinical Epidemiology, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy. paola.rosati@opbg.net.
authors.forename: Paola
authors.identifier: http://orcid.org/0000-0002-1713-4879
authors.initials: P
authors.lastname: Rosati
authors.affiliation: G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy.|Health Care Research, General and Visceral Surgery, University Hospital Ulm, President Institute of Clinical Economics (ICE) e.V., Ulm, 89070, Germany.
authors.forename: Franz
authors.initials: F
authors.lastname: Porzsolt
authors.affiliation: G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Ricciotti
authors.affiliation: G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Testa
authors.affiliation: G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Inglese
authors.affiliation: G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy.
authors.forename: Ferruccio
authors.initials: F
authors.lastname: Giustini
authors.affiliation: G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy.
authors.forename: Ersilia
authors.initials: E
authors.lastname: Fiscarelli
authors.affiliation: G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Zazza
authors.affiliation: G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy.|Faculty of Medicine and Surgery, La Sapienza University, Rome, 00185, Italy.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Carlino
authors.affiliation: G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy.
authors.forename: Valerio
authors.initials: V
authors.lastname: Balassone
authors.affiliation: General Surgery and Transplantation Department, University Tor Vergata, Rome, 00133, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Fiorito
authors.affiliation: G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy.|Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, 41124, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: D'Amico
keywords: Clinical trial registries; Critical appraisal; Dissemination bias; Quality reporting; Randomised controlled trials; Reporting bias; Reporting discrepancies; Risk of bias; Selective outcome reporting