Investigating the trustworthiness of randomized controlled trials in osteopathic research: a systematic review with meta-analysis

Sénéquier, A; Draper-Rodi, J; Alvarez Bustins, G; Braithwaite, FA; Brown, J; Corcoran, D; Forrest, L; Godsi, E; MacMillan, A; Menard, M; Carvajal, SR; Scocca, C; Treffel, L; Vaucher, P; Wagner, A; Soliman, N; Abbey, H

Investigating the trustworthiness of randomized controlled trials in osteopathic research: a systematic review with meta-analysis

Sénéquier, A Draper-Rodi, J Alvarez Bustins, G Braithwaite, FA Brown, J Corcoran, D Forrest, L Godsi, E MacMillan, A Menard, M Carvajal, SR Scocca, C Treffel, L Vaucher, P Wagner, A Soliman, N Abbey, H

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Publisher:: Elsevier
Publication Type:: Journal Article
Citation:: Journal of Clinical Epidemiology, 2025, 183, pp. 111788
Issue Date:: 2025-07

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Field	Value	Language
dc.contributor.author	Sénéquier, A
dc.contributor.author	Draper-Rodi, J
dc.contributor.author	Alvarez Bustins, G
dc.contributor.author	Braithwaite, FA
dc.contributor.author	Brown, J
dc.contributor.author	Corcoran, D
dc.contributor.author	Forrest, L
dc.contributor.author	Godsi, E
dc.contributor.author	MacMillan, A
dc.contributor.author	Menard, M
dc.contributor.author	Carvajal, SR
dc.contributor.author	Scocca, C
dc.contributor.author	Treffel, L
dc.contributor.author	Vaucher, P
dc.contributor.author	Wagner, A
dc.contributor.author	Soliman, N
dc.contributor.author	Abbey, H
dc.date.accessioned	2026-05-14T02:02:35Z
dc.date.available	2025-04-10
dc.date.available	2026-05-14T02:02:35Z
dc.date.issued	2025-07
dc.identifier.citation	Journal of Clinical Epidemiology, 2025, 183, pp. 111788
dc.identifier.issn	0895-4356
dc.identifier.issn	1878-5921
dc.identifier.uri	http://hdl.handle.net/10453/194972
dc.description.abstract	OBJECTIVES To systematically investigate trustworthiness (methodological rigor, transparency, good governance, research integrity, and absence of misconduct) in randomized 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 (RoB) 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 synthesized descriptively. RESULTS Sixty-one RCTs were included (median sample size 45, interquartile range (IQR) 30-76), largely studying healthy volunteers (29 ). Most had high RoB (74 ), and only 7 acknowledged potential conflicts from authors professional ties. No journals appeared on cautionary lists, although 23 of articles were published within 2 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 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. PLAIN LANGUAGE SUMMARY Clinical trials are studies that test if medical treatments work. Doctors a
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier
dc.relation.ispartof	Journal of Clinical Epidemiology
dc.relation.isbasedon	10.1016/j.jclinepi.2025.111788
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	01 Mathematical Sciences, 11 Medical and Health Sciences
dc.subject.classification	Epidemiology
dc.subject.classification	4202 Epidemiology
dc.subject.mesh	Humans
dc.subject.mesh	Randomized Controlled Trials as Topic
dc.subject.mesh	Trust
dc.subject.mesh	Manipulation, Osteopathic
dc.subject.mesh	Osteopathic Medicine
dc.subject.mesh	Research Design
dc.subject.mesh	Humans
dc.subject.mesh	Manipulation, Osteopathic
dc.subject.mesh	Trust
dc.subject.mesh	Osteopathic Medicine
dc.subject.mesh	Research Design
dc.subject.mesh	Randomized Controlled Trials as Topic
dc.subject.mesh	Humans
dc.subject.mesh	Randomized Controlled Trials as Topic
dc.subject.mesh	Trust
dc.subject.mesh	Manipulation, Osteopathic
dc.subject.mesh	Osteopathic Medicine
dc.subject.mesh	Research Design
dc.title	Investigating the trustworthiness of randomized controlled trials in osteopathic research: a systematic review with meta-analysis
dc.type	Journal Article
utslib.citation.volume	183
utslib.location.activity	United States
utslib.for	01 Mathematical Sciences
utslib.for	11 Medical and Health Sciences
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
utslib.copyright.status	open_access	*
pubs.consider-herdc	true
dc.rights.license	This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/
dc.date.updated	2026-05-14T02:02:33Z
pubs.publication-status	Published
pubs.volume	183

Abstract:

OBJECTIVES To systematically investigate trustworthiness (methodological rigor, transparency, good governance, research integrity, and absence of misconduct) in randomized 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 (RoB) 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 synthesized descriptively. RESULTS Sixty-one RCTs were included (median sample size 45, interquartile range (IQR) 30-76), largely studying healthy volunteers (29 ). Most had high RoB (74 ), and only 7 acknowledged potential conflicts from authors professional ties. No journals appeared on cautionary lists, although 23 of articles were published within 2 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 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. PLAIN LANGUAGE SUMMARY Clinical trials are studies that test if medical treatments work. Doctors a

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