Bias towards publishing positive results in orthopedic and general surgery: a patient safety issue?

Hasenboehler, Erik A.; Choudhry, Imran K.; Newman, Justin T.; Smith, Wade R.; Ziran, Bruce H.; Stahel, Philip F.

doi:10.1186/1754-9493-1-4

Cited by 68 publications

(64 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…11 This bias may be particularly problematic in the field of surgery, in which clinicians are reluctant to be associated with a negative outcome. 12 In contradistinction to pHDPE, there is a large body of evidence describing the use of ePTFE in rhinoplasty. [13][14][15] The low infection rate for ePTFE seen in our study mirrors that of earlier reports.…”

Section: Commentmentioning

confidence: 99%

Complications Associated With Alloplastic Implants in Rhinoplasty

Winkler¹,

Soler²,

Leong³

et al. 2012

Arch Facial Plast Surg

View full text Add to dashboard Cite

Objective: To evaluate the incidence of infection and extrusion of porous high-density polyethylene (pHDPE) and expanded polytetrafluoroethylene (ePTFE) implants used in rhinoplasty at a high-volume, academic facial plastic surgery practice.Methods: A total of 662 rhinoplasty procedures performed by 3 faculty surgeons from 1999 to 2008 were retrospectively reviewed. Patient demographics, medical comorbidities, operative details, and postoperative course findings were collected from patient records.Results: The incidence of postoperative infection was 2.8% (19 of 662 patients). In each case of infection, alloplastic material had been used. Infections occurred in 1 in 5 rhinoplasty procedures in which pHDPE implants were used. In patients in whom ePTFE was used alone, the infection rate was 5.3%. Exposure developed in 12% of patients in whom an alloplast was used during surgery. Factors notably not associated with infection on bivariate analysis included sex, surgeon, purpose of procedure (functional vs cosmetic), current tobacco use, or history of cocaine use (P Ͼ .05 for all).Conclusions: To our knowledge, this study represents the largest evaluation of the use of pHDPE implants in rhinoplasty to date. Our findings are in contrast to those of previous studies regarding the use of pHDPE in rhinoplasty and parallel to those regarding the use of ePTFE. Caution is strongly recommended when considering the use of pHDPE in rhinoplasty.

show abstract

Section: Commentmentioning

confidence: 99%

Complications Associated With Alloplastic Implants in Rhinoplasty

Winkler¹,

Soler²,

Leong³

et al. 2012

Arch Facial Plast Surg

View full text Add to dashboard Cite

show abstract

“…13 Positive outcomes were associated with lower complication rates (p = 0.006, Table 3) and increased presence of statistical analysis (p = 0.001, Table 3). We found no correlation between positive outcomes and study of journal origin (p = 0.071), primary language of article (p = 0.053), study size (p = 0.987), and mean follow-up time (p = 0.481, Table 3).…”

Section: Resultsmentioning

confidence: 96%

“…Positive outcomes were defined as present if the authors directly recommended a procedure or stated that the intervention was generally beneficial, irrespective of absolute outcome values or the presence of statistical significance; negative outcomes were defined as present when the authors advised against the intervention or presented only negative results; and neutral outcomes were defined by the absence of author recommendations or the presence of both positive and negative comments/results. 13-16 For studies comparing more than one intervention for Kienbock's disease, outcomes were considered positive if the authors specifically recommended at least one of the procedures included in the study.…”

Section: Methodsmentioning

confidence: 99%

“…9,13-16 The purpose of this study is to conduct a rigorous evaluation of all available literature regarding the surgical treatment of Kienbock's disease and identify potential areas of publication bias. Using data from published abstracts in both the English and non-English language, we will present a systematic review assessing study characteristics, quality of reporting, and direction of outcomes (positive or neutral/negative) for all published Kienbock's studies.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Publication Bias in Kienböck's Disease: Systematic Review

Squitieri

Petruska

Chung

2010

The Journal of Hand Surgery

View full text Add to dashboard Cite

Purpose Kienbock's disease is considered a “rare disease” and currently affects less than 200,000 people in the U.S. Given the inherent challenges associated with researching rare diseases, the intense effort in hand surgery to treat this uncommon disorder may be susceptible to publication bias in which positive outcomes are preferentially published. The specific aim of this project is to conduct a systematic review of the literature with the hypothesis that publication bias is present for the treatment of Kienbock's disease. Methods We conducted a systematic review of all available abstracts associated with published manuscripts (English and non-English) and abstracts accepted to the 1992-2004 American Society for Surgery of the Hand (ASSH) annual meetings. Data collection included various study characteristics, direction of outcome (positive, neutral/negative), complication rates, mean follow-up time, time to publication, and length of patient enrollment. Results Our study included 175 (124 English, 51 non-English) published Kienbock's manuscripts and 14 Kienbock's abstracts from the 1992-2004 annual ASSH meetings. Abstracts from published manuscripts were associated with a 53% positive outcome rate, which is lower than the 74% positive outcome rate found among other surgical disorders. Over the past 40 years, studies have become more positive (36% to 68%, p = 0.007) and are more likely to incorporate statistical analysis testing (0% to 55%, p <0.001). Of the 14 abstracts accepted to ASSH, 11 (79%) were published in peer-reviewed journals. Ten of the 14 accepted abstracts (71%) were considered positive, and there was no significant difference in publication rate between studies with positive (n = 10) and non-positive (n = 4) outcomes (p = 1.000). Conclusions The acceptance rate for negative outcomes studies regarding Kienbock's disease is higher than for other surgical disorders. This may indicate a relative decrease in positive outcome bias among published Kienbock's studies compared to other surgical disorders. However, the increasing positive outcome rate for published Kienbock's studies over time may suggest a trend of increasing publication bias among journals toward Kienbock's studies.

show abstract

“…7 Failure to publish trials or portions of trials with negative results leads to reporting bias. 8,9 The failure to publish an entire study because of results obtained is referred to as publication bias. When results and outcomes are selectively published by the authors this is referred to as selective outcome reporting bias.…”

Section: Literature Searchmentioning

confidence: 99%

Evaluation of a Review Article

Turlik¹

2009

FAOJ

View full text Add to dashboard Cite

The Foot and Ankle Online Journal 2 (6): 5Different types of reviews are described and it is suggested that systematic reviews/meta-analysis are the best type of review to use to determine treatment efficacy. How to evaluate a systematic review is explained using as an example an article from the foot and ankle literature. This is another article in the ongoing evidence-based medicine series produced for The Foot and Ankle Online Journal.

show abstract

Bias towards publishing positive results in orthopedic and general surgery: a patient safety issue?

Cited by 68 publications

References 28 publications

Complications Associated With Alloplastic Implants in Rhinoplasty

Complications Associated With Alloplastic Implants in Rhinoplasty

Publication Bias in Kienböck's Disease: Systematic Review

Evaluation of a Review Article

Contact Info

Product

Resources

About