Paeck Tatjana, Ferreira Manuela L, Sun Clive, Lin Chung-Wei Christine, Tiedemann Anne, Maher Chris G
The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
Arthritis Care Res (Hoboken). 2014 Aug;66(8):1220-6. doi: 10.1002/acr.22261.
There is evidence to suggest that older adults are underrepresented in randomized controlled trials of health interventions. The aim of this review was to systematically examine the age-related inclusion criteria distribution of participants in randomized controlled trials (RCTs) of low back pain (LBP) interventions and to investigate if this distribution pattern changes over time.
We identified, in PubMed, 1,047 RCTs on nonspecific LBP published since 1992, of which a random sample of 400 was assessed for inclusion in the review. Included studies were grouped according to treatment type. Data were extracted on year of publication, types of treatment, total number of participants, age inclusion criteria, and age of included participants.
A total of 274 RCTs published between 1992 and 2010 met the inclusion criteria. A total of 41.6% (n = 114) of the included trials excluded people ages >65 years. The pooled mean age of participants was 44.3 years (95% confidence interval 42.4-46.3); the pooled minimum age for inclusion was 19.8 years and the pooled maximum age for inclusion was 65.4 years. We found no trend of including older participants in RCTs on LBP over time.
Despite an aging population around the globe, older adults are largely excluded from RCTs evaluating management of LBP, and there is no evidence of change in this practice over the last 2 decades.
有证据表明，在健康干预的随机对照试验中，老年人的代表性不足。本综述的目的是系统地研究腰痛（LBP）干预随机对照试验（RCT）中参与者与年龄相关的纳入标准分布情况，并调查这种分布模式是否随时间变化。
我们在PubMed中检索了自1992年以来发表的1047项关于非特异性腰痛的随机对照试验，其中随机抽取400项进行评估以纳入本综述。纳入的研究根据治疗类型进行分组。提取了关于发表年份、治疗类型、参与者总数、年龄纳入标准以及纳入参与者年龄的数据。
1992年至2010年间发表的274项随机对照试验符合纳入标准。纳入试验中共有41.6%（n = 114）排除了65岁以上的人群。参与者的合并平均年龄为44.3岁（95%置信区间42.4 - 46.3）；纳入的合并最小年龄为19.8岁，合并最大年龄为65.4岁。我们发现，随着时间的推移，在腰痛随机对照试验中纳入老年参与者没有趋势。
尽管全球人口老龄化，但老年人在很大程度上被排除在评估腰痛管理的随机对照试验之外，并且在过去20年中没有证据表明这种做法有所改变。
