Azorin J-M, Adida M, Blin O, Simon N, Fakra E, Cermolacce M, Bottai T, Pringuey D, Micoulaud-Franchi J-A, Belzeaux R, Kaladjian A
SHU Psychiatrie Adultes, Hôpital Sainte Marguerite, 13274 Marseille Cedex 9, France.
SHU Psychiatrie Adultes, Hôpital Sainte Marguerite, 13274 Marseille Cedex 9, France.
Encephale. 2016 Dec;42(6S):S26-S29. doi: 10.1016/S0013-7006(17)30050-7.
To correctly interpret the results of a randomised controlled trial (RCT), practitioners have to spot bias and other potential problems present in the trial. Internal as well as external validity of the trial are linked to the presence of such bias. The internal validity is ensured by a clear definition of the objectives of the trial. The number of patients to be included in the trial is calculated on the basis of the main objective of the trial and more precisely on the basis of the primary endpoint selected to assess the efficacy of treatment. This is the best way to ensure that the statistical significance of the result may have a clinical relevance. Internal validity depends also on the process of patients selection, the methods used to ensure comparability of groups and treatments, the criteria employed to assess efficacy, and the methods for the analysis of data. External validity refers to subjects that have been excluded from the trial, limitations of RCTs, as well as the coherence and clinical relevance of the trial. Internal validity has to be fueled by external validity.
为了正确解读随机对照试验(RCT)的结果,从业者必须识别试验中存在的偏倚和其他潜在问题。试验的内部效度和外部效度都与这类偏倚的存在有关。试验的内部效度通过明确试验目标来确保。纳入试验的患者数量是根据试验的主要目标计算得出的,更确切地说是根据为评估治疗效果而选定的主要终点来计算的。这是确保结果的统计学显著性可能具有临床相关性的最佳方法。内部效度还取决于患者选择过程、用于确保组间和治疗方法可比性的方法、评估疗效所采用的标准以及数据分析方法。外部效度指的是被排除在试验之外的受试者、随机对照试验的局限性以及试验的连贯性和临床相关性。内部效度必须由外部效度来推动。