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一项系统评价干预措施时选择性纳入结果的潜在影响的实证研究:研究方案。

An empirical investigation of the potential impact of selective inclusion of results in systematic reviews of interventions: study protocol.

机构信息

School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, VIC 3004, Australia.

出版信息

Syst Rev. 2013 Apr 10;2:21. doi: 10.1186/2046-4053-2-21.

Abstract

BACKGROUND

Systematic reviewers may encounter a multiplicity of outcome data in the reports of randomised controlled trials included in the review (for example, multiple measurement instruments measuring the same outcome, multiple time points, and final and change from baseline values). The primary objectives of this study are to investigate in a cohort of systematic reviews of randomised controlled trials of interventions for rheumatoid arthritis, osteoarthritis, depressive disorders and anxiety disorders: (i) how often there is multiplicity of outcome data in trial reports; (ii) the association between selection of trial outcome data included in a meta-analysis and the magnitude and statistical significance of the trial result, and; (iii) the impact of the selection of outcome data on meta-analytic results.

METHODS/DESIGN: Forty systematic reviews (20 Cochrane, 20 non-Cochrane) of RCTs published from January 2010 to January 2012 and indexed in the Cochrane Database of Systematic Reviews (CDSR) or PubMed will be randomly sampled. The first meta-analysis of a continuous outcome within each review will be included. From each review protocol (where available) and published review we will extract information regarding which types of outcome data were eligible for inclusion in the meta-analysis (for example, measurement instruments, time points, analyses). From the trial reports we will extract all outcome data that are compatible with the meta-analysis outcome as it is defined in the review and with the outcome data eligibility criteria and hierarchies in the review protocol. The association between selection of trial outcome data included in a meta-analysis and the magnitude and statistical significance of the trial result will be investigated. We will also investigate the impact of the selected trial result on the magnitude of the resulting meta-analytic effect estimates.

DISCUSSION

The strengths of this empirical study are that our objectives and methods are pre-specified and transparent. The results may inform methods guidance for systematic review conduct and reporting, particularly for dealing with multiplicity of randomised controlled trial outcome data.

摘要

背景

系统评价者在纳入评价的随机对照试验报告中可能会遇到多重结局数据(例如,多个测量工具测量同一结局、多个时间点以及结局的最终值和基线变化值)。本研究的主要目的是,在对类风湿关节炎、骨关节炎、抑郁障碍和焦虑障碍干预措施的随机对照试验的系统评价队列中,调查以下内容:(i)试验报告中存在多重结局数据的频率;(ii)纳入荟萃分析的试验结局数据选择与试验结果的大小和统计学意义之间的关联;以及(iii)结局数据选择对荟萃分析结果的影响。

方法/设计:将随机抽取 2010 年 1 月至 2012 年 1 月发表、并在 Cochrane 系统评价数据库(CDSR)或 PubMed 中索引的 40 篇 RCT 系统评价(20 篇 Cochrane 评价,20 篇非 Cochrane 评价)。将纳入每篇评价的首个连续性结局的荟萃分析。如果有评价方案,将从每个评价方案(如果可用)和已发表的评价中提取关于有资格纳入荟萃分析的结局数据类型的信息(例如,测量工具、时间点、分析)。从试验报告中提取所有与评价中定义的荟萃分析结局以及评价方案中的结局数据纳入标准和层级相匹配的结局数据。我们将调查纳入荟萃分析的试验结局数据选择与试验结果的大小和统计学意义之间的关联。我们还将调查所选试验结果对荟萃分析效应估计值大小的影响。

讨论

本实证研究的优势在于,我们的目标和方法是预先指定和透明的。研究结果可能为系统评价的实施和报告方法指南提供信息,特别是在处理随机对照试验结局数据的多重性方面。

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