Investigating the trustworthiness of randomised controlled trials in osteopathic research: a systematic review with meta-analysis
File(s)
Published version
Author(s)
Sénéquier, Amandine
Draper-Rodi, Jerry
Alvarez Bustins, Gerard
Braithwaite, Felicity
Brown, Jessica
Type
Journal Article
Abstract
Objective
To systematically investigate trustworthiness (methodological rigour, transparency, good governance, research integrity, and absence of misconduct) in randomised controlled trials (RCTs) of osteopathic manual therapy.
Methods
This prospectively registered review (PROSPERO-ID: CRD42023457697) searched MEDLINE®, EMBASE, CINAHL, AMED, PEDro, ostmed.dr, and Chiroindex for RCTs evaluating osteopathic treatments (January 2021-June 2024). Risk-of-bias was assessed using Cochrane tool 2, while trustworthiness was assessed with the Cochrane Pregnancy and Childbirth Screening Tool and the REAPPRAISED checklist. Journal trustworthiness, misleading representations in abstracts (‘spin’), and results plausibility (via meta-analysis) were also assessed. Findings were synthesised descriptively.
Results
Sixty-one RCTs were included (median sample size 45, IQR 30-76), largely studying healthy volunteers (29%). Most had high risk-of-bias (74%), and only 7% acknowledged potential conflicts from authors’ professional ties. No journals appeared on cautionary lists, although 23% of articles were published within two months of submission. Only 27% of contactable authors engaged with reviewers. Seven abstracts (12%) were free of spin. Methodological concerns included poor missing data handling (31%), selective analyses (38%), unacknowledged multiple testing (36%), and outcome switching (12%). Meta-analysis found two outliers and five further with very large effects, while 19% provided inadequate data for pooling.
Limitations
Limitations include incomplete reports and lack of validated trustworthiness assessment tools.
Conclusion
Adherence to best practices in osteopathic RCTs needs improvement to enhance evidence-based decision making, reduce research waste, and enhance reproducibility. Further research should explore whether these findings apply to other small, under-resourced fields.
Funding
The Osteopathic Foundation.
To systematically investigate trustworthiness (methodological rigour, transparency, good governance, research integrity, and absence of misconduct) in randomised controlled trials (RCTs) of osteopathic manual therapy.
Methods
This prospectively registered review (PROSPERO-ID: CRD42023457697) searched MEDLINE®, EMBASE, CINAHL, AMED, PEDro, ostmed.dr, and Chiroindex for RCTs evaluating osteopathic treatments (January 2021-June 2024). Risk-of-bias was assessed using Cochrane tool 2, while trustworthiness was assessed with the Cochrane Pregnancy and Childbirth Screening Tool and the REAPPRAISED checklist. Journal trustworthiness, misleading representations in abstracts (‘spin’), and results plausibility (via meta-analysis) were also assessed. Findings were synthesised descriptively.
Results
Sixty-one RCTs were included (median sample size 45, IQR 30-76), largely studying healthy volunteers (29%). Most had high risk-of-bias (74%), and only 7% acknowledged potential conflicts from authors’ professional ties. No journals appeared on cautionary lists, although 23% of articles were published within two months of submission. Only 27% of contactable authors engaged with reviewers. Seven abstracts (12%) were free of spin. Methodological concerns included poor missing data handling (31%), selective analyses (38%), unacknowledged multiple testing (36%), and outcome switching (12%). Meta-analysis found two outliers and five further with very large effects, while 19% provided inadequate data for pooling.
Limitations
Limitations include incomplete reports and lack of validated trustworthiness assessment tools.
Conclusion
Adherence to best practices in osteopathic RCTs needs improvement to enhance evidence-based decision making, reduce research waste, and enhance reproducibility. Further research should explore whether these findings apply to other small, under-resourced fields.
Funding
The Osteopathic Foundation.
Date Issued
2025-07-01
Date Acceptance
2025-04-10
Citation
Journal of Clinical Epidemiology, 2025, 183
ISSN
0895-4356
Publisher
Elsevier BV
Journal / Book Title
Journal of Clinical Epidemiology
Volume
183
Copyright Statement
© 2025 The Author(s). Published by Elsevier Inc.
License URL
Identifier
10.1016/j.jclinepi.2025.111788
Subjects
Physical therapy modalities
Trustworthiness
Clinical trials
Methodology
Reproducibility
Research integrity
Publication Status
Published
Article Number
111788
Date Publish Online
2025-04-16