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Reporting Bias Is Highly Prevalent in Systematic Reviews and Meta-Analyses Related to Medial Patellofemoral Ligament
Kenneth T Nguyen1, Erin L Brown1, William C Rittmeyer1
1Tulane University School of Medicine, New Orleans, Louisiana, U.S.A.
Purpose:
To analyze reporting bias in the form of spin present in systematic reviews and meta-analyses related to medial patellofemoral ligament reconstruction (MPFLR).
Methods:
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, systematic reviews were collected from PubMed, Web of Science, and Embase using the search "medial patellofemoral ligament reconstruction" or "MPFLR" AND "systematic review" OR "meta-analysis." Abstracts were assessed for 15 common spin types. A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) was used to evaluate the quality of the studies. Characteristics such as Preferred Reporting Items for Systematic Reviews and Meta-Analyses adherence, publication year, and level of evidence were analyzed. Associations between these factors and spin presence or type were determined using statistical tests, including t tests, analysis of variance, Fisher tests, and Spearman rank coefficients.
Results:
The initial database search identified 1,044 studies, of which a total of 57 studies were included. Spin was present in the abstract in 51 of 57 studies (89.5%). Each type of spin was observed in at least 1 study's abstract with the exceptions of spin types 1, 7, 13, and 15. The 3 most common types were type 5 (48/57, 84.2%), followed by type 3 (32/57, 56.1%) and type 9 (30/57, 52.6%). Of the included studies, 91.2% received a critically low AMSTAR 2 confidence rating, and only 5.3% reported a conflict of interest. There was a statistically significant negative correlation between the numerical AMSTAR 2 rating and the presence of spin (P < .01).
Conclusions:
Most systematic reviews on MPFLR received critically low AMSTAR 2 ratings, reflecting the poor quality of evidence in this area. Nearly 90% of abstracts exhibited at least 1 type of spin, with spin types 3, 5, and 9 being the most common, suggesting a tendency to overstate the efficacy of MPFLR for patellar instability.
Level Of Evidence:
Level IV, systematic review of Level II-IV studies.
Insights
Reporting bias, or spin, is prevalent in systematic reviews of medial patellofemoral ligament reconstruction (MPFLR), with nearly 90% of abstracts showing spin. Low study quality, indicated by AMSTAR 2 ratings, correlates with this bias, suggesting overstated MPFLR efficacy.
Area of Science:
- Orthopedics
- Biomedical Engineering
- Evidence-Based Medicine
Background:
- Medial patellofemoral ligament reconstruction (MPFLR) is a common surgical procedure.
- Systematic reviews and meta-analyses are crucial for synthesizing evidence on MPFLR outcomes.
- Reporting bias, specifically 'spin,' can distort the perceived effectiveness of interventions.
Purpose of the Study:
- To assess the prevalence and types of reporting bias (spin) in systematic reviews and meta-analyses concerning MPFLR.
- To evaluate the quality of these systematic reviews using the AMSTAR 2 tool.
- To identify factors associated with the presence and type of spin in MPFLR literature.
Main Methods:
- Systematic reviews on MPFLR were identified from major databases (PubMed, Web of Science, Embase).
- Abstracts were analyzed for 15 predefined types of spin.
- Study quality was assessed using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) checklist.
- Statistical analyses, including t-tests, ANOVA, Fisher's tests, and Spearman correlations, were employed.
Main Results:
- Of 57 included studies, 89.5% (51/57) exhibited spin in their abstracts.
- Spin types 5, 3, and 9 were most frequent, observed in 84.2%, 56.1%, and 52.6% of studies, respectively.
- A significant negative correlation was found between AMSTAR 2 scores and the presence of spin (P < .01).
- Over 91% of studies received critically low AMSTAR 2 ratings, indicating poor methodological quality.
Conclusions:
- Systematic reviews on MPFLR frequently contain reporting bias (spin).
- The high prevalence of spin, coupled with critically low study quality (AMSTAR 2 ratings), suggests an overstatement of MPFLR effectiveness.
- Further research and adherence to reporting guidelines are needed to improve the reliability of evidence synthesis in this field.
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