Can we trust what we read on reviews abstracts of interventions for low back pain? A methodological review

Article type
Authors
Port Nascimento D1, M Moseley A2, G Maher C2, Zoldan Gonzalez G1, Costa Araujo A1, Oliveira Pena Costa L1
1Universidade Cidade de São Paulo
2The University of Sydney
Abstract
Background: Abstracts of systematic reviews are widely read by healthcare professionals as the starting point for clinical decisions. However, if an abstract is inadequately reported, the results might lead to an overestimated interpretation of treatment effects (i.e. spin of information).

Objectives: To investigate reporting quality and spin of information of review abstracts on low back pain, as well as to investigate whether some review characteristics were associated with abstract reporting quality.
Methods: Eligibility criteria were full-published systematic reviews on low back pain, published from 2015 to 2017, retrieved from the Physiotherapy Evidence Database. Two independent authors collected data and resolved disagreements by consensus. We used AMSTAR 2 to assess the methodological quality of reviews. The 12-item checklist for abstracts from PRISMA was used to evaluate the abstracts' reporting quality (range 0 to 12, higher is better). A seven-item list was used to evaluate spin of information in the reviews' abstracts (range 0 to 7, where higher is worse). We presented results descriptively and performed linear regression analysis too.

Results: We included 65 eligible reviews and separated the analysis into Cochrane (n = 9) and non-Cochrane (n = 56) abstracts, as the results differed significantly. The methodological quality presented high to moderate overall confidence for Cochrane Reviews, while non-Cochrane reviews presented low to critically low methodological quality. The mean PRISMA for fully reported items was 4.1 (SD 1.9) in non-Cochrane abstracts and 9.9 (SD 1.1) in Cochrane abstracts. Spin was observed in 80% of the total sample. Higher reporting quality was associated with higher number of words in the abstract and lower levels of spin.

Conclusions: Most abstracts of low back pain reviews present spin of information and poor reporting quality. We advise readers to rely on abstracts published on journals with high methodological and reporting standards, such as Cochrane reviews. We also suggest that journal editors allow 500 words per abstract and strongly encourage reviewers to continuously develop their methodological research skills.

Patient involvement: Patients should seek out clinicians who are aware of the importance of higher methodological and reporting standards in clinical research.