Guerrera Francesco, Renaud Stéphane, Tabbò Fabrizio, Filosso Pier Luigi
Department of Thoracic Surgery, University of Torino, Torino, Italy.
Department of Thoracic Surgery, Nancy University Hospital, Nancy, France.
J Thorac Dis. 2017 Aug;9(8):2692-2696. doi: 10.21037/jtd.2017.06.147.
Randomized controlled trials (RCTs) are considered one of the highest level of evidence in clinical practice, due to their strong confidence and robustness in producing data. The "randomization" (e.g., allocating patients randomly in each group of the study) allows eliminating many pre-analytical differences that might bias the entire study. Nevertheless, RCTs aren't free of internal pitfalls that might make them not easy to be developed or utilized. Our objective is to explain RCT management difficulties and suggest certain tips useful for the design of a RCT in thoracic disease domain. In particular have a realistic timeline, define a clear objective and precise endpoints, balance the study with a correct randomization and focus on the right equilibrium between strict selection criteria and more heterogeneous parameters are key elements that help researchers assuring a strong scientific validity.
随机对照试验(RCTs)被认为是临床实践中最高级别的证据之一,因为它们在产生数据方面具有很强的可信度和稳健性。“随机化”(例如,将患者随机分配到研究的每组中)可以消除许多可能使整个研究产生偏差的分析前差异。然而,随机对照试验并非没有内部缺陷,这些缺陷可能使其难以开展或应用。我们的目的是解释随机对照试验管理中的困难,并提出一些对胸科疾病领域随机对照试验设计有用的建议。特别是制定一个现实的时间表、定义明确的目标和精确的终点、通过正确的随机化使研究平衡,以及关注严格选择标准和更多异质性参数之间的正确平衡,这些都是帮助研究人员确保强大科学有效性的关键要素。