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在 Cochrane 综述中纳入的 20920 项随机对照试验中,研究随时间推移而出现的报告质量差和方法学不足的演变:研究中的研究。

Evolution of poor reporting and inadequate methods over time in 20 920 randomised controlled trials included in Cochrane reviews: research on research study.

机构信息

INSERM, U1153, Paris, France

Cochrane France, Paris, France.

出版信息

BMJ. 2017 Jun 8;357:j2490. doi: 10.1136/bmj.j2490.

Abstract

To examine how poor reporting and inadequate methods for key methodological features in randomised controlled trials (RCTs) have changed over the past three decades. Mapping of trials included in Cochrane reviews. Data from RCTs included in all Cochrane reviews published between March 2011 and September 2014 reporting an evaluation of the Cochrane risk of bias items: sequence generation, allocation concealment, blinding, and incomplete outcome data. For each RCT, we extracted consensus on risk of bias made by the review authors and identified the primary reference to extract publication year and journal. We matched journal names with to get 2014 impact factors. We considered the proportions of trials rated by review authors at unclear and high risk of bias as surrogates for poor reporting and inadequate methods, respectively. We analysed 20 920 RCTs (from 2001 reviews) published in 3136 journals. The proportion of trials with unclear risk of bias was 48.7% for sequence generation and 57.5% for allocation concealment; the proportion of those with high risk of bias was 4.0% and 7.2%, respectively. For blinding and incomplete outcome data, 30.6% and 24.7% of trials were at unclear risk and 33.1% and 17.1% were at high risk, respectively. Higher journal impact factor was associated with a lower proportion of trials at unclear or high risk of bias. The proportion of trials at unclear risk of bias decreased over time, especially for sequence generation, which fell from 69.1% in 1986-1990 to 31.2% in 2011-14 and for allocation concealment (70.1% to 44.6%). After excluding trials at unclear risk of bias, use of inadequate methods also decreased over time: from 14.8% to 4.6% for sequence generation and from 32.7% to 11.6% for allocation concealment. Poor reporting and inadequate methods have decreased over time, especially for sequence generation and allocation concealment. But more could be done, especially in lower impact factor journals.

摘要

为了考察过去三十年中,随机对照试验(RCT)中关键方法特征的报告质量差和方法不充分的情况如何变化。 对 Cochrane 综述中包含的试验进行了映射。 数据来自于 2011 年 3 月至 2014 年 9 月期间发表的所有 Cochrane 综述中报告了 Cochrane 偏倚风险评估项目的 RCT:随机序列生成、分配隐藏、盲法和不完整结局数据。 对于每个 RCT,我们提取了综述作者的偏倚风险共识,并确定了主要参考文献以提取出版年份和期刊。我们将期刊名称与 进行匹配,以获得 2014 年的影响因子。 我们将综述作者评价为不确定和高偏倚风险的试验比例分别视为报告质量差和方法不充分的替代指标。 我们分析了 2001 年发表在 3136 种期刊上的 20920 项 RCT。 随机序列生成不确定风险的试验比例为 48.7%,分配隐藏不确定风险的试验比例为 57.5%;高偏倚风险的试验比例分别为 4.0%和 7.2%。 对于盲法和不完整结局数据,不确定风险的试验比例分别为 30.6%和 24.7%,高风险的试验比例分别为 33.1%和 17.1%。 期刊影响因子越高,不确定或高偏倚风险的试验比例越低。 不确定风险的试验比例随时间推移而降低,特别是随机序列生成,从 1986-1990 年的 69.1%降至 2011-14 年的 31.2%,分配隐藏(从 70.1%降至 44.6%)。 排除不确定风险的试验后,不充分方法的使用也随时间推移而减少:随机序列生成从 14.8%降至 4.6%,分配隐藏从 32.7%降至 11.6%。 报告质量差和方法不充分的情况随时间推移而减少,特别是在随机序列生成和分配隐藏方面。 但是,还有更多的工作要做,特别是在影响因子较低的期刊中。

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