Prevalence of Spin in Reviews on Intrawound Application of Vancomycin for Surgical Site Prophylaxis in Spine Surgery.

Abstract

Study design: Systematic Review.

Objectives: Systematic reviews and meta-analyses that aggregate data on the intrawound application of vancomycin for surgical site infection (SSI) prophylaxis in spine surgeries are at an increased risk of spin, the overstating of beneficial effects of an intervention. The purpose of this study was to identify studies that coalesce outcomes of intrawound vancomycin SSI prophylaxis in spine surgeries and define the prevalence and types of spin in the identified literature. Secondarily, this study aimed to identify patterns within study characteristics that were associated with certain spin types.

Methods: This study was conducted using the Preferred Reporting Items for Systemic Reviews and Meta-Analyses guidelines. A search was performed in 4 databases (PubMed, SCOPUS, Medline and Cochrane) for systematic reviews and meta-analyses on intrawound vancomycin use for SSI prophylaxis in spine surgeries. Two authors independently assessed studies for inclusion criteria and then aggregated study characteristics: titles, publication journal and year, authors, level of evidence, etc. Each study was subsequently evaluated for the presence of 15 different spin types. Statistical analysis was performed for patterns between spin prevalence and study characteristics.

Results: From the database search, 18 studies met the inclusion criteria. In total, 13 studies (72%) were found to have spin. The most common types of spin identified were spin type 9 ("Conclusion claims the beneficial effect of the experimental treatment despite reporting bias"), found in 9 (50.00%) studies and type 3 ("Selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention"), found in 7 (38.89%) studies.

Conclusions: There is a high prevalence of spin in systematic reviews and meta-analyses on the intrawound application of vancomycin for SSI prophylaxis in spine surgery. Our analysis demonstrated that studies tended to selectively report positive findings while minimizing negative outcomes within abstracts.