Over 30% of Systematic Reviews and Meta-analyses Focused on Rotator Cuff Tear Treatments Contained Spin in the Abstract


      The purpose of this study is to determine the prevalence of spin in the abstracts of systematic reviews and meta-analyses on treatments for rotator cuff tears and whether various study and publishing journal characteristics were associated with the presence of spin.


      A search strategy was developed for Ovid MEDLINE and Ovid Embase to retrieve systematic reviews focused on treatments for rotator cuff tears. For an article to be included, it must meet the following criteria: (1) the article must be a systematic review with or without a meta-analysis, (2) the article must pertain to the treatment of rotator cuff tears, (3) the article must only contain human subjects, and (4) the article must be accessible in English. Systematic reviews were analyzed for spin using a previously developed classification scheme in a masked, duplicate manner. Binary logistic regression was used to examine independent associations via unadjusted odds ratios and 95% confidence intervals between the presence of spin and study characteristics.


      Search queries returned 932 articles, of which 121 systematic reviews and meta-analyses were eligible. A total of 36.4% (44/121) of systematic reviews contained spin. Among the general characteristics evaluated, there were no correlations with spin.


      Spin was present in more than one-third of systematic reviews and meta-analyses covering rotator cuff tear treatments. Spin was not associated with any general study or journal characteristics, which indicates that clinicians must be aware of the potential presence of spin in all such abstracts.

      Clinical Relevance

      Clinicians rely on systematic reviews and meta-analyses, especially abstracts of these articles, to provide succinct guidance on best practices in patient care. The presence of spin could adversely affect patient care; thus, steps should be taken to improve the reporting quality of abstracts on rotator cuff tear treatment.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Deprés-Tremblay G.
        • Chevrier A.
        • Snow M.
        • Hurtig M.B.
        • Rodeo S.
        • Buschmann M.D.
        Rotator cuff repair: a review of surgical techniques, animal models, and new technologies under development.
        J Shoulder Elbow Surg. 2016; 25: 2078-2085
        • Edwards P.
        • Ebert J.
        • Joss B.
        • Bhabra G.
        • Ackland T.
        • Wang A.
        Exercise rehabilitation in the non-operative management of rotator cuff tears: A review of the literature.
        Int J Sports Phys Ther. 2016; 11: 279-301
        • Savoie III, F.H.
        • Field L.D.
        • Jenkins R.N.
        Costs analysis of successful rotator cuff repair surgery: An outcome study. Comparison of gatekeeper system in surgical patients.
        Arthroscopy. 1995; 11: 672-676
        • Meislin R.J.
        • Sperling J.W.
        • Stitik T.P.
        Persistent shoulder pain: Epidemiology, pathophysiology, and diagnosis.
        Am J Orthop. 2005; 34 (suppl): 5-9
        • Sambunjak D.
        • Franić M.
        Steps in the undertaking of a systematic review in orthopaedic surgery.
        Int Orthop. 2012; 36: 477-484
        • Barry H.C.
        • Ebell M.H.
        • Shaughnessy A.F.
        • Slawson D.C.
        • Nietzke F.
        Family physicians’ use of medical abstracts to guide decision making: style or substance?.
        J Am Board Fam Pract. 2001; 14: 437-442
        • Yavchitz A.
        • Ravaud P.
        • Altman D.G.
        • et al.
        A new classification of spin in systematic reviews and meta-analyses was developed and ranked according to the severity.
        J Clin Epidemiol. 2016; 75: 56-65
        • Liberati A.
        • Altman D.G.
        • Tetzlaff J.
        • et al.
        The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration.
        PLoS Med. 2009; 6e1000100
        • Murad M.H.
        • Wang Z.
        Guidelines for reporting meta-epidemiological methodology research.
        Evid Based Med. 2017; 22: 139-142
        • Reddy A.
        • Shepard S.
        • Ottwell R.L.
        Rotator cuff injury—spin.
        Date accessed: July 7, 2020
        • Ottwell R.
        • Rogers T.C.
        • Michael Anderson J.
        • Johnson A.
        • Vassar M.
        Evaluation of spin in the abstracts of systematic reviews and meta-analyses focused on the treatment of acne vulgaris: Cross-sectional analysis.
        JMIR Dermatol. 2020; 3e16978
        • Shamseer L.
        • Moher D.
        • Clarke M.
        • et al.
        Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: Elaboration and explanation.
        BMJ. 2015; 350: g7647
      1. Rayyan Systems, Inc.
        Date accessed: June 2, 2020
        • Coursera
        Introduction to systematic review and meta-analysis.
        • Beller E.M.
        • Glasziou P.P.
        • Altman D.G.
        • et al.
        PRISMA for Abstracts: Reporting systematic reviews in journal and conference abstracts.
        PLoS Med. 2013; 10e1001419
        • Checketts J.X.
        • Riddle J.
        • Zaaza Z.
        • Boose M.A.
        • Whitener J.H.
        • Vassar M.B.
        An evaluation of spin in lower extremity joint trials.
        J Arthroplasty. 2019; 34: 1008-1012
        • Kinder N.C.
        • Weaver M.D.
        • Wayant C.
        • Vassar M.
        Presence of “spin” in the abstracts and titles of anaesthesiology randomised controlled trials.
        Br J Anaesth. 2019; 122: e13-e14
      2. Reynolds-Vaughn V, Riddle J, Brown J, Schiesel M, Wayant C, Vassar M. Evaluation of spin in the abstracts of emergency medicine randomized controlled trials [published online May 14, 2019]. Ann Emerg Med.

        • Wayant C.
        • Margalski D.
        • Vaughn K.
        • Vassar M.
        Evaluation of spin in oncology clinical trials.
        Crit Rev Oncol Hematol. 2019; 144: 102821
        • Nascimento D.P.
        • Gonzalez G.Z.
        • Araujo A.C.
        • Moseley A.M.
        • Maher C.G.
        • Costa L.O.P.
        Eight out of every ten abstracts of low back pain systematic reviews presented spin and inconsistencies with the full text: An analysis of 66 systematic reviews.
        J Orthop Sports Phys Ther. 2020; 50: 17-23
        • Li S.
        • Sun H.
        • Luo X.
        • et al.
        The clinical effect of rehabilitation following arthroscopic rotator cuff repair: A meta-analysis of early versus delayed passive motion.
        Medicine. 2018; 97e9625
        • Tripepi G.
        • Jager K.J.
        • Dekker F.W.
        • Zoccali C.
        Selection bias and information bias in clinical research.
        Nephron Clinical Practice. 2010; 115: c94-c99
        • Liu F.
        • Dong J.
        • Kang Q.
        • Zhou D.
        • Xiong F.
        Subacromial balloon spacer implantation for patients with massive irreparable rotator cuff tears achieves satisfactory clinical outcomes in the short and middle of follow-up period: A meta-analysis.
        Knee Surg Sports Traumatol Arthrosc. 2021; 29: 143-153
        • Marcelo A.
        • Gavino A.
        • Isip-Tan I.T.
        • et al.
        A comparison of the accuracy of clinical decisions based on full-text articles and on journal abstracts alone: A study among residents in a tertiary care hospital.
        Evid Based Med. 2013; 18: 48-53
        • Boutron I.
        Spin in scientific publications: A frequent detrimental research practice.
        Ann Emerg Med. 2020; 75: 432-434
        • Gómez-García F.
        • Ruano J.
        • Aguilar-Luque M.
        • et al.
        Abstract analysis method facilitates filtering low-methodological quality and high-bias risk systematic reviews on psoriasis interventions.
        BMC Med Res Methodol. 2017; 17 (180)
        • Boutron I.
        • Altman D.G.
        • Hopewell S.
        • Vera-Badillo F.
        • Tannock I.
        • Ravaud P.
        Impact of spin in the abstracts of articles reporting results of randomized controlled trials in the field of cancer: The SPIIN randomized controlled trial.
        J Clin Oncol. 2014; 32: 4120-4126