Gewandter Jennifer S, Smith Shannon M, McKeown Andrew, Edwards Kenessa, Narula Aastha, Pawlowski Joseph R, Rothstein Daniel, Desjardins Paul J, Dworkin Samuel F, Gross Robert A, Ohrbach Richard, Rappaport Bob A, Sessle Barry J, Turk Dennis C, Dworkin Robert H
J Am Dent Assoc. 2015 Apr;146(4):246-54.e6. doi: 10.1016/j.adaj.2014.12.023.
Statistical methods and adverse events (that is, harms) data affect the accuracy of conclusions about the risk-to-benefit ratio of treatments for temporomandibular disorders (TMDs). The authors reviewed the quality of reporting in TMD clinical trials to highlight practices that are in need of improvement.
The authors included articles published between 1969 and May 31, 2013, in which the investigators reported randomized clinical trials of TMD treatments with pain as a principal outcome variable. Investigators in trials of nonpharmacologic and noninvasive treatments were required to at least mask the participants and assessors; all others were required to be double masked.
Ninety articles qualified for this review: 39 published between 1971 and 2005 (older articles) and 51 published between 2006 and 2013 (newer articles). Specification of primary outcome analyses, methods to accommodate missing data, and adverse event collection methods and rates were generally poor. In some cases, there was apparent improvement from the older to the newer cohort; however, reporting of these methodological details remained inadequate even in the newer articles.
This review is designed to alert authors, reviewers, editors, and readers of TMD clinical trials to these issues and improve reporting quality in the future.
统计方法和不良事件(即危害)数据会影响关于颞下颌关节紊乱病(TMD)治疗风险效益比结论的准确性。作者回顾了TMD临床试验的报告质量,以突出需要改进的做法。
作者纳入了1969年至2013年5月31日发表的文章,其中研究者报告了以疼痛作为主要结局变量的TMD治疗随机临床试验。非药物和非侵入性治疗试验的研究者至少要对参与者和评估者设盲;其他所有试验都要求双盲。
90篇文章符合本综述要求:39篇发表于1971年至2005年(较旧文章),51篇发表于2006年至2013年(较新文章)。主要结局分析的规范、处理缺失数据的方法以及不良事件收集方法和发生率总体较差。在某些情况下,从较旧队列到较新队列有明显改善;然而,即使在较新文章中,这些方法学细节的报告仍然不足。
本综述旨在提醒TMD临床试验的作者、审稿人、编辑和读者注意这些问题,并在未来提高报告质量。