Overinterpretation and misreporting of prognostic factor studies in oncology: a systematic review

doi:10.1038/s41416-018-0305-5

. 2018 Nov;119(10):1288-1296.

doi: 10.1038/s41416-018-0305-5. Epub 2018 Oct 24.

Overinterpretation and misreporting of prognostic factor studies in oncology: a systematic review

Emmanuelle Kempf^{1

2}, Jennifer A de Beyer¹, Jonathan Cook¹, Jane Holmes¹, Seid Mohammed¹, Tri-Long Nguyên^{1

3}, Iveta Simera⁴, Marialena Trivella¹, Douglas G Altman¹, Sally Hopewell¹, Karel G M Moons^{5

6}, Raphael Porcher⁷, Johannes B Reitsma^{5

6}, Willi Sauerbrei⁸, Gary S Collins^{9

10}

Affiliations

¹ Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK.
² Department of Medical Oncology, Henri Mondor and Albert Chenevier Teaching Hospital, APHP, Créteil, France.
³ Laboratory UPRES EA2415, Biostatistics, Epidemiology, Clinical Research and Health Economics, University of Montpellier, Montpellier, France.
⁴ Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
⁵ Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
⁶ Cochrane Netherlands, UMC Utrecht, Utrecht University, Utrecht, The Netherlands.
⁷ Department of Epidemiology, Hôtel Dieu Teaching Hospital, APHP, Paris, France.
⁸ Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
⁹ Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK. gary.collins@csm.ox.ac.uk.
¹⁰ NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, OX3 9DU, UK. gary.collins@csm.ox.ac.uk.

PMID: 30353050
PMCID: PMC6251031
DOI: 10.1038/s41416-018-0305-5

Overinterpretation and misreporting of prognostic factor studies in oncology: a systematic review

Emmanuelle Kempf et al. Br J Cancer. 2018 Nov.

. 2018 Nov;119(10):1288-1296.

doi: 10.1038/s41416-018-0305-5. Epub 2018 Oct 24.

Authors

Affiliations

¹ Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK.
² Department of Medical Oncology, Henri Mondor and Albert Chenevier Teaching Hospital, APHP, Créteil, France.
³ Laboratory UPRES EA2415, Biostatistics, Epidemiology, Clinical Research and Health Economics, University of Montpellier, Montpellier, France.
⁴ Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
⁵ Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
⁶ Cochrane Netherlands, UMC Utrecht, Utrecht University, Utrecht, The Netherlands.
⁷ Department of Epidemiology, Hôtel Dieu Teaching Hospital, APHP, Paris, France.
⁸ Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
⁹ Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK. gary.collins@csm.ox.ac.uk.
¹⁰ NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, OX3 9DU, UK. gary.collins@csm.ox.ac.uk.

PMID: 30353050
PMCID: PMC6251031
DOI: 10.1038/s41416-018-0305-5

Abstract

Background: Cancer prognostic biomarkers have shown disappointing clinical applicability. The objective of this study was to classify and estimate how study results are overinterpreted and misreported in prognostic factor studies in oncology.

Methods: This systematic review focused on 17 oncology journals with an impact factor above 7. PubMed was searched for primary clinical studies published in 2015, evaluating prognostic factors. We developed a classification system, focusing on three domains: misleading reporting (selective, incomplete reporting, misreporting), misleading interpretation (unreliable statistical analysis, spin) and misleading extrapolation of the results (claiming irrelevant clinical applicability, ignoring uncertainty).

Results: Our search identified 10,844 articles. The 98 studies included investigated a median of two prognostic factors (Q1-Q3, 1-7). The prognostic factors' effects were selectively and incompletely reported in 35/98 and 24/98 full texts, respectively. Twenty-nine articles used linguistic spin in the form of strong statements. Linguistic spin rejecting non-significant results was found in 34 full-text results and 15 abstract results sections. One in five articles had discussion and/or abstract conclusions that were inconsistent with the study findings. Sixteen reports had discrepancies between their full-text and abstract conclusions.

Conclusions: Our study provides evidence of frequent overinterpretation of findings of prognostic factor assessment in high-impact medical oncology journals.

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Conflict of interest statement

The authors declare no competing interests.

Figures

**Fig. 1**
Flow chart of the study selection

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References

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[1] Temel JS, Shaw AT, Greer JA. Challenge of prognostic uncertainty in the modern era of cancer therapeutics. J. Clin. Oncol. 2016;34:3605–3609. doi: 10.1200/JCO.2016.67.8573. - DOI - PubMed

[2] Temel JS, Shaw AT, Greer JA. Challenge of prognostic uncertainty in the modern era of cancer therapeutics. J. Clin. Oncol. 2016;34:3605–3609. doi: 10.1200/JCO.2016.67.8573. - DOI - PubMed

[3] Hagerty RG, et al. Communicating with realism and hope: incurable cancer patients’ views on the disclosure of prognosis. J. Clin. Oncol. 2005;23:1278–1288. doi: 10.1200/JCO.2005.11.138. - DOI - PubMed

[4] Hagerty RG, et al. Communicating with realism and hope: incurable cancer patients’ views on the disclosure of prognosis. J. Clin. Oncol. 2005;23:1278–1288. doi: 10.1200/JCO.2005.11.138. - DOI - PubMed

[5] Lagarde SM, et al. Patient preferences for the disclosure of prognosis after esophagectomy for cancer with curative intent. Ann. Surg. Oncol. 2008;15:3289–3298. doi: 10.1245/s10434-008-0068-y. - DOI - PubMed

[6] Lagarde SM, et al. Patient preferences for the disclosure of prognosis after esophagectomy for cancer with curative intent. Ann. Surg. Oncol. 2008;15:3289–3298. doi: 10.1245/s10434-008-0068-y. - DOI - PubMed

[7] Miyata H, Takahashi M, Saito T, Tachimori H, Kai I. Disclosure preferences regarding cancer diagnosis and prognosis: to tell or not to tell? J. Med. Ethics. 2005;31:447–451. doi: 10.1136/jme.2003.007302. - DOI - PMC - PubMed

[8] Miyata H, Takahashi M, Saito T, Tachimori H, Kai I. Disclosure preferences regarding cancer diagnosis and prognosis: to tell or not to tell? J. Med. Ethics. 2005;31:447–451. doi: 10.1136/jme.2003.007302. - DOI - PMC - PubMed

[9] Nie X, et al. Poor-prognosis disclosure preference in cancer patient-caregiver dyads and its association with their quality of life and perceived stress: a cross-sectional survey in mainland China. Psychooncology. 2016;25:1099–1105. doi: 10.1002/pon.4055. - DOI - PubMed

[10] Nie X, et al. Poor-prognosis disclosure preference in cancer patient-caregiver dyads and its association with their quality of life and perceived stress: a cross-sectional survey in mainland China. Psychooncology. 2016;25:1099–1105. doi: 10.1002/pon.4055. - DOI - PubMed

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Overinterpretation and misreporting of prognostic factor studies in oncology: a systematic review

Affiliations

Overinterpretation and misreporting of prognostic factor studies in oncology: a systematic review

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

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Cited by

References

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