Lampert Anette, Hoffmann Georg F, Ries Markus
Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany.
Cooperation Unit Clinical Pharmacy, University of Heidelberg, Heidelberg, Germany.
PLoS One. 2016 Jan 6;11(1):e0144973. doi: 10.1371/journal.pone.0144973. eCollection 2016.
Although selective reporting of clinical trial results introduces bias into evidence based clinical decision making, publication bias in pediatric epilepsy is unknown today. Since there is a considerable ambiguity in the treatment of an important and common clinical problem, pediatric seizures, we assessed the public availability of results of phase 3 clinical trials that evaluated treatments of seizures in children and adolescents as a surrogate for the extent of publication bias in pediatric epilepsy.
We determined the proportion of published and unpublished study results of phase 3 clinical trials that were registered as completed on ClinicalTrials.gov. We searched ClinicalTrials.gov, PubMed, and Google Scholar for publications and contacted principal investigators or sponsors. The analysis was performed according to STROBE criteria.
Considering studies that were completed before 2014 (N = 99), 75 (76%) pediatric phase 3 clinical trials were published but 24 (24%) remained unpublished. The unpublished studies concealed evidence from 4,437 patients. Mean time-to-publication was 25 SD ± 15.6 months, more than twice as long as mandated.
Ten years after the ICMJE's clinical trials registration initiative there is still a considerable amount of selective reporting and delay of publication that potentially distorts the body of evidence in the treatment of pediatric seizures.
尽管选择性报告临床试验结果会给基于证据的临床决策带来偏差,但目前尚不清楚儿科癫痫领域是否存在发表偏倚。由于在治疗一个重要且常见的临床问题——儿童癫痫发作方面存在相当大的不确定性,我们评估了评估儿童和青少年癫痫发作治疗方法的3期临床试验结果的公开可得性,以此作为儿科癫痫发表偏倚程度的一个替代指标。
我们确定了在ClinicalTrials.gov上注册为已完成的3期临床试验中已发表和未发表研究结果的比例。我们在ClinicalTrials.gov、PubMed和谷歌学术上搜索出版物,并联系了主要研究者或赞助商。分析按照STROBE标准进行。
考虑2014年之前完成的研究(N = 99),75项(76%)儿科3期临床试验已发表,但24项(24%)仍未发表。未发表的研究掩盖了来自4437名患者的证据。平均发表时间为25±15.6个月标准差,比规定时间长两倍多。
在国际医学期刊编辑委员会(ICMJE)的临床试验注册倡议实施十年后,仍存在大量的选择性报告和发表延迟现象,这可能会扭曲儿科癫痫发作治疗的证据体系。