Rheumatology studies make the evidence sound better than it is
One article on PainSci cites Mathieu 2012: Studying the Studies
PainSci notes on Mathieu 2012:
Researchers determined that almost 25% of abstracts have misleading conclusions … and even more so if you look only at studies with negative results, where the rate of misleading conclusions jumps to an alarming 45%. That is, study abstracts clearly tend to make the evidence sound more positive than it is.
And of course that’s all that most people ever read. None of this is really surprising — if anything, I’m surprised it isn’t worse — but it is useful to have some hard data about it.
See also some entertaining commentary by Neil O’Connell for BodyInMind.org.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
INTRODUCTION: Readers of scientific articles often read only the abstract and its conclusions because of lack of time or of access to the full-length articles.
OBJECTIVES: To assess the prevalence of misleading conclusions in abstracts of randomized controlled trials (RCTs) in rheumatology, determine whether trials are registered and whether abstract conclusions are based on the primary outcome (PO), and identify the predictors of misleading abstract conclusions.
METHODS: We searched Medline, Embase and the Cochrane Collaboration for reports of RCTs assessing rheumatoid arthritis, osteoarthritis or spondylarthropathies published between January 2006 and April 2008. Abstract conclusions were misleading if: the PO was not reported in the conclusion; the conclusions were based on only a secondary outcome or subgroup results; the results and conclusions were in disagreement; negative results were suggested as equivalent, or if there was no discussion of benefits and risks in cases of serious adverse events.
RESULTS: Of the 144 reports selected, we focused on the 105 articles containing a clear PO. Twenty-four reports (23%) contained misleading conclusions. Lack of PO reporting (n=10) and conclusions disagreeing with article results (n=7) were the most frequent reasons. Nineteen out of 144 (13.2%) declared study registration with clear and similar registered and published POs and no misleading abstract conclusions. Reports of negative results showed a higher frequency of misleading conclusions as did those assessing osteoarthritis. On multivariable analysis, only negative results predicted misleading abstract conclusions (OR=9.58 [3.20-28.70]).
CONCLUSIONS: Almost one-quarter of these RCT in rheumatology had misleading conclusions in the abstract, especially those with negative results.
Specifically regarding Mathieu 2012:
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Inciting events associated with lumbar disc herniation. Suri 2010 Spine J.
- Prediction of an extruded fragment in lumbar disc patients from clinical presentations. Pople 1994 Spine (Phila Pa 1976).
- Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. Konstantinou 2015 BMC Musculoskelet Disord.
- Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Kuyken 2022 Evid Based Ment Health.
- Is there a relationship between throbbing pain and arterial pulsations? Mirza 2012 J Neurosci.