Background: ‘Spin’ of study findings is common in reports of diagnostic accuracy studies. Multiple studies have shown that clinicians may view journals more favourably based on a higher impact factor. There is a growing body of evidence signalling there may be better methodological quality and higher reporting standards in higher impact factor journals in the diagnostic accuracy literature.

Objectives: The purpose of this study was to evaluate the frequency of ‘spin’ in reports of systematic reviews of diagnostic accuracy studies in high impact factor journals, with the hypothesis that the incidence of ‘spin’ may be lower compared to a series of reviews from ‘all-comer’ journals previously analyzed.

Methods: MEDLINE was searched from January 2010 to January 2019. Systematic reviews of diagnostic accuracy studies were included if they reported a meta-analyses and were published in a journal with impact factor >5. Two investigators independently scored each included systematic review for positivity of conclusions as well as actual and potential overinterpretation practices.

Results: Of 137 included systematic reviews, 63(46%) contained one or more forms of actual overinterpretation in the abstract; 52 (38%) in the full-text report; 108 (79%) contained a form of potential overinterpretation. Comparing to the previously assessed series, reviews in this series were less likely to contain one or more forms of actual overinterpretation in the abstract and full-text report or one or more forms of potential overinterpretation (p