Rhetorical Strategies Used in the Reporting of Implantable Defibrillator Primary Prevention Trials

Previous studies have suggest that the authors of randomized trial reports frequently use rhetorical strategies, such as framing, the use of ratios rather than absolute values to report results, and underreporting of complications, to convince readers of treatment efficacy. The objective of this stu...

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Veröffentlicht in:The American journal of cardiology 2011-06, Vol.107 (12), p.1806-1811
1. Verfasser: Wilson, John R., MD
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container_title The American journal of cardiology
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creator Wilson, John R., MD
description Previous studies have suggest that the authors of randomized trial reports frequently use rhetorical strategies, such as framing, the use of ratios rather than absolute values to report results, and underreporting of complications, to convince readers of treatment efficacy. The objective of this study was to determine if such rhetorical strategies were used in the publication of implantable-cardioverter defibrillator (ICD) primary prevention trials. Medline and the Cochrane Central Register of Controlled Trials were searched for all publications that described ICD primary prevention trials and that involved >100 subjects. Each publication was analyzed for evidence of message framing, the exclusive use of ratios to report outcomes, underreporting of ICD complications, and interpretation bias favoring ICD therapy. Ten publications were identified. Introductory remarks in 8 of the 10 publications cited the evaluation of ICD benefits as the sole objective and mentioned only background studies that supported ICD efficacy, suggesting message framing in support of ICD efficacy. Five publications provided no specific information about the frequency of unsuccessful ICD implantations, and 8 publications provided incomplete or no information about implantation and postimplantation complications. ICD complications were not mentioned in the discussion sections of 9 publications, and none of the publications included a comprehensive comparison of ICD benefits versus risks, consistent with interpretation bias. Ratios and statistically insignificant data were not used to emphasize ICD benefits. In conclusion, message framing, underreporting of ICD complications, and interpretation bias were used to emphasize ICD efficacy in the reporting of ICD primary prevention trials.
doi_str_mv 10.1016/j.amjcard.2011.02.320
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The objective of this study was to determine if such rhetorical strategies were used in the publication of implantable-cardioverter defibrillator (ICD) primary prevention trials. Medline and the Cochrane Central Register of Controlled Trials were searched for all publications that described ICD primary prevention trials and that involved &gt;100 subjects. Each publication was analyzed for evidence of message framing, the exclusive use of ratios to report outcomes, underreporting of ICD complications, and interpretation bias favoring ICD therapy. Ten publications were identified. Introductory remarks in 8 of the 10 publications cited the evaluation of ICD benefits as the sole objective and mentioned only background studies that supported ICD efficacy, suggesting message framing in support of ICD efficacy. Five publications provided no specific information about the frequency of unsuccessful ICD implantations, and 8 publications provided incomplete or no information about implantation and postimplantation complications. ICD complications were not mentioned in the discussion sections of 9 publications, and none of the publications included a comprehensive comparison of ICD benefits versus risks, consistent with interpretation bias. Ratios and statistically insignificant data were not used to emphasize ICD benefits. 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Vascular system</topic><topic>Cardiovascular</topic><topic>Clinical trials</topic><topic>Death, Sudden, Cardiac - prevention &amp; control</topic><topic>Defibrillators</topic><topic>Defibrillators, Implantable - adverse effects</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Primary Prevention</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. 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source MEDLINE; Elsevier ScienceDirect Journals
subjects Bias
Biological and medical sciences
Cardiology
Cardiology. Vascular system
Cardiovascular
Clinical trials
Death, Sudden, Cardiac - prevention & control
Defibrillators
Defibrillators, Implantable - adverse effects
Humans
Medical sciences
Primary Prevention
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Randomized Controlled Trials as Topic - standards
Rhetoric
Studies
Writing
title Rhetorical Strategies Used in the Reporting of Implantable Defibrillator Primary Prevention Trials
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