Misleading reporting in major fertility journals: poor use of confidence intervals and absolute differences

Article type
Authors
Glujovsky D1, Sueldo C2, Borghi C2, Nicotra P2, Andreucci S2, Ciapponi A1
1IECS - Instituto de Efectividad Clínica y Sanitaria, Argentina
2CEGYR - Centro de Estudios en Genética y Reproducción, Argentina
Abstract
Background: To get a correct interpretation of the findings in a study, the authors should use correct measures to report them. Although there are lots of items recommended by reporting guidelines, some, specifically, could have a high-impact on the key message for the reader. Some of them (i.e. P value and relative risks) are more frequently used than others (confidence intervals (CI) and interpretation of absolute risks differences), and missing these others provides an incomplete overview of the clinical scenario.
Objectives: To evaluate the proportion of randomized controlled trials (RCTs) published in the top fertility journals that reported their results providing the estimated effect size and its precision; and for binary outcomes, the presentation of both absolute and relative effect sizes. Additionally, we did a descriptive analysis of the interpretation of those results.
Methods: All the RCTs published in top fertility journals in 2014 were analyzed by pairs of independent reviewers, evaluating the titles and abstracts of identified articles. As a second step, two randomly selected independent reviewers, assessed each included study to finally include them in the analysis and to do the data extraction. Discrepancies were resolved by consensus. We analyzed the abstract and the results section of the full text separately to see if the authors mentioned the P value and a CI for the main outcome and for secondary outcomes. For binary outcomes, we evaluated if any relative measure (i.e. RR, odds ratio or relative risk reduction) was used and if any absolute measure (i.e. absolute risk reduction or number needed to treat) was mentioned. For continuous measures, we evaluated if the mean difference and its CI was used. We analyzed whether any reference related to any clinically relevant result was mentioned in the Materials and methods section. We also evaluated the Discussion and Conclusions and described the authors' interpretation from the results that they published.
Results: While more than 90% reported P value, less than 50% reported CI and absolute measures. More results and conclusions will be shown at the Colloquium.