Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK.
Rheumatology Department, Queen Elizabeth Hospital, NHS Foundation Trust, Kings Lynn, Norfolk, UK.
Age Ageing. 2019 Jul 1;48(4):595-598. doi: 10.1093/ageing/afz018.
clinical trials test the effectiveness or efficacy of treatments. It is important that researchers evaluate interventions with the most meaningful outcome measures. The 2014 hip fracture core outcome set recommended that mortality, mobility, pain, activities of daily living and health-related quality of life (HRQOL) should be assessed in all trials of patient with hip fracture. The purpose of this analysis was to determine the uptake of these recommendation.
all trials registered from 1997 to 2018 recruiting participants following hip fracture were identified from the ClinicalTrials.gov trials registry. The frequency of each core domain adopted annually were assessed.
311 trials were identified and analysed. On analysing trial registries for years which presented a minimum of 10 registrations, full core outcome set adoption ranged from 0% (2017; 2018) to 24% (2009). Mortality and mobility were the most consistently reported domains (mortality: 27% (2017) to 56% (2011); mobility: 36% (2015) to 60% (2004)). In contrast, pain and HRQOL were least reported (pain: 14% (2017) to 61% (2015); HRQOL: 10% (2010) to 11% (2008)). There was no clear change in core outcome domain set adoption following the publication of Hayward et al.'s (2014) core outcome set.
there has been limited adoption of the hip fracture core outcome set from its publication in 2014. Further consideration to improve implementation is required to improved uptake.
临床试验测试治疗的有效性。研究人员使用最有意义的结果测量方法来评估干预措施非常重要。2014 年髋部骨折核心结局集建议,所有髋部骨折患者的试验均应评估死亡率、活动能力、疼痛、日常生活活动和健康相关生活质量(HRQOL)。本分析的目的是确定这些建议的采用情况。
从 ClinicalTrials.gov 试验注册处确定了从 1997 年到 2018 年注册的所有招募髋部骨折患者的试验。每年采用每个核心领域的频率进行评估。
确定并分析了 311 项试验。分析至少有 10 项注册的年份的试验注册,完整核心结局集的采用率从 0%(2017 年;2018 年)到 24%(2009 年)不等。死亡率和活动能力是报告最一致的领域(死亡率:27%(2017 年)至 56%(2011 年);活动能力:36%(2015 年)至 60%(2004 年))。相比之下,疼痛和 HRQOL 的报告最少(疼痛:14%(2017 年)至 61%(2015 年);HRQOL:10%(2010 年)至 11%(2008 年))。Hayward 等人(2014 年)核心结局集发表后,核心结局域集的采用并没有明显改变。需要进一步考虑以提高实施率,从而提高采用率。
自 2014 年髋部骨折核心结局集发布以来,其采用率有限。需要进一步考虑提高实施率,以提高采用率。