Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.
Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.
JAMA Netw Open. 2018 Aug 3;1(4):e181065. doi: 10.1001/jamanetworkopen.2018.1065.
As medical knowledge and clinical practice rapidly evolve over time, there is an imperative to publish results of clinical trials in a timely way and reduce unnecessary delays.
To characterize the age of clinical trial data at the time of publication in journals with a high impact factor and highlight the time from final data collection to publication.
A cross-sectional analysis was conducted of all randomized clinical trials published from January 1 through December 31, 2015, in the Annals of Internal Medicine, BMJ, JAMA, JAMA Internal Medicine, Lancet, and New England Journal of Medicine. Multivariable linear regression analyses were conducted to assess whether data age (adjusted for follow-up duration) and publication time were associated with trial characteristics.
The outcome measures were the midpoint of data collection until publication (data age), the time from first participant enrollment to last participant enrollment (enrollment time), and the time from final data collection to publication (publication time).
There were 341 clinical trials published in 2015 by the 6 journals. For assessment of the primary end point, 37 trials (10.9%) had a follow-up period of less than 1 month, 172 trials (50.4%) had a follow-up period of 1 month to 1 year, and 132 trials (38.7%) had a follow-up period of more than 1 year. For all trials, the median data age at publication was 33.9 months (interquartile range, 23.5-46.3 months). Among trials with a follow-up period of 1 month or less, the median data age was 30.6 months (interquartile range, 18.6-39.0 months). A total of 68 trials (19.9%) required more than 4 years to complete enrollment. The median time from the completion of data collection to publication was 14.8 months (interquartile range, 7.4-22.2 months); publication time was 2 or more years in 63 trials (18.5%). In multivariable regression analyses adjusted for follow-up time, inconclusive or unfavorable trial results were significantly associated with older data age (>235 days). Compared with trials funded only by private industry, trials funded by government were associated with a significantly longer time to publication (>180 days).
Clinical trials in journals with a high impact factor were published with a median data age of nearly 3 years. For a substantial proportion of studies, time for enrollment and time from completion of data collection to publication were quite long, indicating marked opportunities for improvement in clinical trials to reduce data age.
随着医学知识和临床实践的快速发展,及时发表临床试验结果并减少不必要的延误至关重要。
描述高影响因子期刊上发表的临床试验数据的年龄,并强调从最终数据收集到发表的时间。
对 2015 年 1 月 1 日至 12 月 31 日期间在《内科学年鉴》、《英国医学杂志》、《美国医学会杂志》、《美国医学会杂志-内科学》、《柳叶刀》和《新英格兰医学杂志》上发表的所有随机临床试验进行了横断面分析。采用多变量线性回归分析评估数据年龄(随访时间调整后)和发表时间是否与试验特征相关。
结局指标是数据收集到发表的中点(数据年龄)、从第一例参与者入组到最后一例参与者入组的时间(入组时间)以及从最终数据收集到发表的时间(发表时间)。
在 2015 年,这 6 种期刊共发表了 341 项临床试验。对于主要终点评估,37 项试验(10.9%)的随访期小于 1 个月,172 项试验(50.4%)的随访期为 1 个月至 1 年,132 项试验(38.7%)的随访期超过 1 年。对于所有试验,发表时的中位数数据年龄为 33.9 个月(四分位距,23.5-46.3 个月)。在随访期为 1 个月或更短的试验中,中位数数据年龄为 30.6 个月(四分位距,18.6-39.0 个月)。共有 68 项试验(19.9%)需要超过 4 年才能完成入组。从数据收集完成到发表的中位数时间为 14.8 个月(四分位距,7.4-22.2 个月);63 项试验(18.5%)发表时间为 2 年或以上。在调整随访时间的多变量回归分析中,不确定或不利的试验结果与较老的数据年龄(>235 天)显著相关。与仅由私营企业资助的试验相比,政府资助的试验与发表时间显著延长(>180 天)相关。
高影响因子期刊上发表的临床试验发表时的中位数数据年龄接近 3 年。对于相当一部分研究,入组时间和从数据收集完成到发表的时间都相当长,表明临床试验在减少数据年龄方面有很大的改进空间。