Evaluating "spin" in the abstracts of systematic reviews and meta-analyses on robotic-assisted total knee arthroplasty.

Abstract

Spin bias in the abstract of systematic reviews and meta-analyses (SRMAs) may impact readers' perception of a treatment's efficacy. This study assessed spin in the abstracts of SRMAs on robotic-assisted total knee arthroplasty (RA-TKA). MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews were searched for SRMAs on outcomes of RA-TKA. The nine most severe types of spin described by Yavchitz et al. were evaluated in the abstracts of included SRMAs. Full-text methodological quality of included SRMAs was then assessed using the AMSTAR-2 tool. Associations between SRMA characteristics (e.g. citation count, publication year, journal impact factor) and the presence of any type of spin was analyzed using unadjusted odds ratios (ORs). Twenty-four SRMAs were included, 13 (54.1%) contained at least one form of spin. The most common was Type 3 spin (33%), characterized by selective emphasis on favorable outcomes, followed by Type 5 spin (29%), where conclusions claimed benefit despite high risk of bias. Using the AMSTAR-2 tool, methodological confidence was low (12.5%) or critically low (87.5%). Higher citation count was associated with increased odds of spin (OR 6.00, 95%CI 1.02-35.37). SRMAs published in 2023 or later were associated with decreased odds of spin (OR 0.17, 95%CI 0.03-0.98). Spin bias was present in the abstracts of over half of RA-TKA SRMAs, most commonly Type 3 and Type 5. Given the growing popularity of RA-TKA, SRMAs in this field should ensure fair presentation of all assessed outcomes and interpret findings in the context of potential reporting bias. LOE: IV.