Scales Charles D, Norris Regina D, Keitz Sheri A, Peterson Bercedis L, Preminger Glenn M, Vieweg Johannes, Dahm Philipp
Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
J Urol. 2007 Mar;177(3):1090-4; discussion 1094-5. doi: 10.1016/j.juro.2006.10.027.
Randomized, controlled trials are the gold standard for evidence based assessment of therapeutic interventions. In 1996 the Consolidated Standards of Reporting Trials statement was published in an effort to standardize the reporting of clinical trials. To our knowledge we report the first systematic assessment of randomized, controlled trial quality in the urology literature by Consolidated Standards of Reporting Trials standards.
All human subject randomized, controlled trials published in 4 leading urology journals in 1996 and 2004 were identified for formal review. A standardized evaluation form was developed based on the Consolidated Standards of Reporting Trials statement. Each article was evaluated by 2 independent reviewers and discrepancies were settled by consensus. A Consolidated Standards of Reporting Trials criteria summary score was calculated on a scale of 0 to 22.
A total of 152 randomized, controlled trials met inclusion criteria. The mean+/-SEM Consolidated Standards of Reporting Trials summary score was 10.2+/-0.3 (median 10.3) and 12.0+/-0.3 (median 12.2) in 1996 and 2004, respectively, with a mean difference of 1.8 (95% CI 1.0, 2.6; p=0.001). Reporting of important methodological criteria, eg sample size justification and randomization implementation, improved from 1996 to 2004. Improvement notwithstanding, reporting of key methodological criteria remained consistently below 50% in 2004.
This formal review suggests that randomized, controlled trial reporting in the urology literature has improved since the publication of the Consolidated Standards of Reporting Trials statement in 1996. Certain areas, such as reporting of trial methods, continue to meet Consolidated Standards of Reporting Trials criteria in fewer than half of publications. Ongoing graduate and postgraduate education in trial design and evidence based practice may result in further improvement in randomized, controlled trial reporting.
随机对照试验是基于证据评估治疗干预措施的金标准。1996年,《报告试验的统一标准》声明发表,旨在规范临床试验的报告。据我们所知,我们首次按照《报告试验的统一标准》对泌尿外科文献中的随机对照试验质量进行了系统评估。
确定1996年和2004年在4种主要泌尿外科杂志上发表的所有人体随机对照试验进行正式审查。根据《报告试验的统一标准》声明制定了标准化评估表。每篇文章由2名独立评审员进行评估,分歧通过协商解决。计算《报告试验的统一标准》标准总结评分,范围为0至22分。
共有152项随机对照试验符合纳入标准。1996年和2004年,《报告试验的统一标准》总结评分的均值±标准误分别为10.2±0.3(中位数10.3)和12.0±0.3(中位数12.2),平均差异为1.8(95%可信区间1.0,2.6;p = 0.001)。从1996年到2004年,重要方法学标准(如样本量合理性和随机化实施)的报告有所改善。尽管有改善,但关键方法学标准的报告在2004年仍一直低于50%。
这项正式审查表明,自1996年《报告试验的统一标准》声明发表以来,泌尿外科文献中随机对照试验的报告有所改善。某些领域,如试验方法的报告,在不到一半的出版物中仍符合《报告试验的统一标准》标准。在试验设计和循证实践方面持续开展研究生和研究生后教育可能会使随机对照试验报告得到进一步改善。