medical journal editors

Abstract: Spin in clinical trials includes reporting practices that distort the presentation of results. This is particularly critical in medicine, where spin is present in more than 50% of randomized controlled trials that fail to reach statistical significance. The comparison of primary and reported outcomes is crucial for detecting several types of spin, including outcome switching. We used 300 pairs of outcomes labeled with semantic similarity to develop a system for automatic detection of outcome switching. We evaluated baseline text similarity models and open-source LLMs using generated similarity scores and the Youden index to determine the classification threshold. The proposed approach involves prompt engineering, classification based on token probabilities, and majority voting for the final decision. The results on the test set of 2,496 examples with an F1 score of 0.78 and an accuracy of 0.90 outperform baseline text similarity models but trail behind fine-tuned versions of BERT. We used LLMs to generate natural language explanations for the classified instances and manually assessed their quality.

Abstract: Scientific search systems can find papers that are relevant to a question, but they generally do not assess the quality of the evidence that those papers provide. We present Kurate, a system that uses large language models (LLMs) to assess the quality of published studies. Kurate uses both the paper and its related documents (e.g., the study's trial registration and protocol), and links each of its judgments to the passage of text on which that judgment is based. We applied Kurate to a corpus of 4,347 papers (3,913 of which report randomized trials) and scored each paper on 8 dimensions of study design and reporting: specifically, statistical power, causal identification, preregistration, selective reporting, measurement validity, analysis prespecification, reporting transparency, and conflict of interest and funding. Across the corpus, we found that papers most often exhibited issues with statistical power, selective reporting, and analysis prespecification, although average quality differed between clinical areas. When compared against expert annotations of 60 held-out clinical-trial documents, the information Kurate extracted matched the expert label in 221/242 protocol scorepoints and 294/370 results-publication scorepoints, with AC1 0.94 and 0.81, respectively. Using a well-reputed, high quality clinical trial as a worked example, we show how a single paper's overall grade breaks down into separate judgments, with each linked to specific evidence from the trial's registration, protocol, and published report. Together, these results show that large-scale quality assessment of this kind is feasible, and that it can be used to address meta-scientific research questions.