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随机对照试验报告质量在治疗成人高级别脑胶质瘤中的应用。

Quality of Randomized Controlled Trials Reporting in the Treatment of Adult Patients with High-Grade Gliomas.

机构信息

Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France.

Department of Biostatistics, Centre Antoine Lacassagne, Nice, France.

出版信息

Oncologist. 2018 Mar;23(3):337-345. doi: 10.1634/theoncologist.2017-0196. Epub 2017 Nov 13.

Abstract

BACKGROUND

The randomized controlled trial (RCT) is the gold standard to objectively assess the effect of treatments. To help improve the quality of RCTs, experts established a list of recommendations, the CONsolidated Standards of Reporting Trials (CONSORT) Statement. In this study, we evaluated the implementation of the CONSORT Statement in the field of high-grade gliomas in adult patients and looked for criteria associated with higher quality of RCTs.

MATERIALS AND METHODS

We searched all high-grade gliomas RCTs published in PubMed between January 1990 and December 2016. The quality of these RCTs was assessed by completing a modified CONSORT Score (CS).

RESULTS

Ninety-six published RCTs were identified. The median CS was 19.5 on a scale of 0-33. Items were not equally reported. Items regarding the method of randomization or the blinding were reported in less than 25% of RCTs. However, the CS has constantly improved over the years. Before the implementation of the CONSORT Statement in 1996, the median CS was 13, whereas it was 17 for the period 1996-2004 and 22 after 2005. A higher CS was observed when RCTs were published in a journal with an impact factor above 10 ( < .001) or after 2010 ( = .001), when the primary outcome was clearly defined ( < .001) and for RCTs that enrolled more than 200 patients ( = .004).

CONCLUSION

Although there has been a steady improvement in the CS over the years in the field of high-grade gliomas, a major effort must be made in the reporting methods for randomization and blinding.

IMPLICATIONS FOR PRACTICE

This study showed that the quality of reporting of randomized control trials (RCTs) concerning the treatment of high-grade gliomas is poor. Factors associated with a better quality of reports were identified and should be incorporated into the design of future RCTs. When clinicians read the results of RCTs, they should be aware of the possible inadequate reporting from these trials and take it into account for the management of their patients. This study identifies how RCTs can be improved in their reporting but also in their design, in order to advance care for patients with high-grade gliomas in the future.

摘要

背景

随机对照试验(RCT)是客观评估治疗效果的金标准。为了帮助提高 RCT 的质量,专家们制定了一系列建议,即 CONSORT 报告标准(CONSORT)声明。在这项研究中,我们评估了 CONSORT 声明在成人高级别脑胶质瘤领域的实施情况,并寻找与 RCT 质量更高相关的标准。

材料和方法

我们在 PubMed 中搜索了 1990 年 1 月至 2016 年 12 月期间发表的所有高级别脑胶质瘤 RCT。通过完成改良 CONSORT 评分(CS)评估这些 RCT 的质量。

结果

共确定了 96 项发表的 RCT。0-33 分制的中位数 CS 为 19.5。项目没有均等报告。关于随机化方法或盲法的项目在不到 25%的 RCT 中报告。然而,CS 多年来一直在不断提高。在 1996 年 CONSORT 声明实施之前,CS 的中位数为 13,而在 1996-2004 年期间为 17,在 2005 年之后为 22。当 RCT 发表在影响因子高于 10(<.001)的期刊上或在 2010 年后(=0.001)、主要结局定义明确(<.001)和纳入超过 200 名患者的 RCT 时(=0.004),CS 更高。

结论

尽管在高级别脑胶质瘤领域,CS 多年来一直在稳步提高,但在随机化和盲法的报告方法方面仍需做出重大努力。

实践意义

本研究表明,高级别脑胶质瘤治疗的随机对照试验(RCT)报告质量较差。确定了与报告质量更高相关的因素,应将其纳入未来 RCT 的设计中。当临床医生阅读 RCT 的结果时,他们应该意识到这些试验可能存在报告不充分,并在为患者治疗时考虑到这一点。本研究确定了如何在报告和设计方面改进 RCT,以便为未来高级别脑胶质瘤患者的治疗提供帮助。

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