Highlights
- A group of trials with trust concerns had major impacts on the results of systematic reviews and clinical guidelines.
- They substantially impacted effect sizes and influenced the conclusions and recommendations drawn.
- There is a need for a greater focus on the trustworthiness of studies in evidence appraisal.
The damage done by compromised can clinical trials is not marginal or theoretical, especially when their results make it into systematic reviews, clinical texts or clinical practice. They can cause serious harm, suffering and even death. Institutions, funding bodies, registers and publishes have a clear role. Retractions must be promptly and clearly reported. Researchers and authors must take care never to cite retracted work. Anything that undermines the reliability of the scientific record, especially in relation to medical/professional practice is a series form of misconduct and should be treated as such.
Perspective
We found that a group of trials of CBT for spinal pain with concerns relating to their trustworthiness have had substantial impacts on the analyses and conclusions of systematic reviews and clinical practice guidelines. This highlights the need for a greater focus on the trustworthiness of studies in evidence appraisal.
Keywords
Clinical trials, spinal pain, trustworthiness, systematic reviews, clinical practice guidelines
O’Connell, N. E., Moore, R. A., Stewart, G., Fisher, E., Hearn, L., Eccleston, C., Wewege, M., & de C Williams, A. C. (2023). Trials we cannot trust: investigating their impact on systematic reviews and clinical guidelines in spinal pain. The journal of pain, S1526-5900(23)00467-4. Advance online publication. https://doi.org/10.1016/j.jpain.2023.07.003
Publisher (Open Access): https://www.jpain.org/article/S1526-5900(23)00467-4/fulltext
trials of cognitive behavioural therapy (CBT) and exercise in spinal pain. We identified
multiple concerns in eight trials, judging them untrustworthy. In this study, we systematically
explored the impact of these t…
