Delgado-Rodriguez M, Ruiz-Canela M, De Irala-Estevez J, Llorca J, Martinez-Gonzalez A
Division of Preventive Medicine and Public Health, University of Jaén School of Environmental Sciences, Spain.
J Epidemiol Community Health. 2001 Aug;55(8):569-72. doi: 10.1136/jech.55.8.569.
This study assessed several methodological aspects related to the quality of published controlled clinical trials (CCTs) in relation to the participation of an epidemiologist/biostatistician (E/B).
Handsearch of CCTs published in four medical leading journals for 1993-1995.
Quality variables, abstracted from a review, were related to authors' specialties. Five hundred and ninety four CCTs were identified via a hand search. The department/unit membership was used to attribute authors' specialties. Of 594 CCTs identified, in 127 the authors' specialties could not be known, leaving 467 trials for analysis.
E/B participation occurred in 178 trials (38.1%). This participation was more frequent in multicentric, bigger, and in those trials describing any funding agency. These factors were controlled for in the analysis. E/B participation was positively associated with pre-study sample size estimation (OR = 1.5, 95% confidence intervals (CI) 1.0, 2.3), with reporting the dates for starting/ending the study (OR = 2.1, 95% CI 1.4, 3.3), with using an objectively assessed outcome (OR = 2.4, 95% CI 1.2, 4.6) and with the intention to treat principle (OR = 2.0, 95% CI 1.3, 3.0). The overall quality score was higher in trials where E/B participated.
The results suggest that E/B improve the quality (at least of reports) of clinical trials. Given that quality of research is frequently used to evaluate potential sources of heterogeneity between trials, these results are relevant for meta-analysis.
本研究评估了已发表的对照临床试验(CCT)质量在与流行病学家/生物统计学家(E/B)参与相关方面的若干方法学问题。
手工检索1993 - 1995年在四种主要医学期刊上发表的CCT。
从一篇综述中提取的质量变量与作者的专业相关。通过手工检索识别出594项CCT。根据部门/单位成员身份来确定作者的专业。在识别出的594项CCT中,有127项无法得知作者的专业,剩余467项试验用于分析。
178项试验(38.1%)有E/B参与。这种参与在多中心、规模较大以及描述了任何资助机构的试验中更为频繁。在分析中对这些因素进行了控制。E/B参与与研究前样本量估计呈正相关(比值比(OR)= 1.5,95%置信区间(CI)1.0,2.3),与报告研究开始/结束日期(OR = 2.1,95% CI 1.4,3.3)、使用客观评估的结局(OR = 2.4,95% CI 1.2,4.6)以及意向性分析原则(OR = 2.0,95% CI 1.3,3.0)呈正相关。E/B参与的试验总体质量评分更高。
结果表明E/B可提高临床试验的质量(至少是报告质量)。鉴于研究质量经常被用于评估试验间潜在的异质性来源,这些结果对荟萃分析具有重要意义。