Transparency in positive airway pressure therapy trials: an evaluation of reporting quality
Publication: Journal of Comparative Effectiveness Research
Abstract
Aim: Accurate and detailed reporting of nonpharmacological interventions such as positive airway pressure (PAP) therapy is essential for reproducibility, yet previous research shows frequent reporting deficiencies. Due to the complexity of PAP therapy, we evaluated the quality of PAP intervention reporting in ClinicalTrials.gov and publications, and assessed consistency between them. Materials & methods: ClinicalTrials.gov was searched on 16 May 2023, for adult obstructive sleep apnea trials involving PAP therapy. Trials were evaluated for registration completeness (21 WHO Trial Registration DataSet items) and intervention reporting (adapted 12-item Template for Intervention Description and Replication checklist). Publications identified on 3 September 2025, following a 2-year publication period, were compared with registered data for participant characteristics, outcomes and intervention reporting. Results: Among 299 included trials, 178 corresponding publications were identified. Reporting of PAP therapy was frequently incomplete in registry and publications, with key procedural details – such as mask fitting, device acclimatization and adherence strategies – missing in the majority of records. Substantial discrepancies were also found between the registered and published data. Sample size calculation was reported in 56.1% of publications but in none of the trial registrations, with participant numbers differing in 29.3% of articles. Inconsistencies were most common for secondary outcomes (43.3%), while primary outcomes differed from those registered in 24.2% of publications. Conclusion: Incomplete and inconsistent reporting of PAP therapy across registry and corresponding publications may be compatible with selective reporting. Rather than pointing to individual misconduct, these discrepancies indicate that key information on protocol changes, outcomes and adherence is fragmented across sources, limiting the ability of clinicians and researchers to appraise trial findings in full. Strengthening adherence to trial registration requirements and structured intervention-reporting frameworks is therefore essential to improve transparency and reinforce confidence in the evidence base for obstructive sleep apnea management.
Plain language summary: How well are positive airway pressure therapy trials reported in clinical registries & published articles?
What is this article about?
Positive airway pressure (PAP) therapy is the main treatment for obstructive sleep apnea, a common condition in which breathing repeatedly stops during sleep. For patients and doctors to trust and replicate clinical trials, every detail of how the treatment was applied must be clearly reported. We investigated how well PAP therapy trials describe their methods in the ClinicalTrials.gov registry and in published journal articles, and whether these two sources match each other.
What were the results?
Reporting of key practical details, such as how the PAP mask was fitted, how patients were introduced to the device, and what strategies were used to help patients stick with treatment, was missing in the majority of both registry records and published articles. Participant numbers differed in nearly a third of articles, and defined study outcomes changed between registration and publication in up to 43% of cases.
What do the results mean?
Incomplete and inconsistent reporting of PAP therapy trials makes it difficult for researchers, clinicians and patients to judge whether trial results are reliable or to reproduce the treatments tested. Journals, editors and researchers should require strict adherence to reporting guidelines (such as the TIDieR checklist) and ensure that what is registered matches what is ultimately published, in order to improve the quality and trustworthiness of sleep apnea research.
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Received: 16 March 2026
Accepted: 23 June 2026
Published online: 23 July 2026
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Transparency in positive airway pressure therapy trials: an evaluation of reporting quality. (2026) Journal of Comparative Effectiveness Research. DOI: 10.57264/cer-2026-0058
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