Cancer Center of Southeastern Ontario, Queen's University, 25 King St West, Kingston, Ontario, Canada.
J Clin Oncol. 2012 Oct 1;30(28):3552-7. doi: 10.1200/JCO.2012.41.8319. Epub 2012 May 29.
Clinicians may read only the abstract of an article to keep abreast of newly published randomized controlled trials (RCTs). However, discordances have been noticed in summary conclusions in the abstracts and the main body of some articles. This article evaluated such discordances in detail.
RCTs of systemic therapy for lung cancer published between 2004 and 2009 were considered. Conclusions in the body of the articles and those in the abstracts were graded by using a 7-point Likert scale; 1 for strong endorsement of the control arm, 4 for a neutral statement, and 7 for strong endorsement of the experimental arm. Conclusions were classified as discordant if the difference in scores was ≥ 2. χ(2) tests and logistic regression were used to identify factors associated with discordance.
From among 114 eligible RCTs identified (90 for non-small-cell and 24 for small-cell lung cancer), 11 (10%) articles presented discordant conclusions in the abstract and in the body of the articles. Discordance was most common when the experimental arm was strongly supported in the abstract but not in the body of the article (nine of 11; 82%); however, the converse was much less common (two of 11; 18%; P < .001). Intraclass correlations for the two reviewers were ≥ 0.9. The discordances were found to be independent of trial-related factors.
Conclusive statements in the abstract can differ from those in the full text. Clinicians should use caution when they consider making changes in their practice on the basis of reading only the abstract of a published RCT.
临床医生可能只读文章的摘要以了解最新发表的随机对照试验(RCT)的进展。然而,一些文章的摘要和正文的总结结论存在差异。本文详细评估了这些差异。
考虑了 2004 年至 2009 年间发表的针对肺癌的全身治疗 RCT。采用 7 分李克特量表对文章正文和摘要中的结论进行评分;1 分表示强烈支持对照组,4 分表示中立陈述,7 分表示强烈支持实验组。如果评分差异≥2,则认为结论不一致。采用卡方检验和逻辑回归分析来识别与不一致性相关的因素。
从 114 项合格的 RCT 中(90 项非小细胞肺癌,24 项小细胞肺癌),11 篇文章(10%)的摘要和正文的结论不一致。当实验组在摘要中得到强烈支持而在正文部分却没有得到支持时(9/11;82%),不一致最为常见;而反之则较少见(2/11;18%;P<.001)。两位审稿人的组内相关系数≥0.9。这些差异与试验相关因素无关。
摘要中的结论可能与全文的结论不同。临床医生在仅根据已发表 RCT 的摘要来考虑改变其临床实践时应谨慎。