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临床试验.gov 上严重不良事件和死亡率数据与相应期刊文章和 FDA 医疗审查的比较: 横断面分析。

Comparison of Data on Serious Adverse Events and Mortality in ClinicalTrials.gov, Corresponding Journal Articles, and FDA Medical Reviews: Cross-Sectional Analysis.

机构信息

Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA, 01655-0002, USA.

Department of Family Medicine and Community Health, Meyers Primary Care Institute, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA, 01655-0002, USA.

出版信息

Drug Saf. 2018 Sep;41(9):849-857. doi: 10.1007/s40264-018-0666-y.

Abstract

INTRODUCTION

Inconsistencies in data on serious adverse events (SAEs) and mortality in ClinicalTrials.gov and corresponding journal articles pose a challenge to research transparency.

OBJECTIVE

The objective of this study was to compare data on SAEs and mortality from clinical trials reported in ClinicalTrials.gov and corresponding journal articles with US Food and Drug Administration (FDA) medical reviews.

METHODS

We conducted a cross-sectional study of a randomly selected sample of new molecular entities approved during the study period 1 January 2013 to 31 December 2015. We extracted data on SAEs and mortality from 15 pivotal trials from ClinicalTrials.gov and corresponding journal articles (the two index resources), and FDA medical reviews (reference standard). We estimated the magnitude of deviations in rates of SAEs and mortality between the index resources and the reference standard.

RESULTS

We found deviations in rates of SAEs (30% in ClinicalTrials.gov and 30% in corresponding journal articles) and mortality (72% in ClinicalTrials.gov and 53% in corresponding journal articles) when compared with the reference standard. The intra-class correlation coefficient between the three resources was 0.99 (95% confidence interval [CI] 0.98-0.99) for SAE rates and 0.99 (95% CI 0.97-0.99) for mortality rates.

CONCLUSION

There are differences in data on rates of SAEs and mortality in randomized clinical trials in both ClinicalTrials.gov and journal articles compared with FDA reviews. Further efforts should focus on decreasing existing discrepancies to enhance the transparency and reproducibility of data reporting in clinical trials.

摘要

简介

ClinicalTrials.gov 和相应的期刊文章中严重不良事件(SAE)和死亡率数据的不一致性给研究透明度带来了挑战。

目的

本研究旨在比较 ClinicalTrials.gov 报告的临床试验中的 SAE 和死亡率数据与美国食品和药物管理局(FDA)医学审查报告的数据。

方法

我们对研究期间(2013 年 1 月 1 日至 2015 年 12 月 31 日)批准的新分子实体进行了一项随机选择样本的横断面研究。我们从 ClinicalTrials.gov 和相应的期刊文章(两个索引资源)中提取了 15 项关键试验的 SAE 和死亡率数据,以及 FDA 医学审查报告(参考标准)。我们估计了索引资源与参考标准之间 SAE 和死亡率发生率偏差的幅度。

结果

与参考标准相比,我们发现了 SAE 发生率(ClinicalTrials.gov 为 30%,相应的期刊文章为 30%)和死亡率(ClinicalTrials.gov 为 72%,相应的期刊文章为 53%)的偏差。三个资源之间的组内相关系数为 SAE 发生率 0.99(95%置信区间[CI]0.98-0.99),死亡率 0.99(95% CI 0.97-0.99)。

结论

ClinicalTrials.gov 和期刊文章中随机临床试验的 SAE 和死亡率数据与 FDA 审查存在差异。应进一步努力减少现有差异,以提高临床试验数据报告的透明度和可重复性。

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