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面向消费者直接宣传医学辅助生殖成功率:对全国诊所网站的一项综述

Direct-to-consumer advertising of success rates for medically assisted reproduction: a review of national clinic websites.

作者信息

Wilkinson Jack, Vail Andy, Roberts Stephen A

机构信息

Centre for Biostatistics, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK.

Research and Development, Salford Royal NHS Foundation Trust, Salford, UK.

出版信息

BMJ Open. 2017 Jan 12;7(1):e012218. doi: 10.1136/bmjopen-2016-012218.

Abstract

OBJECTIVES

To establish how medically assisted reproduction (MAR) clinics report success rates on their websites.

SETTING

Websites of private and NHS clinics offering in vitro fertilisation (IVF) in the UK.

PARTICIPANTS

We identified clinics offering IVF using the Choose a Fertility Clinic facility on the website of the Human Fertilisation and Embryology Authority (HFEA). Of 81 clinics identified, a website could not be found for 2, leaving 79 for inclusion in the analysis.

PRIMARY AND SECONDARY OUTCOME MEASURES

Outcome measures reported by clinic websites. The numerator and denominator included in the outcome measure were of interest.

RESULTS

53 (67%) websites reported their performance using 51 different outcome measures. It was most common to report pregnancy (83% of these clinics) or live birth rates (51%). 31 different ways of reporting pregnancy and 9 different ways of reporting live birth were identified. 11 (21%) reported multiple birth or pregnancy rates. 1 clinic provided information on adverse events. It was usual for clinics to present results without relevant contextual information such as sample size, reporting period, the characteristics of patients and particular details of treatments.

CONCLUSIONS

Many combinations of numerator and denominator are available for the purpose of reporting success rates for MAR. The range of reporting options available to clinics is further increased by the possibility of presenting results for subgroups of patients and for different time periods. Given the status of these websites as advertisements to patients, the risk of selective reporting is considerable. Binding guidance is required to ensure consistent, informative reporting.

摘要

目的

确定医学辅助生殖(MAR)诊所在其网站上如何报告成功率。

背景

英国提供体外受精(IVF)的私立和国民保健服务(NHS)诊所的网站。

参与者

我们通过人类受精与胚胎学管理局(HFEA)网站上的“选择生育诊所”设施确定了提供IVF的诊所。在确定的81家诊所中,有2家找不到网站,剩下79家纳入分析。

主要和次要结局指标

诊所网站报告的结局指标。对结局指标中包含的分子和分母感兴趣。

结果

53个(67%)网站使用51种不同的结局指标报告了它们的表现。最常报告的是妊娠率(这些诊所的83%)或活产率(51%)。确定了31种不同的报告妊娠的方式和9种不同的报告活产的方式。11个(21%)报告了多胎妊娠或多胎出生率。1家诊所提供了不良事件的信息。诊所通常在没有相关背景信息的情况下呈现结果,如样本量、报告期、患者特征和治疗的具体细节。

结论

为了报告MAR的成功率,分子和分母有多种组合可供选择。通过呈现患者亚组和不同时间段的结果,诊所可用的报告选项范围进一步扩大。鉴于这些网站作为向患者宣传的性质,选择性报告的风险相当大。需要有约束力的指南来确保报告的一致性和信息性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62f5/5278289/0207d7101a94/bmjopen2016012218f01.jpg

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