Melander Hans, Ahlqvist-Rastad Jane, Meijer Gertie, Beermann Björn
Medical Products Agency, Box 23, S-751 03 Uppsala, Sweden.
BMJ. 2003 May 31;326(7400):1171-3. doi: 10.1136/bmj.326.7400.1171.
To investigate the relative impact on publication bias caused by multiple publication, selective publication, and selective reporting in studies sponsored by pharmaceutical companies.
42 placebo controlled studies of five selective serotonin reuptake inhibitors submitted to the Swedish drug regulatory authority as a basis for marketing approval for treating major depression were compared with the studies actually published (between 1983 and 1999).
Multiple publication: 21 studies contributed to at least two publications each, and three studies contributed to five publications. Selective publication: studies showing significant effects of drug were published as stand alone publications more often than studies with non-significant results. Selective reporting: many publications ignored the results of intention to treat analyses and reported the more favourable per protocol analyses only.
The degree of multiple publication, selective publication, and selective reporting differed between products. Thus, any attempt to recommend a specific selective serotonin reuptake inhibitor from the publicly available data only is likely to be based on biased evidence.
调查制药公司资助的研究中多次发表、选择性发表和选择性报告对发表偏倚的相对影响。
将提交给瑞典药品监管机构作为治疗重度抑郁症营销批准依据的5种选择性5-羟色胺再摄取抑制剂的42项安慰剂对照研究,与实际发表的研究(1983年至1999年之间)进行比较。
多次发表:21项研究每项至少促成了两篇发表,3项研究促成了5篇发表。选择性发表:显示药物有显著效果的研究比结果不显著的研究更常作为独立发表物发表。选择性报告:许多发表物忽略了意向性分析的结果,仅报告了更有利的符合方案分析。
不同产品在多次发表、选择性发表和选择性报告的程度上存在差异。因此,仅根据公开可得数据推荐特定的选择性5-羟色胺再摄取抑制剂的任何尝试,都可能基于有偏差的证据。