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在主要肿瘤学会议上展示随机对照试验的非最终结果。

Presentation of nonfinal results of randomized controlled trials at major oncology meetings.

作者信息

Booth Christopher M, Le Maître Aurélie, Ding Keyue, Farn Kristen, Fralick Michael, Phillips Cameron, Cescon David W, Meyer Ralph M

机构信息

National Cancer Institute of Canada Clinical Trials Group, Cancer Research Institute, Queen's University, Kingston, ON, Canada.

出版信息

J Clin Oncol. 2009 Aug 20;27(24):3938-44. doi: 10.1200/JCO.2008.18.8771. Epub 2009 Jul 20.

Abstract

PURPOSE

To assess the frequency, implications, and factors associated with reporting nonfinal analyses (NFAs) of randomized controlled trials (RCTs) as abstract publications.

METHODS

We identified 138 consecutive reports of RCTs testing systemic therapy for lymphoma, breast, colorectal, or non-small-cell lung cancer published in six major journals between 2000 and 2004. We then searched proceedings of seven major cancer meetings, 1990 to 2004, for abstracts related to these publications which presented efficacy results. Articles and abstracts were compared for discordance in sample size, median follow-up, results, and conclusions. Abstracts were evaluated for statements explicitly noting or implying that results were not final. Factors associated with discordance were assessed by uni- and multivariate analyses.

RESULTS

We identified 303 related abstracts; 197 were eligible. In 86 abstracts (44%), results were stated or implied to be NFA; this was explicitly stated in 41 (21%). The NFAs included 12 where accrual was ongoing. Discordance with article was found in 124 abstracts (63%) and was more common with NFAs (67 of 86 [78%] v 57 of 111 [51%]; P = .0001). When compared with articles, authors' conclusions were substantively different in 17 abstracts (10%). Factors most associated with data discordance were lymphoma trial (odds ratio [OR], 3.8; 95% CI, 1.5 to 10.8), cooperative group trial (OR, 2.8; 95% CI, 1.4 to 5.6), and presentation of a NFA (OR, 2.9; 95% CI, 1.5 to 5.8).

CONCLUSION

Meeting abstracts often include NFAs and are frequently discordant with subsequent article publication.

摘要

目的

评估将随机对照试验(RCT)的非最终分析(NFA)作为摘要发表的频率、影响及相关因素。

方法

我们确定了2000年至2004年间在六种主要期刊上发表的138篇连续的RCT报告,这些试验测试了淋巴瘤、乳腺癌、结直肠癌或非小细胞肺癌的全身治疗。然后,我们在1990年至2004年的七次主要癌症会议的会议记录中搜索与这些发表文章相关的、呈现疗效结果的摘要。比较文章和摘要在样本量、中位随访时间、结果和结论方面的不一致性。评估摘要中是否有明确指出或暗示结果并非最终结果的陈述。通过单因素和多因素分析评估与不一致性相关的因素。

结果

我们确定了303篇相关摘要;197篇符合条件。在86篇摘要(44%)中,结果被陈述或暗示为非最终分析;其中41篇(21%)明确陈述了这一点。非最终分析包括12篇仍在入组的情况。124篇摘要(63%)与文章存在不一致,在非最终分析中更常见(86篇中的67篇[78%]对111篇中的57篇[51%];P = 0.0001)。与文章相比,作者的结论在17篇摘要(10%)中存在实质性差异。与数据不一致最相关的因素是淋巴瘤试验(优势比[OR],3.8;95%置信区间,1.5至10.8)、协作组试验(OR,2.8;95%置信区间,1.4至5.6)以及非最终分析的呈现(OR,2.9;95%置信区间,1.5至5.8)。

结论

会议摘要经常包含非最终分析,且常常与随后的文章发表不一致。

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