Allen Michael, MacLeod Tanya, Handfield-Jones Richard, Sinclair Douglas, Fleming Michael
Evidence-based Programs, Continuing Medical Education, Dalhousie University, Halifax, Nova Scotia, Canada.
J Contin Educ Health Prof. 2010 Fall;30(4):221-8. doi: 10.1002/chp.20086.
Clinical trial data can be presented in ways that exaggerate treatment effectiveness. Physicians consider therapy more effective, and may be more likely to make inappropriate practice changes, when data are presented in relative terms such as relative risk reduction rather than in absolute terms such as absolute risk reduction and number needed to treat. Our purpose was to determine (1) how frequently continuing medical education (CME) speakers present research data in relative terms compared to absolute terms; (2) how knowledgeable CME speakers and learners are about these terms; and (3) how CME learners want these terms presented.
Analysis of videotapes and PowerPoint slides of 26 CME presentations, questionnaire survey of CME speakers and learners, and focus groups with learners.
Speakers presented data more frequently in relative than absolute terms, but most frequently in general terms such as frequencies, percentages, graphs, and P-values with no data. Of 1367 PowerPoint slides, 269 presented research data, and of these, 225 (84%) presented data in general terms, 50 (19%) in relative terms and 19 (7%) in absolute terms. CME speakers understood relative and absolute terms better than learners. Approximately 25-35% of speakers and 45-65% of learners could not correctly calculate relative risk reduction, absolute risk reduction, and number needed to treat. Learners wished to have these terms presented in CME programs in a consistent and easily understood format and requested a brief review of them at the beginning of CME programs.
Presentation of research data in most CME programs is inadequate to allow learners to make fully informed therapeutic decisions. Speakers and learners need professional development to improve their presentation and understanding of research data.
临床试验数据的呈现方式可能会夸大治疗效果。当数据以相对风险降低等相对术语而非绝对风险降低和需治疗人数等绝对术语呈现时，医生会认为治疗更有效，并且可能更倾向于做出不恰当的临床实践改变。我们的目的是确定：（1）继续医学教育（CME）演讲者以相对术语而非绝对术语呈现研究数据的频率；（2）CME演讲者和学习者对这些术语的了解程度；（3）CME学习者希望这些术语如何呈现。
对26场CME讲座的录像带和PowerPoint幻灯片进行分析，对CME演讲者和学习者进行问卷调查，并与学习者进行焦点小组讨论。
演讲者以相对术语而非绝对术语呈现数据的频率更高，但最常以频率、百分比、图表和无数据的P值等一般术语呈现。在1367张PowerPoint幻灯片中，269张呈现了研究数据，其中225张（84%）以一般术语呈现数据，50张（19%）以相对术语呈现，19张（7%）以绝对术语呈现。CME演讲者对相对和绝对术语的理解比学习者更好。约25%-35%的演讲者和45%-65%的学习者无法正确计算相对风险降低、绝对风险降低和需治疗人数。学习者希望CME课程以一致且易于理解的格式呈现这些术语，并要求在CME课程开始时对其进行简要回顾。
大多数CME课程中研究数据的呈现方式不足以让学习者做出充分知情的治疗决策。演讲者和学习者需要专业发展来提高他们对研究数据的呈现和理解能力。
