Spin on adverse effects in abstracts of systematic reviews of orthodontic interventions: a cross-sectional study (part 2)

Background: It is critical that abstracts of systematic reviews transparently report both the beneficial and adverse effects of interventions without misleading the readers. This cross-sectional study assessed whether adverse effects of interventions were reported or considered in abstracts of systematic reviews of orthodontic interventions and whether spin on adverse effects was identified when comparing the abstracts with what was sought and reported in these reviews. Methods: This cross-sectional study (part 2 of 2) used the same sample of 98 systematic reviews orthodontic interventions as used in part 1. Eligible reviews were retrieved from the Cochrane Database of Systematic Reviews and the 5 leading orthodontic journals between August 1 2009 and July 31 2021. Prevalence proportions were sought for 3 outcomes as defined in the published protocol. Univariable logistic regression models were built to explore associations between the presence of spin in the abstract and a series of predictors. Odds ratios (OR) 95% confidence intervals (95% CI) were used to quantify the strength of associations and their precision. Results: 76.5% (75/98) of eligible reviews reported or considered (i.e., discussed, weighted etc.) potential adverse effects of orthodontic interventions in the abstract and the proportion of spin on adverse effects was 40.8% (40/98) in the abstract of these reviews. Misleading reporting was the predominant category of spin, i.e., 90% (36/40). Our explorative analyses found that compared to the Cochrane Database of Systematic Reviews all 5 orthodontic journals had similar odds of the presence of spin on adverse effects in abstracts of systematic reviews of orthodontic interventions. The odds of the presence of spin did not change over the sampled years (OR: 1.03, 95% CI: 0.9 to 1.16) and did not depend on the number of authors (OR: 0.93, 95% CI: 0.71 to 1.21), or on the type of orthodontic intervention (OR: 1.1, 95% CI: 0.45 to 2.67), or whether conflicts of interests were reported (OR: 0.74, 95% CI: 0.32 to 1.68). Conclusion: End users of systematic reviews of orthodontic interventions have to be careful when interpreting results on adverse effects in the abstracts of these reviews, because they could be jeopardized by uncertainties such as not being reported and misleading reporting as a result of spin.