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; James J Young; Liz Dennett; Stephen M Perle; Chad Cook; Carsten Juhl; Jan Hartvigsen

doi:10.1016/j.msksp.2025.103480

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, James J Young, Liz Dennett, Stephen M Perle, Chad Cook, Carsten Juhl, Jan Hartvigsen

^*Corresponding author af dette arbejde

Afdeling for Fysio- og Ergoterapi HGH

Abstract

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.

Originalsprog	Engelsk
Artikelnummer	103480
Tidsskrift	Musculoskeletal science & practice
Vol/bind	81
Sider (fra-til)	103480
ISSN	2468-7812
DOI	https://doi.org/10.1016/j.msksp.2025.103480
Status	Udgivet - feb. 2026

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10.1016/j.msksp.2025.103480Licens: CC BY

Citationsformater

Nim, C., Frederiksen, M., Aspinall, S., Downie, A., Funabashi, M., Harsted, S., Jenkins, H., McNaughton, D., Nyirö, L., Roseen, E. J., Young, J. J., Dennett, L., Perle, S. M., Cook, C., Juhl, C., & Hartvigsen, J. (2026). Latent classes of trial reporting and publication practices in spinal manipulation research: a meta-epidemiological study. Musculoskeletal science & practice, 81, 103480. Artikel 103480. https://doi.org/10.1016/j.msksp.2025.103480

Nim, C, Frederiksen, M, Aspinall, S, Downie, A, Funabashi, M, Harsted, S, Jenkins, H, McNaughton, D, Nyirö, L, Roseen, EJ, Young, JJ, Dennett, L, Perle, SM, Cook, C, Juhl, C & Hartvigsen, J 2026, 'Latent classes of trial reporting and publication practices in spinal manipulation research: a meta-epidemiological study', Musculoskeletal science & practice, bind 81, 103480, s. 103480. https://doi.org/10.1016/j.msksp.2025.103480

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

abstract = "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.",

keywords = "Humans, Manipulation, Spinal/methods, Randomized Controlled Trials as Topic, Research Design/standards, Epidemiologic Studies, Male",

author = "Casper Nim and Michelle Frederiksen and Sasha Aspinall and Aron Downie and Martha Funabashi and Steen Harsted and Hazel Jenkins and David McNaughton and Luana Nyir{\"o} and Roseen, {Eric J} and Young, {James J} and Liz Dennett and Perle, {Stephen M} and Chad Cook and Carsten Juhl and Jan Hartvigsen",

year = "2026",

month = feb,

doi = "10.1016/j.msksp.2025.103480",

language = "English",

volume = "81",

pages = "103480",

journal = "Musculoskeletal science & practice",

issn = "2468-7812",

publisher = "Elsevier Inc",

}

TY - JOUR

T1 - Latent classes of trial reporting and publication practices in spinal manipulation research

T2 - a meta-epidemiological study

AU - Nim, Casper

AU - Frederiksen, Michelle

AU - Aspinall, Sasha

AU - Downie, Aron

AU - Funabashi, Martha

AU - Harsted, Steen

AU - Jenkins, Hazel

AU - McNaughton, David

AU - Nyirö, Luana

AU - Roseen, Eric J

AU - Young, James J

AU - Dennett, Liz

AU - Perle, Stephen M

AU - Cook, Chad

AU - Juhl, Carsten

AU - Hartvigsen, Jan

PY - 2026/2

Y1 - 2026/2

N2 - 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.

AB - 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.

KW - Humans

KW - Manipulation, Spinal/methods

KW - Randomized Controlled Trials as Topic

KW - Research Design/standards

KW - Epidemiologic Studies

KW - Male

U2 - 10.1016/j.msksp.2025.103480

DO - 10.1016/j.msksp.2025.103480

M3 - Review

C2 - 41468809

SN - 2468-7812

VL - 81

SP - 103480

JO - Musculoskeletal science & practice

JF - Musculoskeletal science & practice

M1 - 103480

ER -

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

Abstract

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