Division of Orthopaedic Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.
Am J Sports Med. 2012 Sep;40(9):1970-7. doi: 10.1177/0363546512448363. Epub 2012 Jun 7.
There is increasing evidence that a significant proportion of randomized trials in medicine, and recently in orthopaedics, do not go on to publication.
The objectives of this study were (1) to determine publication rates of randomized controlled trials in sports medicine that have been registered with ClinicalTrials.gov (CTG) and (2) to compare the registration summaries of randomized trials on CTG with final published manuscripts on pertinent methodological variables.
Systematic review.
Two independent investigators searched ClinicalTrials.gov for all closed and completed trials related to sports medicine until June 2009 using a text search strategy. The authors then searched for publications resulting from these registered trials in peer-reviewed journals that are indexed with MEDLINE and/or EMBASE as of February 2012 based on study authors and key words provided in the study protocol. Details of primary outcomes and secondary outcomes, study sponsors, and sample size were extracted and compared between registrations and publications.
Of 34 closed and completed trials registered on CTG, there were 20 resultant publications in peer-reviewed journals (58.8%). There was no significant relationship between source of funding and rate of publication (P > .05). The authors found a discrepancy between the CTG registration summary and the manuscript in at least one methodological variable (primary/secondary outcomes, inclusion/exclusion criteria, sample size) in 16 of 20 (80.0%) articles and a discrepancy in the primary outcome in 8 of 20 (40.0%) published trials.
Although registration of sports medicine trials in CTG does not consistently result in publication or disclosure of results at 32 months from the time of study completion, observed publication rates are higher than in other orthopaedic subspecialties. Changes are also frequently made to the final presentation of eligibility criteria and primary and secondary outcomes that are not reflected in the registered trial data.
越来越多的证据表明,医学领域,尤其是最近的骨科领域,相当一部分随机试验并未发表。
本研究的目的是:(1) 确定在 ClinicalTrials.gov (CTG) 注册的运动医学随机对照试验的发表率;(2) 比较 CTG 上注册的随机试验的注册摘要与相关方法学变量的最终发表的手稿。
系统评价。
两名独立的调查员使用文本搜索策略在 CTG 上搜索截至 2009 年 6 月所有与运动医学相关的已关闭和完成的试验。然后,根据研究方案中提供的研究作者和关键词,作者在同行评议的期刊中搜索从这些注册试验中产生的出版物,这些期刊被 MEDLINE 和/或 EMBASE 索引。提取并比较了注册和出版物中的主要和次要结局、研究赞助商和样本量等细节。
在 CTG 上注册的 34 项已关闭和完成的试验中,有 20 项在同行评议的期刊上发表了论文(58.8%)。资金来源与发表率之间无显著关系(P>.05)。作者发现,在 20 篇文章中的 16 篇(80.0%)中,CTG 注册摘要与手稿至少在一个方法学变量(主要/次要结局、纳入/排除标准、样本量)上存在差异,在 20 项已发表的试验中有 8 项(40.0%)存在主要结局的差异。
尽管在完成研究 32 个月后,运动医学试验在 CTG 上的注册并不总是导致发表或结果披露,但观察到的发表率高于其他骨科亚专科。在最终呈现的纳入和排除标准以及主要和次要结局方面,也经常进行更改,而这些更改并没有反映在注册试验数据中。