Rates of positive vs negative studies in the spine literature.

Background: Accuracy in the interpretation of data, and publication of studies regardless of outcomes are vital to the development of the scientific literature.

Objective: To determine the proportion of studies in the spine literature that report positive results.

Study Design: Review article of studies published in nine major spine, pain, and physical medicine and rehabilitation (PM&R) journals from January 1, 2018-December 31, 2022.

Patient Sample: Not applicable.

Methods: Articles that reported on pain and/or function from 2018 to 2022 in nine major journals were reviewed by two independent evaluators. The articles were graded as either positive or negative based on the authors' own conclusions about their work.

Results: Overall, 91 % [95 % CI 88-94 %] of all articles were reported to have positive results. No significant differences were found between the broad categories of spine, pain, and PM&R journals. When comparing different categories of treatments, there were lower rates of positive results from medication/supplement studies (54 % [95 % CI 27-81 %]) compared to studies of spine injections/interventions (95 % [95 % CI 91-99 %]) and those of surgery (100 % [95 % CI 96-100 %]), and a lower rate of positive results from studies on physical treatments (85 % [95 % CI 75-95 %]) compared to those of surgery (100 % [95 % CI 96-100 %]). Studies with placebo controls were less likely to report positive results (60 % [95 % CI 44-76 %]) compared to those that did not use placebo controls (96 % [95 % CI 94-98 %]).

Conclusions: Despite the vast majority of studies in the spine literature concluding positive results, the high disease prevalence of spine conditions and the enormous burden on the healthcare system remain.