Analysis of Reporting Bias in Vertebral Augmentation

Area of Science:

• Orthopedics
• Geriatrics
• Radiology

Background:

• Osteoporotic vertebral compression fractures (OVCFs) are a major cause of morbidity and mortality, with increasing incidence due to an aging population.
• Vertebral augmentation (VA) was once the standard treatment, but controversy arose after two 2009 sham trials.
• Inconsistent reporting and bias in scientific literature impact treatment decisions for OVCFs.

Purpose of the Study:

• To examine sources of bias in reporting on vertebral augmentation for OVCFs.
• To compare publications with biased reporting against the current body of scientific literature.
• To ensure vulnerable populations receive appropriate treatment for OVCFs.

Main Methods:

• Perspective analysis of scientific publications.
• Review of prospective randomized controlled trials (PRCTs) and meta-analyses.
• Comparison of current literature with older, potentially biased, trial data.

Main Results:

• Five of six PRCTs and both meta-analyses demonstrate VA is superior to nonsurgical management (NSM).
• Recent assessments overemphasize older NEJM sham trials, ignoring more current, robust evidence.
• Biased reporting leads to conclusions not representative of the complete data.

Conclusions:

• There is a need to address biased reporting in OVCF literature.
• Vertebral augmentation (vertebroplasty, kyphoplasty) is supported by current evidence as superior to NSM.
• Accurate reporting is crucial for providing optimal care to patients with OVCFs.