Doi Yuriko
National Institute of Public Health.
Nihon Koshu Eisei Zasshi. 2016;63(10):599-605. doi: 10.11236/jph.63.10_599.
Evidence-based medicine (EBM) is fundamental to ensuring high-quality medical care. It requires systematic reviews and meta-analyses to synthesize diverse information available from individual clinical studies. However, the literature reviewed may represent an incomplete and selective set of research findings, which could lead to publication/reporting biases and distort the true picture of research as a whole. Prospective registry of all clinical trials in the world is mandatory to reduce the biases, which have been disclosed on the International Clinical Trials Registry Platform (ICTRP) of the World Health Organization (WHO) since 2007. The Japan Primary Registries Network (JPRN) is included in the ICTRP. ClinicalTrials.gov, the U.S. clinical trial registry, reports the standardized data of registered trials and offers access to submitted outcomes online. However, the JPRN does not systematically include the outcomes. On April 14, 2015, the WHO published a new statement online on the public disclosure of clinical trial results, which requires researchers to define the timeframes of reporting main findings and key outcomes, to call for results-reporting older, but still unpublished trials, and to outline steps to improve linkages between clinical trial registry entries and their published results. The WHO's new position will facilitate global efforts to reduce publication/reporting biases in clinical trials. Japan will have to actively participate in these efforts as well.
循证医学(EBM)是确保高质量医疗保健的基础。它需要系统评价和荟萃分析来综合个体临床研究中可得的各种信息。然而,所审查的文献可能代表了一组不完整且有选择性的研究结果,这可能导致发表/报告偏倚,并扭曲整个研究的真实情况。为减少这些偏倚,对全球所有临床试验进行前瞻性注册是必要的,自2007年以来,世界卫生组织(WHO)国际临床试验注册平台(ICTRP)已披露了这些偏倚。日本初级注册机构网络(JPRN)被纳入ICTRP。美国临床试验注册库ClinicalTrials.gov报告注册试验的标准化数据,并提供在线获取所提交结果的途径。然而,JPRN并未系统地纳入这些结果。2015年4月14日,WHO在网上发布了一份关于临床试验结果公开披露的新声明,要求研究人员确定报告主要发现和关键结果的时间框架,呼吁报告那些年代较久但仍未发表的试验结果,并概述改善临床试验注册条目与其发表结果之间联系的步骤。WHO的新立场将促进全球减少临床试验中发表/报告偏倚的努力。日本也必须积极参与这些努力。