Clinical Trial Registry Use in Orthopaedic Surgery Systematic Reviews

Research output: Contribution to conferencePosterpeer-review


Arjun K. Reddy, BA; Medical Student; J. Michael Anderson, B.S., Harrison Gray, B.S., Keith Fishbeck, D.O., Matt Vassar, Ph.D

Background: Results from systematic reviews and meta-analyses—the highest level of evidence—often drive clinical decision-making and health policy. Often, unpublished trial data are omitted from systematic reviews, raising concerns about the extent of reliability and validity of results drawn from systematic reviews. We aimed to determine the extent to which systematic review authors include searches of clinical trial registries for unpublished data when conducting systematic reviews in orthopaedic surgery.

Methods: Systematic reviews were gathered from the top 5 orthopaedic surgery journals based on the h5-index from Google Scholar Metrics. Systematic reviews published in the Cochrane Database of Systematic Reviews, which requires inclusion of a clinical trial registry search, served as controls. For the primary outcome, each systematic review from the top 5 orthopaedic journals was screened to determine whether the authors for each study searched for unpublished data in clinical trial registries. We then compared the rate of registry searches with the control. For the secondary analysis, a search of was performed for unpublished trial data for 100 randomized systematic reviews.

Results: All Cochrane systematic reviews (100%, 38/38) included clinical trial registry searches, while the top 5 orthopaedic journals had 31 studies that looked at clinical trial registries (6.5%, 31/480). The secondary analysis yielded 59 systematic review articles that could have included unpublished clinical trial data from one or more studies to their sample (59.0%, 59/100).

Conclusion: Systematic reviews published in the top orthopaedic surgery journals seldomly included a search for unpublished clinical trial data. The exclusion of clinical trial registry searches potentially contributes to publication bias within the orthopaedic literature. Moving forward, review authors should include clinical trial registry searches for unpublished clinical trial data to provide the most accurate representation of the available evidence for systematic reviews and meta-analyses.
Original languageAmerican English
StatePublished - 22 Feb 2021
EventOklahoma State University Center for Health Sciences Research Days 2021: Poster presentation - Oklahoma State University Center for Health Sciences Campus, Tulsa, United States
Duration: 22 Feb 202126 Feb 2021


ConferenceOklahoma State University Center for Health Sciences Research Days 2021
Country/TerritoryUnited States


  • Grey Literature
  • Systematic Reviews
  • General Orthopaedics
  • Trial Registry Use
  • Cochrane Collaboration


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