Description
Objective: To quantify transparency gaps in orthodontic randomized controlled trials by linking trial registry records to publications and characterizing timing of registration, publication delay, and selective outcome reporting signals using automated text-based methods.
Methods: A retrospective computational audit was designed around trial registries (e.g., ClinicalTrials.gov and other major registries used in orthodontics) and bibliographic records. Registry entries marked completed were programmatically screened for publication linkage using identifier matching (e.g., registration IDs) and document-similarity approaches aligned with prior registry-publication linkage research. Trial-level transparency indicators included (i) prospective vs retrospective registration, (ii) completion to publication lag, (iii) presence/absence of posted results in the registry when available, and (iv) primary-outcome consistency between registry and publication (omission, downgrade, or introduction of new primary outcomes).
Results: In a large orthodontic registry cohort (registered up to January 2017), 266 orthodontic trials were identified, 80 were completed, 76% were registered retrospectively, and only 33 (41%) were published at the time of assessment; median completion-to-publication time was 20.1 months and 22 (28%) remained unpublished even after 5 years. In a complementary registry to publication discrepancy study up to April 2018, 124 completed orthodontic RCT registry entries were found and 53 linked to published final reports; outcome-reporting discrepancies were observed in 47% of publications, and only 16% of published orthodontic RCTs were registered. Recent evidence focusing on leading orthodontic journals (2018-2024) found that among 139 eligible RCTs with registry-publication pairs, 71.2% were retrospectively registered and selective outcome reporting was identified in 50.4%, most commonly via omission of a registered primary outcome (19.4%), downgrading of a registered primary outcome (18.0%), or introduction of a new primary outcome (16.5%). Additionally, an orthodontics-specific ClinicalTrials.gov evaluation reported that results posting in the registry was extremely rare at the time assessed (only one study had results posted).
Conclusion: A week-scale, no-imaging computational audit can yield publishable orthodontic transparency metrics by linking registries to publications and scoring outcome consistency. Across multiple independent orthodontic assessments, retrospective registration, delayed/non-publication, and frequent outcome discrepancies remain persistent, supporting the need for stronger prospective registration norms, registry-publication linkage enforcement, and editorial checks for outcome switching.
Disciplines
Orthodontics and Orthodontology
Keywords
Orthodontics, randomized controlled trials, trial registration, transparency, selective outcome reporting, registry-publication linkage, text mining One sentence summary: Automated linkage of orthodontic trial registries to publications reveals persistent transparency gaps high retrospective registration, substantial non-publication, and frequent primary-outcome inconsistencies using a fully computational pipeline.
Document Type
Poster
Recommended Citation
Osman, Stephen P.; licari, frank; patil, shankargouda; and bhandi, shilpa, "Orthodontic Trial Transparency Audit: Automated Registry to Publication Linkage and Outcome-Switching Signals in Registered RCTs" (2026). Annual Research Symposium. 12.
https://ecommons.roseman.edu/researchsymposium/2026/clinical/12
Included in
Orthodontic Trial Transparency Audit: Automated Registry to Publication Linkage and Outcome-Switching Signals in Registered RCTs
Objective: To quantify transparency gaps in orthodontic randomized controlled trials by linking trial registry records to publications and characterizing timing of registration, publication delay, and selective outcome reporting signals using automated text-based methods.
Methods: A retrospective computational audit was designed around trial registries (e.g., ClinicalTrials.gov and other major registries used in orthodontics) and bibliographic records. Registry entries marked completed were programmatically screened for publication linkage using identifier matching (e.g., registration IDs) and document-similarity approaches aligned with prior registry-publication linkage research. Trial-level transparency indicators included (i) prospective vs retrospective registration, (ii) completion to publication lag, (iii) presence/absence of posted results in the registry when available, and (iv) primary-outcome consistency between registry and publication (omission, downgrade, or introduction of new primary outcomes).
Results: In a large orthodontic registry cohort (registered up to January 2017), 266 orthodontic trials were identified, 80 were completed, 76% were registered retrospectively, and only 33 (41%) were published at the time of assessment; median completion-to-publication time was 20.1 months and 22 (28%) remained unpublished even after 5 years. In a complementary registry to publication discrepancy study up to April 2018, 124 completed orthodontic RCT registry entries were found and 53 linked to published final reports; outcome-reporting discrepancies were observed in 47% of publications, and only 16% of published orthodontic RCTs were registered. Recent evidence focusing on leading orthodontic journals (2018-2024) found that among 139 eligible RCTs with registry-publication pairs, 71.2% were retrospectively registered and selective outcome reporting was identified in 50.4%, most commonly via omission of a registered primary outcome (19.4%), downgrading of a registered primary outcome (18.0%), or introduction of a new primary outcome (16.5%). Additionally, an orthodontics-specific ClinicalTrials.gov evaluation reported that results posting in the registry was extremely rare at the time assessed (only one study had results posted).
Conclusion: A week-scale, no-imaging computational audit can yield publishable orthodontic transparency metrics by linking registries to publications and scoring outcome consistency. Across multiple independent orthodontic assessments, retrospective registration, delayed/non-publication, and frequent outcome discrepancies remain persistent, supporting the need for stronger prospective registration norms, registry-publication linkage enforcement, and editorial checks for outcome switching.