Moderate to high prevalence of spin revealed in abstracts and main texts of medical publications: A systematic review of research-on-research studies
et al., Journal of Clinical Epidemiology, doi:10.1016/j.jclinepi.2026.112264, Apr 2026
Review of the prevalence of "spin" - defined as reporting practices that distort results to create misleading conclusions - across medical literature. Authors analyze 133 research-on-research studies, showing spin in 59% of randomized controlled trial (RCT) abstracts and 65% of their main texts.
Authors primarily relied on expert-consensus frameworks that flag internal structural and statistical discordances, such as inappropriately highlighting significant secondary outcomes when primary endpoints fail, or claiming treatment equivalence from non-significant data.
They likely do not detect broader, domain-specific flaws requiring deep subject-matter expertise - such as the intentionally biased sampling of background literature or omission of contradictory trials.
Su et al., 2 Apr 2026, peer-reviewed, 5 authors.
Contact: n.su@acta.nl.
Abstract: ## Journal Pre-proof
Moderate to high prevalence of spin revealed in abstracts and main texts of medical publications: A systematic review of research-on-research studies
Naichuan Su, Michiel van der Linden, Geert van der Heijden, Stefan Listl, Clovis Mariano Faggion, Jr.
PII:
S0895-4356(26)00139-3
DOI:
https://doi.org/10.1016/j.jclinepi.2026.112264
Reference:
JCE 112264
To appear in:
Journal of Clinical Epidemiology
Received Date:
14 June 2025
Revised Date:
7 March 2026
Accepted Date:
27 March 2026
Please cite this article as: Su N, van der Linden M, van der Heijden G, Listl S, Faggion Jr CM, Moderate to high prevalence of spin revealed in abstracts and main texts of medical publications: A systematic review of research-on-research studies, Journal of Clinical Epidemiology (2026), doi: https:// doi.org/10.1016/j.jclinepi.2026.112264.
This is a PDF of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability. This version will undergo additional copyediting, typesetting and review before it is published in its final form. As such, this version is no longer the Accepted Manuscript, but it is not yet the definitive Version of Record; we are providing this early version to give early visibility of the article. Please note that Elsevier's sharing policy for the Published Journal Article applies to this version, see: https://www.elsevier.com/about/policies-andstandards/sharing#4-published-journal-article. Please also note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
© 2026 Published by Elsevier Inc.
Background and aim
- Spin is any (reporting) practice, consciously or unconsciously, that leads to misinterpretation or overinterpretation of study findings.
- Spin can be misleading and may affect healthcare decisions.
- We aim to assess prevalence of spin in medical publications, based on a systematic review
Conclusions
Moderate to high prevalence of spin revealed in abstracts and main texts of medical publications: A systematic review of research-on-research studies
Methods
- 133 research-on-research studies (RoRSs) assessing spin in any types of primary studies (e.g. RCTs, systematic reviews [SRs]) in any field of medicine were included
Results
- Spin is moderately to highly prevalent in abstracts and main texts of RCTs and SRs in medicine but rare in titles;
- The high prevalence of spin may cause misinformed clinical decision-making and highlights the need for improving reporting standards in medical publications.
Higher risk of having spin in SR abstracts
The image in the graphical abstract was generated using ChatGPT (OpenAI, GPT-5.3).
Moderate to high prevalence of spin revealed in abstracts and main texts of medical publications: A systematic review of research-on-research studies
Naichuan Su a, *, Michiel van der Linden a , Geert van der Heijden a , Stefan Listl b,c , Clovis Mariano Faggion Jr d a Department of Oral Public Health, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
b Department of Dentistry - Quality and Safety of Oral Healthcare, Radboud University Medical Center, Radboud Universiteit, Nijmegen, The Netherlands c Section for Oral Health, Heidelberg Institute of Global Health, Heidelberg University Hospital and Medical Faculty, Heidelberg University, Heidelberg,..
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