Brown Dorothy Cimino
Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010, USA.
J Am Vet Med Assoc. 2006 Sep 15;229(6):990-3. doi: 10.2460/javma.229.6.990.
To determine how selection bias (allocation bias) was controlled in published clinical trials.
Retrospective study.
97 parallel-group controlled clinical trials published from January 2000 through December 2005 in 12 peer-reviewed journals.
Journals were hand searched to identify eligible reports. Details concerning allocation of animals to study groups, baseline characteristics of the groups, and the number of animals allocated to each group were recorded.
Randomization was the stated method of allocating animals to groups in 87% of the reports, yet in only 11% of reports were both randomization of the group allocation process and concealment of the allocation sequence described. Studies reported as randomized were more likely to report baseline characteristics of the study groups for comparison than studies that did not report randomization (88% vs 54%). Studies in which baseline group characteristics were reported had more subjects allocated to each study group (median, 16) than those that did not (median, 11).
Randomization was reported as the method of allocating study animals to groups in most publications, indicating that the potential power of randomization in controlling selection bias is appreciated by clinical investigators seeking to determine the efficacy of an intervention. However, in most reports, little corroborating information was included to support the claim. The absence of this information makes it difficult for practitioners to critically review the impact of bias on study results and make informed decisions regarding patients.
确定已发表的临床试验中选择偏倚(分配偏倚)是如何得到控制的。
回顾性研究。
2000年1月至2005年12月在12种同行评审期刊上发表的97项平行组对照临床试验。
人工检索期刊以识别符合条件的报告。记录有关将动物分配至研究组的详细情况、各组的基线特征以及分配至每组的动物数量。
87%的报告称随机化是将动物分配至组别的方法,但只有11%的报告描述了组分配过程的随机化及分配序列的隐藏。与未报告随机化的研究相比,报告为随机化的研究更有可能报告研究组的基线特征以供比较(88%对54%)。报告了基线组特征的研究中,每个研究组分配的受试者比未报告的研究更多(中位数分别为16和11)。
大多数出版物称随机化是将研究动物分配至组别的方法,这表明试图确定干预措施疗效的临床研究人员认识到随机化在控制选择偏倚方面的潜在作用。然而,在大多数报告中,几乎没有提供确凿信息来支持这一说法。缺乏这些信息使得从业者难以严格审查偏倚对研究结果的影响,并就患者做出明智的决策。