RT Journal Article
T1 Distortion in the Communication of Nonsignificant Primary Outcomes: The Spin Strategy in Multiple Sclerosis Trials
A1 Mascareñas García, Marta
A1 Rivero de Aguilar, Alejandro
A1 Candal Pedreira, Cristina
A1 García, Guadalupe
A1 Guerra Tort, Carla
A1 Martín Gisbert, Lucía
A1 Rey Brandariz, Julia
A1 Pérez Ríos, Mónica
A1 Varela Lema, María Leonor
AB ObjectiveSpin refers to reporting strategies that highlight the benefits of an experimental treatment or divert attention from nonsignificant primary outcomes. We aimed to assess spin in randomized controlled trials (RCTs) on pharmaceutical efficacy in multiple sclerosis (MS) and explore associated factors.MethodsA systematic literature search was conducted in MedLine (PubMed), EMBASE, and Cochrane using database-specific thesauri (“Multiple Sclerosis” and “Drug Therapy”) to identify relevant studies. We included multiple sclerosis phase 3 and 4 randomized controlled trials with parallel, superiority designs that were published between 2013 and 2024 reporting nonsignificant primary outcomes. Spin was assessed in title, abstract conclusion, results, discussion, and conclusions. A descriptive analysis was followed by exploratory bivariate logistic regression. Independent variables included trial phase, sample size, drug type, comparison, follow-up time, registration, Consolidated Standards of Reporting Trials (CONSORT) mention, risk of bias (RoB2), journal quartile, first author affiliation, and conflict of interest.ResultsForty articles met inclusion criteria. Spin appeared in at least one section in 25 articles (62.5%) and in 3 or more in 19 articles (47.5%). The most frequent locations were abstract conclusions, discussion, and conclusions. Spin was significantly associated with smaller sample size (odds ratio [OR] = 7.00, 95% confidence interval [CI] = 1.29–37.91, p = 0.024), non-Q1 journals (OR = 4.38, 95% CI = 1.03–18.63, p = 0.046), and first author affiliation outside Europe or the United States (OR = 5.09, 95% CI = 1.15–22.62, p = 0.032).InterpretationSpin is common in MS randomized controlled trials with nonsignificant primary outcomes and may mislead clinical decisions. ANN NEUROL 2026;99:316–327
PB Wiley
YR 2026
FD 2026-01-26
LK https://hdl.handle.net/10347/46891
UL https://hdl.handle.net/10347/46891
LA eng
NO Mascareñas-García, M., Rivero-de-Aguilar, A., Candal-Pedreira, C., García, G., Guerra-Tort, C., Martín-Gisbert, L., Rey-Brandariz, J., Ríos, M.P.-R., Casal-Acción, B., Santiago-Pérez, M.I., & Varela-Lema, L. (2026). Distortion in the Communication of Nonsignificant Primary Outcomes: The Spin Strategy in Multiple Sclerosis Trials. Annals of Neurology, 99: 316-327. https://doi.org/10.1002/ana.78125
NO There are no funders to report.
DS Minerva
RD 24 abr 2026