Evidence of spin in clinical trials in the surgical literature

Padhraig S. Fleming


The pre-eminence of evidence-based medicine has led to a growing emphasis on the requirement for complete, clear and unbiased reporting of research. In particular, a premium has been placed on best research practice within randomized controlled trials, as these constitute a central plank in the assessment of the comparative effectiveness of biomedical interventions. Initiatives to improve the conduct and reporting of clinical trials have encompassed the development of guidelines to enhance overall reporting (1), as well as guidance specific to aspects of trial conduct and reporting including interventions (2) and statistical analysis (3). Notwithstanding this, the quality of trial design and the clarity of reporting has consistently fallen short of these ideals with problems common to diverse areas within medicine and dentistry (4,5).