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You Spin Me Right Round, Baby Right-Round

Posted on January 29, 2026 by
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Yep this is a lyric from some song that Sid no doubt used to listen/bop to when they were a kid. However, spin is sadly something that happens with trial papers

Mascareñas-García M, Rivero-de-Aguilar A, Candal-Pedreira C, García G, Guerra-Tort C, Martín-Gisbert L, Rey-Brandariz J, Ríos MP, Casal-Acción B, Santiago-Pérez MI, Varela-Lema L. Distortion in the Communication of Nonsignificant Primary Outcomes: The Spin Strategy in Multiple Sclerosis Trials. Ann Neurol. 2026 Jan 26. doi: 10.1002/ana.78125.

Objective: Spin refers to reporting strategies that highlight the benefits of an experimental treatment or divert attention from nonsignificant primary outcomes. To assess spin in randomized clinic trials (RCTs) on pharmaceutical efficacy in multiple sclerosis (MS) and explore associated factors.

Methods: A systematic literature search was conducted in MedLine (PubMed), EMBASE, and Cochrane using database-specific thesauri (“Multiple Sclerosis” and “Drug Therapy”) to identify relevant studies. We included multiple sclerosis phase 3 and 4 randomized controlled trials with parallel, superiority designs that were published between 2013 and 2024 reporting nonsignificant primary outcomes. Spin was assessed in title, abstract conclusion, results, discussion, and conclusions. ….. Independent variables included trial phase, sample size, drug type, comparison, follow-up time, registration, Consolidated Standards of Reporting Trials (CONSORT) mention, risk of bias (RoB2), journal quartile, first author affiliation, and conflict of interest.

Results: Forty articles met inclusion criteria. Spin appeared in at least one section in 25 articles (62.5%) and in 3 or more in 19 articles (47.5%). The most frequent locations were abstract conclusions, discussion, and conclusions. Spin was significantly associated with smaller sample size (odds ratio [OR] = 7.00, 95% confidence interval [CI] = 1.29-37.91, p = 0.024), non-Q1 journals (OR = 4.38, 95% CI = 1.03-18.63, p = 0.046), and first author affiliation outside Europe or the United States (OR = 5.09, 95% CI = 1.15-22.62, p = 0.032).

Interpretation: Spin is common in MS randomized controlled trials with nonsignificant primary outcomes and may mislead clinical decisions. 

Surely not because if the trial is non-significant the drug will never make it to market, as it surely would not get past the regulators….Would it get past the reviewers of journals….absolutely. I am sorry to say I am not convinced the articles in Q1 journals or European or United States authours do not employ spin in publications…Some are perhaps the “Sultans of Spin” Indeed it was about 50:50 in those regions Spin v Non Spin and notably in trials that were publicly funded there spin factor was about 6 times more. People look for the positive aspects as negative data seldom gets published…the sink or swin culture is all around science. However remember don’t believe everything you read.

Spin was evaluated in the following sections: Title, Abstract (conclusion), Results, Discussion, and Conclusions/Last paragraph. The following strategies of spin were considered:

  • Type (A) focusing on statistically significant results other than the nonsignificant primary outcome (such as within-group comparison, secondary outcomes, subgroup populations, or in the case of multiple primary outcomes, focusing only on the one being statistically significant). Articles were classified under this type of spin if they reported a positive result of the trial based on secondary analyses while overlooking, downplaying, or understating the negative result of the primary outcome. In cases of multiple outcomes, we also checked whether the multiplicity effect was considered in the analysis;
  • Type (B) interpreting nonsignificant results as treatment equivalence or noninferiority, even though the study was not being designed to assess equivalence or noninferiority;
  • Type (C) claiming benefits of the trial despite statistically nonsignificant results on the primary outcomes;
  • Type (D) other (strategies that could not be classified in any of the other categories).

Source: multiple-sclerosis-research.org

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