Introduction: Selective outcome reporting (SOR) is a bias that can occur in randomized controlled trials (RCTs), defined as the alteration or omission of primary outcome in the publication compared to the original protocol. Researchers may modify outcomes to highlight statistically significant results. This study aimed to assess the prevalence of SOR in RCTs related to dental caries in children and adolescents. Methods: We conducted a search on ClinicalTrials.gov and the International Clinical Trials Registry Platform (ICTRP), using a comprehensive search strategy with terms related to pediatric dentistry and dental caries, up to February 2023. Two independent reviewers included trials with two or more arms focusing on dental caries in pediatric dentistry. Registrations that did not result in at least one published article were excluded. Data on the characteristics and outcomes from the protocols and corresponding publications were extracted. The primary outcome was the prevalence of SOR in the included RCTs. A chi-square test, with a significance level of 5%, was used to assess the association between SOR and pre-specified variables, which was the secondary outcome. Results: A total of 175 protocols and their corresponding publications were included. SOR was identified in 58.9% (n = 103) of the studies, with 41.1% (n = 72) showing discrepancies in the primary outcome’s time frame. Retrospective registrations accounted for 73.7% of the studies. SOR was significantly associated with discrepancies in the follow-up period (p < 0.001) and with study design type (parallel assignment, split-mouth, cluster RCT, and no information) (p = 0.048). Conclusions: The high prevalence of SOR in dental caries RCTs in pediatric dentistry highlights the need for attention to this issue. Ensuring transparency in the research process requires implementing an appropriate pre-registered protocol, disclosing deviations from it, and enabling stakeholders to compare the protocol with the published outcomes which can help reduce research waste.

1.
Gimenez
T
,
Bispo
BA
,
Souza
DP
,
Viganó
ME
,
Wanderley
MT
,
Mendes
FM
, et al
.
Does the decline in caries prevalence of Latin American and caribbean children continue in the new century? Evidence from systematic review with meta-analysis
.
PLoS One
.
2016
;
11
(
10
):
e0164903
.
2.
Wong
MCM
,
Clarkson
J
,
Glenny
AM
,
Lo
ECM
,
Marinho
VCC
,
Tsang
BWK
, et al
.
Cochrane reviews on the benefits/risks of fluoride toothpastes
.
J Dent Res
.
2011
;
90
(
5
):
573
9
.
3.
Frencken
JE
,
Innes
NP
,
Schwendicke
F
.
Managing carious lesions: why do we need consensus on terminology and clinical recommendations on carious tissue removal
.
Adv Dent Res
.
2016
;
28
(
2
):
46
8
.
4.
Kassebaum
NJ
,
Bernabé
E
,
Dahiya
M
,
Bhandari
B
,
Murray
CJ
,
Marcenes
W
.
Global burden of untreated caries: a systematic review and metaregression
.
J Dent Res
.
2015
;
94
(
5
):
650
8
.
5.
Qin
X
,
Zi
H
,
Zeng
X
.
Changes in the global burden of untreated dental caries from 1990 to 2019: a systematic analysis for the Global Burden of Disease study
.
Heliyon
.
2022
;
8
(
9
):
e10714
.
6.
Listl
S
,
Galloway
J
,
Mossey
PA
,
Marcenes
W
.
Global economic impact of dental diseases
.
J Dent Res
.
2015
;
94
(
10
):
1355
61
.
7.
Araujo
MP
,
Al-Yaseen
W
,
Innes
NP
.
A road map for designing and reporting clinical trials in paediatric dentistry
.
Int J Paediatr Dent
.
2020
;
31
(
Suppl 1
):
14
22
.
8.
Laine
C
,
Horton
R
,
DeAngelis
CD
,
Drazen
JM
,
Frizelle
FA
,
Godlee
F
, et al
.
Clinical trial registration: looking back and moving ahead
.
N Engl J Med
.
2007
;
356
(
26
):
2734
6
.
9.
Schulz
KF
,
Grimes
DA
.
Generation of allocation sequences in randomised trials: chance, not choice
.
Lancet
.
2002
;
359
(
9305
):
515
9
.
10.
Murad
MH
,
Asi
N
,
Alsawas
M
,
Alahdab
F
.
New evidence pyramid
.
Evid Based Med
.
2016
;
21
(
4
):
125
7
.
11.
Mhaskar
R
,
Djulbegovic
B
,
Magazin
A
,
Soares
HP
,
Kumar
A
.
Published methodological quality of randomized controlled trials does not reflect the actual quality assessed in protocols
.
J Clin Epidemiol
.
2012
;
65
(
6
):
602
9
.
12.
Raggio
DP
,
Gallegos
CL
,
Laux
CM
,
Elagami
RA
,
Raggio
DP
.
A importância dos estudos clínicos randomizados e seu impacto na tomada de decisão clínica
.
Rev Cient Cro-rj
.
2022
;
7
(
1
):
3
8
.
13.
Boutron
I
,
Dutton
S
,
Ravaud
P
,
Altman
DG
.
Reporting and interpretation of randomized controlled trials with statistically non significant results for primary outcomes
.
JAMA
.
2010
;
303
(
20
):
2058
64
.
14.
Butcher
NJ
,
Mew
EJ
,
Monsour
A
,
Chan
AW
,
Moher
D
,
Offringa
M
.
Outcome reporting recommendations for clinical trial protocols and reports: a scoping review
.
Trials
.
2020
;
21
(
1
):
620
.
15.
World Medical Association
.
World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects
.
JAMA
.
2013
;
310
(
20
):
2191
4
.
16.
Tetzlaff
JM
,
Chan
AW
,
Kitchen
J
,
Sampson
M
,
Tricco
AC
,
Moher
D
.
Guidelines for randomized clinical trial protocol content: a systematic review
.
Syst Rev
.
2012
;
1
:
43
.
17.
De Angelis
C
,
Drazen
JM
,
Frizelle
FA
,
Haug
C
,
Hoey
J
,
Horton
R
, et al,
International Committee of Medical Journal Editors
.
Clinical trial registration: a statement from the international committee of medical journal editors
.
N Engl J Med
.
2004
;
351
(
12
):
1250
1
.
18.
Calvert
M
,
Blazeby
J
,
Altman
DG
,
Revicki
DA
,
Moher
D
,
Brundage
MD
, et al
.
Reporting of patient-reported outcomes in randomized trials: the CONSORT PRO extension
.
JAMA
.
2013
;
309
(
8
):
814
22
.
19.
De Los Reyes
A
,
Kundey
SM
,
Wang
M
.
The end of the primary outcome measure: a research agenda for constructing its replacement
.
Clin Psychol Rev
.
2011
;
31
(
5
):
829
38
.
20.
Andrade
C
.
The primary outcome measure and its importance in clinical trials
.
J Clin Psychiatry
.
2015
;
76
(
10
):
e1320
3
.
21.
Mayo-Wilson
E
,
Li
T
,
Fusco
N
,
Bertizzolo
L
,
Canner
JK
,
Cowley
T
, et al
.
Cherry-picking by trialists and meta-analysts can drive conclusions about intervention efficacy
.
J Clin Epidemiol
.
2017
;
91
:
95
110
.
22.
Yoneoka
D
,
Rieck
B
.
A note on cherry-picking in meta-analyses
.
Entropy
.
2023
;
25
(
4
):
691
.
23.
Saquib
N
,
Saquib
J
,
Ioannidis
JP
.
Practices and impact of primary outcome adjustment in randomized controlled trials: meta-epidemiologic study
.
BMJ
.
2013
;
347
:
f4313
.
24.
Dwan
K
,
Altman
DG
,
Arnaiz
JA
,
Bloom
J
,
Chan
AW
,
Cronin
E
, et al
.
Systematic review of the empirical evidence of study publication bias and outcome reporting bias
.
PLoS One
.
2008
;
3
(
8
):
e3081
.
25.
Chan
AW
,
Tetzlaff
JM
,
Altman
DG
,
Laupacis
A
,
Gøtzsche
PC
,
Krleža-Jerić
K
, et al
.
SPIRIT 2013 statement: defining standard protocol items for clinical trials
.
Ann Intern Med
.
2013
;
158
(
3
):
200
7
.
26.
Moher
D
,
Hopewell
S
,
Schulz
KF
,
Montori
V
,
Gøtzsche
PC
,
Devereaux
PJ
, et al
.
CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials
.
BMJ
.
2010
;
340
:
c869
.
27.
Schulz
KF
,
Altman
DG
,
Moher
D
,
CONSORT Group
.
CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials
.
BMJ
.
2010
;
340
:
c332
.
28.
Butcher
NJ
,
Monsour
A
,
Mew
EJ
,
Chan
AW
,
Moher
D
,
Mayo-Wilson
E
, et al
.
Guidelines for reporting outcomes in trial reports: the CONSORT-outcomes 2022 extension
.
JAMA
.
2022
;
328
(
22
):
2252
64
.
29.
Turner
L
,
Shamseer
L
,
Altman
DG
,
Weeks
L
,
Peters
J
,
Kober
T
, et al
.
Consolidated standards of reporting trials (CONSORT) and the completeness of reporting of randomised controlled trials (RCTs) published in medical journals
.
Cochrane Database Syst Rev
.
2012
;
11
(
11
):
MR000030
.
30.
Jiang
CM
,
Lee
GHM
,
Lo
ECM
,
Chu
CH
,
Wong
MCM
.
Randomized CONTROLLED trials IN dental journals ON children and adolescents: a bibliometric analysis
.
J Evid Based Dent Pract
.
2021
;
21
(
4
):
101621
.
31.
Lancee
M
,
Schuring
M
,
Tijdink
JK
,
Chan
AW
,
Vinkers
CH
,
Luykx
JJ
.
Selective outcome reporting across psychopharmacotherapy randomized controlled trials
.
Int J Methods Psychiatr Res
.
2022
;
31
(
1
):
e1900
.
32.
Sendyk
DI
,
Rovai
ES
,
Souza
NV
,
Deboni
MCZ
,
Pannuti
CM
.
Selective outcome reporting in randomized clinical trials of dental implants
.
J Clin Periodontol
.
2019
;
46
(
7
):
758
65
.
33.
Elagami
RA
,
Tedesco
TK
,
Pannuti
CM
,
da Silva
GS
,
Braga
MM
,
Mendes
FM
, et al
.
Selective outcome reporting in paediatric dentistry restorative treatment randomised clinical trials-A meta-research
.
Int J Paediatr Dent
.
2023
;
33
(
1
):
89
98
.
34.
McHugh
ML
.
Interrater reliability: the kappa statistic
.
Biochem Med
.
2012
;
22
(
3
):
276
82
.
35.
Chan
AW
,
Hróbjartsson
A
,
Haahr
MT
,
Gøtzsche
PC
,
Altman
DG
.
Empirical evidence for selective reporting of outcomes in randomized trials: comparison of protocols to published articles
.
JAMA
.
2004
;
291
(
20
):
2457
65
.
36.
Souza
NV
,
Nicolini
AC
,
Dos Reis
INR
,
Sendyk
DI
,
Cavagni
J
,
Pannuti
CM
.
Selective outcome reporting bias is highly prevalent in randomized clinical trials of nonsurgical periodontal therapy
.
J Periodontal Res
.
2023
;
58
(
1
):
1
11
.
37.
Hannink
G
,
Gooszen
HG
,
Rovers
MM
.
Comparison of registered and published primary outcomes in randomized clinical trials of surgical interventions
.
Ann Surg
.
2013
;
257
(
5
):
818
23
.
38.
Krsticevic
M
,
Saric
D
,
Saric
F
,
Slapnicar
E
,
Boric
K
,
Dosenovic
S
, et al
.
Selective reporting bias due to discrepancies between registered and published outcomes in osteoarthritis trials
.
J Comp Eff Res
.
2019
;
8
(
15
):
1265
73
.
39.
Dwan
K
,
Altman
DG
,
Arnaiz
JA
,
Bloom
J
,
Chan
AW
,
Cronin
E
, et al
.
Systematic review of the empirical evidence of study publication bias and outcome reporting bias
.
PLoS One
.
2008
;
3
(
8
):
e3081
.
40.
Tham
WY
.
Science, interrupted: funding delays reduce research activity but having more grants helps
.
PLoS One
.
2023
;
18
(
4
):
e0280576
.
41.
McDonald
K
,
Seltzer
E
,
Lu
M
,
Gaisenband
SD
,
Fletcher
C
,
McLeroth
P
, et al
.
Quantifying the impact of the COVID-19 pandemic on clinical trial screening rates over time in 37 countries
.
Trials
.
2023
;
24
(
1
):
254
.
42.
Pozos-Guillén
A
,
Chavarría-Bolaños
D
,
Garrocho-Rangel
A
.
Split-mouth design in Paediatric Dentistry clinical trials
.
Eur J Paediatr Dent
.
2017
;
18
(
1
):
61
5
.
43.
Jones
CW
,
Platts-Mills
TF
.
Quality of registration for clinical tri-als published in emergency medicine journals
.
Ann Emerg Med
.
2012
;
60
(
4
):
458
64.e1
.
44.
Zarin
DA
,
Keselman
A
.
Registering a clinical trial in ClinicalTrial.gov
.
Chest
.
2007
;
131
(
3
):
909
91
.
45.
Pannuti
CM
,
Sendyk
DI
,
Graças
YT
,
Takai
SL
,
Sabóia
VPA
,
Romito
GA
, et al
.
Clinically relevant out-comes in dental clinical trials: challenges and proposals
.
Braz Oral Res
.
2020
;
34
(
Suppl 2
):
1
10
.
46.
Munafò
MR
,
Nosek
BA
,
Bishop
DVM
,
Button
KS
,
Chambers
CD
,
du Sert
NP
, et al
.
A manifesto for reproducible science
.
Nat Hum Behav
.
2017
;
1
:
0021
.
47.
Koufatzidou
M
,
Koletsi
D
,
Fleming
PS
,
Polychronopoulou
A
,
Pandis
N
.
Outcome reporting discrepancies between trial entries and published final reports of orthodontic randomized controlled trials
.
Eur J Orthod
.
2019
;
41
(
3
):
225
30
.
48.
Rodríguez Del Águila
M
,
González-Ramírez
A
.
Sample size calculation
.
Allergol Immunopathol
.
2014
;
42
(
5
):
485
92
.
49.
Noordzij
M
,
Dekker
FW
,
Zoccali
C
,
Jager
KJ
.
Sample size calculations
.
Nephron Clin Pract
.
2011
;
118
(
4
):
c319
23
.
50.
Kirkham
JJ
,
Dwan
KM
,
Altman
DG
,
Gamble
C
,
Dodd
S
,
Smyth
R
, et al
.
The impact of outcome reporting bias in randomised controlled trials on a cohort of systematic reviews
.
BMJ
.
2010
;
340
:
c365
.
51.
Clark
GT
,
Mulligan
R
.
Fifteen common mistakes encountered in clinical research
.
J Prosthodont Res
.
2011
;
55
(
1
):
1
6
.
52.
Dickersin
K
,
Chan
S
,
Chalmers
TC
,
Sacks
HS
,
Smith
H
Jr
.
Publication bias and clinical trials
.
Control Clin Trials
.
1987
;
8
(
4
):
343
53
.
53.
Hartling
L
,
Craig
WR
,
Russell
K
,
Stevens
K
,
Klassen
TP
.
Factors influencing the publication of randomized controlled trials in child health research
.
Arch Pediatr Adolesc Med
.
2004
;
158
(
10
):
983
7
.
54.
Mavrogenis
AF
,
Quaile
A
,
Scarlat
MM
.
The good, the bad and the rude peer-review
.
Int Orthop
.
2020
;
44
(
3
):
413
5
.
You do not currently have access to this content.