Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Töölö Hospital, Topeliuksenkatu 5, 00260 Helsinki, Finland; Department of Clinical Sciences, University of Helsinki, Tukholmankatu 8 B, PL 20 Biomedicum, Helsinki, Finland.
Department of Orthopaedics and Traumatology, Hatanpää City Hospital, Hatanpäänkatu 24, 33900 Tampere, Finland.
J Clin Epidemiol. 2014 Jul;67(7):769-72. doi: 10.1016/j.jclinepi.2013.11.011. Epub 2014 Feb 20.
Controversial and misleading interpretation of data from randomized trials is common. How to avoid misleading interpretation has received little attention. Herein, we describe two applications of an approach that involves blinded interpretation of the results by study investigators.
The approach involves developing two interpretations of the results on the basis of a blinded review of the primary outcome data (experimental treatment A compared with control treatment B). One interpretation assumes that A is the experimental intervention and another assumes that A is the control. After agreeing that there will be no further changes, the investigators record their decisions and sign the resulting document. The randomization code is then broken, the correct interpretation chosen, and the manuscript finalized. Review of the document by an external authority before finalization can provide another safeguard against interpretation bias.
We found the blinded preparation of a summary of data interpretation described in this article practical, efficient, and useful.
Blinded data interpretation may decrease the frequency of misleading data interpretation. Widespread adoption of blinded data interpretation would be greatly facilitated were it added to the minimum set of recommendations outlining proper conduct of randomized controlled trials (eg, the Consolidated Standards of Reporting Trials statement).
随机试验数据的有争议和误导性解释很常见。如何避免误导性解释尚未得到太多关注。在此,我们描述了一种方法的两种应用,该方法涉及由研究人员对主要结局数据进行盲法解读来进行结果解释。
该方法包括在对主要结局数据进行盲法审查的基础上对结果进行两种解释(实验性治疗 A 与对照治疗 B 相比)。一种解释假设 A 是实验干预,另一种解释假设 A 是对照。在同意不再进行更改后,研究人员记录其决定并签署由此产生的文件。然后破解随机化代码,选择正确的解释,并完成手稿。在定稿之前,由外部权威机构对文件进行审查可以提供另一种防止解释偏差的保障。
我们发现本文中描述的盲法数据解释准备工作是切实可行、高效且有用的。
盲法数据解释可能会减少误导性数据解释的频率。如果将盲法数据解释添加到概述随机对照试验正确实施的最低建议集中(例如,临床试验报告的统一标准声明),则会极大地促进盲法数据解释的广泛采用。