MRC North West Hub for Trials Methodology Research, Department of Biostatistics, Institute of Translational Medicine, University of Liverpool, Liverpool L69 3GS, UK.
School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health Institute for Health Sciences, Northern Ireland Methodology Hub, Queen's University Belfast, Belfast, UK.
J Clin Epidemiol. 2018 Apr;96:84-92. doi: 10.1016/j.jclinepi.2017.12.020. Epub 2017 Dec 28.
There is increasing recognition that insufficient attention has been paid to the choice of outcomes measured in clinical trials. The lack of a standardized outcome classification system results in inconsistencies due to ambiguity and variation in how outcomes are described across different studies. Being able to classify by outcome would increase efficiency in searching sources such as clinical trial registries, patient registries, the Cochrane Database of Systematic Reviews, and the Core Outcome Measures in Effectiveness Trials (COMET) database of core outcome sets (COS), thus aiding knowledge discovery.
A literature review was carried out to determine existing outcome classification systems, none of which were sufficiently comprehensive or granular for classification of all potential outcomes from clinical trials. A new taxonomy for outcome classification was developed, and as proof of principle, outcomes extracted from all published COS in the COMET database, selected Cochrane reviews, and clinical trial registry entries were classified using this new system.
Application of this new taxonomy to COS in the COMET database revealed that 274/299 (92%) COS include at least one physiological outcome, whereas only 177 (59%) include at least one measure of impact (global quality of life or some measure of functioning) and only 105 (35%) made reference to adverse events.
This outcome taxonomy will be used to annotate outcomes included in COS within the COMET database and is currently being piloted for use in Cochrane Reviews within the Cochrane Linked Data Project. Wider implementation of this standard taxonomy in trial and systematic review databases and registries will further promote efficient searching, reporting, and classification of trial outcomes.
越来越多的人认识到,在临床试验中,人们对测量结果的选择重视不足。由于缺乏标准化的结局分类系统,不同研究之间对结局的描述存在模糊性和变异性,导致结果不一致。通过对结局进行分类,可以提高对临床试验注册库、患者登记库、Cochrane 系统评价数据库和核心结局测量在有效性试验(COMET)核心结局集数据库等来源的搜索效率,从而有助于知识发现。
进行了文献回顾,以确定现有的结局分类系统,但没有一个系统足够全面或细致,无法对临床试验中所有潜在结局进行分类。开发了一种新的结局分类分类法,并作为原理验证,使用这个新系统对 COMET 数据库中的所有已发表的核心结局集(COS)、选定的 Cochrane 评价和临床试验登记条目进行了分类。
将这个新分类法应用于 COMET 数据库中的 COS 发现,299 个 COS 中有 274 个(92%)至少包含一个生理结局,而只有 177 个(59%)包含至少一个影响测量(总体生活质量或某种功能测量),只有 105 个(35%)提到了不良事件。
这个结局分类法将用于对 COMET 数据库中包含的 COS 进行注释,目前正在 Cochrane 链接数据项目中对 Cochrane 评价进行试点使用。在试验和系统评价数据库和登记库中更广泛地实施这个标准分类法,将进一步促进试验结局的高效搜索、报告和分类。