Are Reports of Randomized Controlled Trials Improving over Time?

PLoS One. 2013 Dec 31;8(12):e84779.

Are Reports of Randomized Controlled Trials Improving over Time? A Systematic Review of 284 Articles Published in High-Impact General and Specialized Medical Journals.

To MJ1, Jones J2, Emara M1, Jadad AR3.

Author information

• 1Electronic Living Laboratory for Interdisciplinary Cancer Survivorship Research, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada.
• 2Electronic Living Laboratory for Interdisciplinary Cancer Survivorship Research, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada ; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
• 3Electronic Living Laboratory for Interdisciplinary Cancer Survivorship Research, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada ; Centre for Global eHealth Innovation, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada ; Radiation Medicine Program, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada ; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada ; Department of Anesthesia, Health Policy, University of Toronto, Toronto, Ontario, Canada ; Department of Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Abstract

BACKGROUND:

Inadequate reporting undermines findings of randomized controlled trials (RCTs). This study assessed and compared articles published in high-impact general medical and specialized journals.

METHODS:

Reports of RCTs published in high-impact general and specialized medical journals were identified through a search of MEDLINE from January to March of 1995, 2000, 2005, and 2010. Articles that provided original data on adult patients diagnosed with chronic conditions were included in the study. Data on trial characteristics, reporting of allocation concealment, quality score, and the presence of a trial flow diagram were extracted independently by two reviewers, and discrepancies were resolved by consensus or independent adjudication. Descriptive statistics were used for quantitative variables. Comparisons between general medical and specialized journals, and trends over time were performed using Chi-square tests.

RESULTS:

Reports of 284 trials were analyzed. There was a significantly higher proportion of RCTs published with adequate reporting of allocation concealment (p = 0.003), presentation of a trial flow diagram (p<0.0001) and high quality scores (p = 0.038) over time. Trials published in general medical journals had higher quality scores than those in specialized journals (p = 0.001), reported adequate allocation concealment more often (p = 0.013), and presented a trial flow diagram more often (p<0.001).

INTERPRETATION:

We found significant improvements in reporting quality of RCTs published in high-impact factor journals over the last fifteen years. These improvements are likely attributed to concerted international efforts to improve reporting quality such as CONSORT. There is still much room for improvement, especially among specialized journals.