Background: A systematic review is an important evidence synthesis technique used to collate results from individual studies, such as treatments for proximal humerus fractures. Therefore it is necessary to minimize bias in systematic reviews, including financial COIs. Financial bias has been shown to result in unreliable assessments of credibility, which is why transparency with COI is essential for accurate assessments of research. Objective: The aim of this study was to characterize the influence of financial bias on the results and conclusions of systematic reviews of proximal humerus fracture treatments and to characterize the nature of disclosed and undisclosed COIs. Methods: Ovid MEDLINE and Ovid Embase databases were searched to locate systematic reviews covering proximal humerus fracture treatments. Following these searches, title and abstract screening was performed in a duplicate, masked fashion. Data from the final reviews were extracted in a triplicate manner. The data included: PubMed ID and/or DOI; journal; publication date; author names; affiliations; interventions; funding source; risk of bias assessment/statement; whether systematic review author(s) on any of the primary studies; the articles primary outcome; whether an overall pooled effect estimate was calculated; pooled effect estimate; type of pooled effect estimate/significance; the primary outcomes favorability of pooled effect estimate; and favorability of narrative results/conclusions. All authors of each systematic review were screened for non-disclosed COIs. Results: We found no relationship between authorial COI and the results and conclusions of the systematic reviews. Among the 17 included systematic reviews, 7 (41.2%) had at least one non-disclosed COI. Of the 7 reviews with a non-disclosed COI, 2 (28.6%) were found to have a high risk of bias. Conclusions: Findings from this study have limited generalizability due to our small sample size. More studies are needed to fully elucidate the effect of financial bias on the results and conclusions of systematic reviews.

Background: Publication bias (PB) can cause an exaggerated estimate of summary effects in systematic reviews (SR). The extent of PB assessment by SRs within oncology journals remains to be determined. Methods: This study looked at SRs from high impact factor oncology journals between 2007 and 2015 using a PubMed search. Articles were sorted and coded for PB. An additional assessment of BP from unevaluated SRs was performed using Egger’s regression and the trim-and-fill method. Findings: Of 182 included SRs, 52 preformed a PB assessment. The most common form of assessment was a funnel plot supplemented by Egger’s regression or Begg’s test (44%, 23/52). PB was a routine finding in these SRs (19%, 10/52). SRs that stated following a reporting guideline frequently failed to do so with regards to assessing PB. The magnitude of effect sizes generally decreased when conducting our independent assessments of PB among SRs in our sample that did not evaluate for it. Interpretation: Our study shows that there exists an underutilization of PB assessments by SRs in clinical oncology. Additionally the methodological validity of SRs can be increased by adhering to reporting guidelines, and through the search of grey literature and clinical trials registries. Funding: No external source of funding

Abstract Purpose: The purpose of this study was to evaluate the quality of reporting in the abstracts of oncology systematic reviews using PRISMA guidelines for abstract writing. Methods: Oncology systematic reviews and meta-analyses from four journals - The Lancet Oncology, Clinical Cancer Research, Cancer Research, and Journal of Clinical Oncology - were selected using a PubMed search. The resulting 337 abstracts were sorted for eligibility and 182 were coded based on a standardized abstraction manual constructed from the PRISMA criteria. Eligible systematic reviews were coded independently and later verified by a second coder, with disagreements handled by consensus. One hundred eighty-two abstracts comprised the final sample. Results: The number of included studies, information regarding main outcomes, and general interpretation of results were described in the majority of abstracts. In contrast, risk of bias or methodological quality appraisals, the strengths and limitations of evidence, funding sources, and registration information were rarely reported. By journal, the most notable difference was a higher percentage of funding sources reported in Lancet Oncology. No detectable upward trend was observed on mean abstract scores after publication of the PRISMA extension for abstracts. Conclusion: Overall, the reporting of essential information in oncology systematic review and meta-analysis abstracts is suboptimal and could be greatly improved. Keywords: Review, Systematic; Meta-Analysis; Cancer; Medical Oncology; Abstracting as Topic; Funding

ABSTRACT Objectives: We evaluated the use of clinical trials registries in published obstetrics and gynecological systematic reviews and meta-analyses. Methods: A review of publications between January 1, 2007, and December 31, 2015, from six obstetrical and gynecological journals (_Obstetrics & Gynecology, Obstetrical & Gynecological Survey, Human Reproduction Update, Gynecologic Oncology, British Journal of Obstetrics and Gynaecology, and American Journal of Obstetrics & Gynecology_) was completed to identify eligible systematic reviews. All systematic reviews included after exclusions were independently reviewed to determine if clinical trials registries had been included as part of the search process. Studies that reported using a trials registry were further examined to determine whether trial data was included in the analysis. Results: Our initial search resulted in 292 articles, which was narrowed to 256 after exclusions. Of the 256 systematic reviews meeting our selection criteria, 47 utilized a clinical trials registry. Eleven of the 47 systematic reviews found unpublished data, and added the unpublished trial data into their results. Conclusion: A majority of systematic reviews in clinical obstetrics and gynecology journals do not conduct searches of clinical trials registries or do not make use of data obtained from these searches.