The Frequency of Clinical Trial Registry Use in Hand Surgery Systematic Reviews

The quality of systematic reviews relies on the inclusion of published and unpublished clinical trials. Unpublished trials often report statistically non-significant results, which if included in systematic reviews would likely alter study conclusions. This study aims to evaluate whether systematic reviews in hand surgery literature conduct searches of clinical trial registries.

PubMed was searched comprehensively to identify all systematic reviews on hand surgery topics. We evaluated articles from both the Cochrane Database of Systematic Reviews (CDSR) and the five journals with the greatest number of published systematic reviews discussing hand surgery topics to determine whether they conducted clinical trial registry searches. A secondary analysis of the articles that did not conduct a registry search was done to identify unpublished trials from ClinicalTrials.gov and the World Health Organization's International Clinical Trials Registry Platform (WHO-ICTRP).

Only 5% of hand surgery related systematic reviews from high-impact journals conducted a clinical trial registry search. In contrast, 100% of the systematic reviews published in CDSR conducted at least one clinical trial registry search. Of the articles that did not perform a registry search, 14% had trial data that could have been included in the article's findings. Literature searches performed after April 2019, the date when ClinicalTrials.gov and WHO-ICTRP records were added to CENTRAL's database, had a lower frequency of CENTRAL searches.

The frequency of clinical trial registry searches in hand surgery systematic reviews is markedly low. Searches of relevant clinical trial registries should be done in accordance with current Cochrane guidelines.