Analysis of Spin in RCTs of Spine Surgery Using ORG–LOC Grading Tool

Abstract
Background Even in highly credible research models, such as randomised control trials (RCTs), many pitfalls do exist that
a practitioner must be aware of, to get the actual sense of the research. The one such pitfall that is much more common but
ironically less explored is the Writers’ bias or the spin. Particularly in the abstracts, it is a potential source of deception to the readers.
Methods We selected 250 recent RCTs from the top 5 spine journals. Baseline data and CONSORT Adherence Score
(CAS) were collected. Abstracts of the RCTs were graded using the level of confdence (LOC) grading tool developed by
the Orthopaedic Research Group. All possible associations of spin were studied to assess the signifcance. Results The median CAS was 11 (IQR 10–12). Only 47.6% (n=119) articles had High LOC with no or one non-critical spin in abstract. 12.4% (n=31) had Moderate LOC and 28% (n=70) had Low LOC. The rest had Critically Low LOC with more than one critical spin. Of the variables analyzed in multivariate regression analysis, only CAS had a (negative) cor-relation with the LOC of the abstracts.
Conclusions Spin-based grading of RCTs is the need of the hour to aid readers to interpret the true essence of research papers.
40% of the RCTs in top spine journals had low to critically low LOC. Objective structuring of abstracts with adherence to
CONSORT guidelines is the way forward to prevent spin.