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Latent classes of trial reporting and publication practices in spinal manipulation research: a meta-epidemiological study
Journal article   Open access   Peer reviewed

Latent classes of trial reporting and publication practices in spinal manipulation research: a meta-epidemiological study

Casper Nim, Michelle Frederiksen, Sasha Aspinall, Aron Downie, Martha Funabashi, Steen Harsted, Hazel Jenkins, David McNaughton, Luana Nyirö, Eric J. Roseen, …
Musculoskeletal science & practice, Vol.81, 103480
2026
DOI: https://doi.org/10.1016/j.msksp.2025.103480
PMID: 41468809
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Published (Version of Record)CC BY V4.0,  Open Access

Abstract

Latent class analysis Research integrity Research waste Spinal manipulation
Background Reliable reporting and publication practices are essential for trustworthy evidence synthesis and clinical decision-making. Objective We aimed to identify latent classes of randomized controlled trials (RCTs) evaluating spinal manipulative therapy (SMT) based on trial reporting and publication practices, and to examine whether these classes influenced treatment effects. Design Meta-epidemiological study. Method Trials were evaluated on whether they met criteria for trial reporting and publication practices across six domains. Latent class analysis was used to identify trial subgroups. Random-effects meta-regression models assessed whether class membership predicted pooled estimates of treatment effects for pain and disability. Results We included 239 RCTs and identified four classes: Dated (23 %), older trials (mostly pre-2010) with consistently low proportions of criteria met; Non-contributing (30 %), newer trials that inconsistently met the criteria, had small samples, and short follow-ups; SMT-focused (15 %), which reported SMT details and fidelity more consistently but otherwise resembled the Non-contributing class; and Pragmatic (33 %), consisting of larger trials, meeting most criteria, but often underreported SMT-specific and fidelity details. Reporting practices had larger impact on class membership than publication practices. Despite differences class membership was not associated with treatment effect estimates and explained minimal outcome variability (R2 ∼1 %). Conclusions Although trial reporting and publication practices varied substantially across SMT trials, these differences were not associated with differences in treatment effects. The widespread failure to meet key criteria raises concerns about the interpretability and credibility of the SMT evidence base. To strengthen transparency and scientific value, future trials should adhere more rigorously to reporting guidelines.

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Domestic collaboration
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Citation topics
1 Clinical & Life Sciences
1.129 Back pain
1.129.98 Low Back Pain
Web Of Science research areas
Rehabilitation
ESI research areas
Clinical Medicine
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