eprintid: 10147091 rev_number: 10 eprint_status: archive userid: 699 dir: disk0/10/14/70/91 datestamp: 2022-04-21 15:43:17 lastmod: 2023-04-17 10:12:42 status_changed: 2022-04-21 15:43:17 type: article metadata_visibility: show sword_depositor: 699 creators_name: Williams, Norman R creators_name: Patrick, Hannah creators_name: Fiorentino, Francesca creators_name: Allen, Alexander creators_name: Sharma, Manuj creators_name: Milošević, Mišel creators_name: Macbeth, Fergus creators_name: Treasure, Tom title: Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC) randomised controlled trial: a systematic review of published responses ispublished: pub divisions: C10 divisions: G88 divisions: B02 divisions: UCL divisions: D16 divisions: C06 divisions: ZZ4 divisions: B04 divisions: F59 keywords: Pulmonary metastasectomy, citation index, colorectal cancer, motivated reasoning, randomised controlled trial note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: OBJECTIVES: The objective of this review was to assess the nature and tone of the published responses to the Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC) randomized controlled trial. METHODS: Published articles that cited the PulMiCC trial were identified from Clarivate Web of Science (©. Duplicates and self-citations were excluded and relevant text extracted. Four independent researchers rated the extracts independently using agreed scales for the representativeness of trial data and the textual tone. The ratings were aggregated and summarized. Two PulMiCC authors carried out a thematic analysis of the extracts. RESULTS: Sixty-four citations were identified and relevant text was extracted and examined. The consensus rating for data inclusion was a median of 0.25 out of 6 (range 0 to 5.25, IQR 0-1.5) and for textual tone the median rating was 1.87 out of 6 (range 0 to 5.75, IQR 1-3.5). The majority of citations did not provide adequate representation of the PulMiCC data and the overall the textual tone was dismissive. Although some were supportive, many discounted the findings because the trial closed early and was underpowered to show non-inferiority. Two misinterpreted the authors' conclusions but there was acceptance that five-year survival was much higher than widely assumed. CONCLUSIONS: Published comments reveal a widespread reluctance to consider seriously the results of a carefully conducted randomized trial. This may be because the results challenge accepted practice because of 'motivated reasoning'. But there is a widespread misunderstanding of the fact that though PulMiCC with 93 patients was underpowered to test non-inferiority, it still provides reliable evidence to undermine the widespread belief in a major survival benefit from metastasectomy. date: 2022-07 date_type: published publisher: Oxford University Press (OUP) official_url: https://doi.org/10.1093/ejcts/ezac253 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1949233 doi: 10.1093/ejcts/ezac253 medium: Print-Electronic pii: 6567629 lyricists_name: Williams, Norman lyricists_name: Treasure, Tom lyricists_id: NWILL06 lyricists_id: TTREA26 actors_name: Flynn, Bernadette actors_id: BFFLY94 actors_role: owner full_text_status: public publication: European Journal of Cardio-Thoracic Surgery volume: 62 number: 1 article_number: ezac253 event_location: Germany citation: Williams, Norman R; Patrick, Hannah; Fiorentino, Francesca; Allen, Alexander; Sharma, Manuj; Milošević, Mišel; Macbeth, Fergus; Williams, Norman R; Patrick, Hannah; Fiorentino, Francesca; Allen, Alexander; Sharma, Manuj; Milošević, Mišel; Macbeth, Fergus; Treasure, Tom; - view fewer <#> (2022) Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC) randomised controlled trial: a systematic review of published responses. European Journal of Cardio-Thoracic Surgery , 62 (1) , Article ezac253. 10.1093/ejcts/ezac253 <https://doi.org/10.1093/ejcts%2Fezac253>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10147091/1/ezac253.pdf