Naka Fludiona, Strober Bruce, Shahriari Mona
University of Connecticut School of Medicine, Farmington, CT.
Department of Dermatology, University of Connecticut Health Center, Farmington, CT.
Clin Dermatol. 2017 Nov-Dec;35(6):583-593. doi: 10.1016/j.clindermatol.2017.08.008. Epub 2017 Aug 9.
Clinical trials are the backbone of modern evidence-based medicine. They are the vital bridge between research-based discovery and cutting edge patient care. Randomized, controlled clinical trials are the gold standard of medical research, providing a method for evaluation and discovery of novel therapies that improve and even save lives. Despite an increase in the number of pediatric and adult clinical trials over recent decades, this growth has not been equal among these populations. The volume of clinical trials involving children lags substantially behind their adult counterparts. Children are not simply little adults. As a result, extrapolating results from adult clinical trials to the treatment of children may be inappropriate and, possibly, harmful. In this review, we discuss the intricacies of performing clinical trials in all patients and stress the unique distinguishing characteristics of pediatric clinical trials.
临床试验是现代循证医学的支柱。它们是基于研究的发现与前沿患者护理之间至关重要的桥梁。随机对照临床试验是医学研究的金标准,为评估和发现可改善甚至挽救生命的新疗法提供了一种方法。尽管近几十年来儿科和成人临床试验的数量有所增加,但这种增长在这些人群中并不均衡。涉及儿童的临床试验数量大幅落后于成人。儿童并非仅仅是小成年人。因此,将成人临床试验的结果外推至儿童治疗可能并不恰当,甚至可能有害。在本综述中,我们讨论了在所有患者中开展临床试验的复杂性,并强调了儿科临床试验独特的显著特征。