Conroy Elizabeth J, Arch Barbara, Harman Nicola L, Lane J Athene, Lewis Steff C, Norrie John, Sydes Matthew R, Gamble Carrol
MRC North West Hub for Trials Methodology Research, Department of Biostatistics, University of Liverpool, Block F Waterhouse Building, 1-5 Brownlow Street, Liverpool, L69 3GL, UK.
Clinical Trials Research Centre, University of Liverpool, Liverpool, UK.
Trials. 2017 Dec 8;18(1):590. doi: 10.1186/s13063-017-2300-1.
The DAMOCLES project established a widely used Data Monitoring Committee (DMC) Charter for randomised controlled trials (RCTs). Typically, within the UK, the DMC is advisory and recommends to another executive body; the Trial Steering Committee (TSC). Despite the executive role of the TSC, the CONSORT Statement does not explicitly require reporting of TSC activity, although is included as an example of good reporting. A lack of guidance on TSC reporting can impact transparency of trial oversight, ultimately leading to a misunderstanding regarding role and, subsequently, further variation in practice. This review aimed to establish reporting practice of TSC involvement in RCTs, and thus make recommendations for reporting.
A cohort examination identifying reporting practice was undertaken. The cohort comprised RCTs published in three leading medical journals (the British Medical Journal, The Lancet and the New England Journal of Medicine) within 6 months in 2012 and the full NIHR HTA Monograph series. Details of TSC constitution and impact were extracted from main publications and published supplements.
Of 415 publications, 264 were eligible. These were typical in terms of trial design. Variations in reporting between journals and monographs was notable. TSC presence was identified in approximately half of trials (n = 144), of which 109 worked alongside a DMC. No publications justified not convening a TSC. When reported, the role of the committee and examples of impact in design, conduct and analysis were summarised.
We present the first review of reporting TSC activity in the published academic literature. An absence of reporting standards with regards to TSC constitution, activity and impact on trial conduct was identified which can influence transparency of reporting trial oversight. Consistent reporting is vital for the benefits and impact of the TSC role to be understood to support adoption of this oversight structure and reduce global variations in practice.
达摩克利斯项目为随机对照试验(RCT)制定了广泛使用的数据监测委员会(DMC)章程。通常在英国,数据监测委员会具有咨询职能,并向另一个执行机构——试验指导委员会(TSC)提出建议。尽管试验指导委员会发挥执行作用,但《CONSORT声明》并未明确要求报告试验指导委员会的活动,不过将其作为良好报告的一个示例。缺乏关于试验指导委员会报告的指南可能会影响试验监督的透明度,最终导致对其作用的误解,进而导致实践中的进一步差异。本综述旨在确定试验指导委员会参与随机对照试验的报告实践,从而提出报告建议。
进行了一项队列研究以确定报告实践。该队列包括2012年6个月内在三种主要医学期刊(《英国医学杂志》《柳叶刀》和《新英格兰医学杂志》)上发表的随机对照试验以及完整的英国国家卫生研究院卫生技术评估专题论文系列。试验指导委员会的组成和影响细节从主要出版物和已发表的增刊中提取。
在415篇出版物中,264篇符合条件。这些在试验设计方面具有代表性。期刊和专题论文之间的报告差异显著。在大约一半的试验(n = 144)中发现了试验指导委员会,其中109个与数据监测委员会协同工作。没有出版物说明不设立试验指导委员会的理由。当进行报告时,会总结委员会的作用以及在设计、实施和分析方面的影响示例。
我们首次对已发表学术文献中试验指导委员会活动的报告进行了综述。发现缺乏关于试验指导委员会组成、活动及其对试验实施影响的报告标准,这可能会影响试验监督报告透明度。一致的报告对于理解试验指导委员会作用的益处和影响至关重要,以支持采用这种监督结构并减少全球实践中的差异。