Somford Matthijs P, van Deurzen Derek F P, Ostendorf Marieke, Eygendaal Denise, van den Bekerom Michel P J
Department of Orthopedic Surgery, Medisch Spectrum Twente, Enschede, The Netherlands.
Department of Orthopedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
J Shoulder Elbow Surg. 2015 Oct;24(10):1619-26. doi: 10.1016/j.jse.2015.03.031. Epub 2015 May 7.
Randomized controlled trials (RCTs) are high in the hierarchy of scientific evidence, but possible sources of bias should be identified or even excluded. This systematic review assessed the methodologic quality and the quality of reporting of the RCTs on the treatment of elbow pathology.
A systematic review of RCTs was performed on the treatment of elbow pathology. PubMed/MEDLINE, Embase, and the Cochrane Library were searched for relevant trials. Thirty-five of the initial 540 articles being an (pseudo) RCT on invasive treatment of elbow pathology in humans were included. These were scored with the use of an adapted Checklists to Evaluate A Report of a Nonpharmacologic Trial (CLEAR-NPT). To assess quality of reporting, points were administered to the articles based on the results from CLEAR-NPT list. The highest possible score for quality is 26 points.
The average quality score was 18.1 points (range, 10-25 points). The mean scores were 19.5 for trials published in the American Journal of Sports Medicine, 19.8 for those published in the Journal of Bone and Joint Surgery, and 20.3 for those published in the Journal of Shoulder and Elbow Surgery.
The most important finding was that the overall quality and the quality of reporting has not improved over the years and that the overall quality of the selected studies and the quality of reporting in these trials is not related to the journal they are published in.
随机对照试验(RCT)在科学证据等级中处于较高位置,但应识别甚至排除可能的偏倚来源。本系统评价评估了关于肘部疾病治疗的随机对照试验的方法学质量和报告质量。
对肘部疾病治疗的随机对照试验进行系统评价。检索了PubMed/MEDLINE、Embase和Cochrane图书馆以查找相关试验。最初的540篇文章中有35篇是关于人类肘部疾病侵入性治疗的(伪)随机对照试验,被纳入研究。使用改编后的非药物试验报告评估清单(CLEAR-NPT)对这些文章进行评分。为评估报告质量,根据CLEAR-NPT清单的结果给文章打分。质量的最高可能分数为26分。
平均质量得分为18.1分(范围为10 - 25分)。发表于《美国运动医学杂志》的试验平均得分为19.5分,发表于《骨与关节外科杂志》的试验平均得分为19.8分,发表于《肩肘外科杂志》的试验平均得分为20.3分。
最重要的发现是,多年来整体质量和报告质量并未提高,并且所选研究的整体质量以及这些试验中的报告质量与它们发表的期刊无关。