Epidemiology and Evidence Based Medicine, School of Public Health, Gansu University of Chinese Medicine, Lanzhou City, Gansu Province, P.R. China; Public Health and Health Services Research, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK.
Public Health and Health Services Research, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK.
J Clin Epidemiol. 2019 Apr;108:17-25. doi: 10.1016/j.jclinepi.2018.12.009. Epub 2018 Dec 15.
The aim of the article was to assess the appropriateness and rationales of subgroup analyses planned in protocols of randomized controlled trials and reported in subsequent corresponding trial publications.
We searched PubMed to identify trial protocols published in journals during 2006-2017. From a total of 3,774 initially identified records, we included a random sample of 479 protocols and identified 280 trial publications corresponding to the included protocols.
Subgroup analyses were specified in 19% of the protocols and reported in 21% of the trial publications. Of the 94 protocols with planned subgroup analyses, 32% mentioned testing for interaction, and only three considered statistical power. Subgroup analyses were not prespecified in 56% of the 59 trial publications with subgroup analyses. Subgroup analyses were stated as prespecified in nine trial publications, without support evidence from the corresponding protocols. Subgroup analyses were often reported insufficiently for assessing the consistency of subgroup effects across studies. Justifications for subgroup analyses were provided in only four trial protocols and seven trial publications.
Inappropriate specification and reporting of subgroup analyses remain problematic in protocols and reports of randomized controlled trials. Justifications or rationales for subgroup analyses were only rarely provided in trial protocols and reports.
本文旨在评估随机对照试验方案中计划的亚组分析的适当性和合理性,并报告随后相应的试验出版物。
我们在 PubMed 中搜索了 2006 年至 2017 年期间发表在期刊上的试验方案。从最初确定的 3774 条记录中,我们随机抽取了 479 个方案,并确定了与纳入方案相对应的 280 个试验出版物。
在方案中,19%规定了亚组分析,在试验出版物中,21%报告了亚组分析。在有计划的亚组分析的 94 个方案中,32%提到了交互检验,只有 3 个考虑了统计功效。在有亚组分析的 59 个试验出版物中,56%没有预先规定亚组分析。在 9 个试验出版物中,亚组分析被陈述为预先设定的,但没有来自相应方案的支持证据。亚组分析的报告往往不足以评估研究间亚组效应的一致性。在仅有的 4 个试验方案和 7 个试验出版物中,对亚组分析提供了理由。
在随机对照试验的方案和报告中,亚组分析的不适当规定和报告仍然存在问题。在试验方案和报告中,对亚组分析的理由或合理性很少提供。