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基于 CONSORT 声明评估新型口服抗凝剂治疗静脉血栓栓塞疾病的随机对照试验报告质量。

Assessment of the reporting quality of RCTs for novel oral anticoagulants in venous thromboembolic disease based on the CONSORT statement.

机构信息

Department of Neurology, School of Medicine, University Hospital of Larissa, University of Thessaly, Biopolis, Mezourlo Hill, 41100, Larissa, Greece.

Department of Neurosurgery, School of Medicine, University Hospital of Larissa, University of Thessaly, Larissa, Greece.

出版信息

J Thromb Thrombolysis. 2019 Nov;48(4):542-553. doi: 10.1007/s11239-019-01931-9.

Abstract

Randomized controlled trials (RCTs) are the cornerstone of evidence based medicine. Ιt is crucial that RCTs have transparent reporting to facilitate their interpretation. The purpose of the present study is the evaluation of the reporting quality of RCTs for novel oral anticoagulants (NOACs) in venous thromboembolism (VTE) based on the CONSORT statement. MEDLINE was meticulously searched, while quoted references by retrieved RCTs were manually screened. The primary objective was to establish the mean CONSORT compliance of RCTs for NOACs in VTE. Secondary objectives were the calculation of compliance per CONSORT item and the investigation for probable determining factors with regards to the reporting quality of RCTs. Reporting above 70% of the items was defined as adequate compliance to the CONSORT statement. A total of 83 articles were considered eligible. Mean adherence to the CONSORT statement was 61.84%, standard deviation (SD) = 18.72. Among retrieved studies, 35 (42.17%) reported above 70% of the items, while 48 (57.83%) described less than 70% of the items. Inter-rater agreement was satisfactory (Cohen's kappa ≥ 0.75). Items with respect to randomization and blinding were principally underreported, whereas the rest of the methodological features and results were more sufficiently reported. Logistic regression failed to demonstrate significant effect for any of the factors investigated. Impact factor [odds ratio (OR) = 1.347, 95% confidence interval (CI) (0.994, 1.826), p = 0.055], number of authors [OR = 1.277, 95% CI (0.975, 1.672), p = 0.076] and presentation of participant flow-diagram [OR = 55.358, 95% CI (0.914, 3351.765), p = 0.055], came closer to significance. Exploratory analysis revealed significant, strong, positive correlation between abstract and article adherence to the CONSORT guidelines (r = 0.851, p < 0.001). Reporting quality of RCTs for NOACs in VTE is moderate. A superior reporting quality is desirable, especially relating to randomization and blinding.

摘要

随机对照试验(RCTs)是循证医学的基石。确保 RCT 具有透明的报告,以方便解释至关重要。本研究的目的是根据 CONSORT 声明评估新型口服抗凝剂(NOACs)治疗静脉血栓栓塞症(VTE)的 RCT 报告质量。精心搜索了 MEDLINE,并手动筛选了检索到的 RCT 的引用参考文献。主要目标是确定 VTE 中 NOACs 的 RCT 符合 CONSORT 标准的平均比例。次要目标是计算每个 CONSORT 项目的依从性,并调查与 RCT 报告质量有关的可能决定因素。报告超过 70%的项目被定义为符合 CONSORT 声明的标准。共有 83 篇文章被认为符合条件。对 CONSORT 声明的平均依从率为 61.84%,标准差(SD)=18.72。在所检索的研究中,35 项(42.17%)报告了超过 70%的项目,而 48 项(57.83%)描述了不到 70%的项目。评分者间一致性令人满意(Cohen's kappa≥0.75)。关于随机化和盲法的项目主要报告不足,而其余的方法学特征和结果则得到了更充分的报告。逻辑回归未能证明任何调查因素有显著影响。影响因子[比值比(OR)=1.347,95%置信区间(CI)(0.994,1.826),p=0.055]、作者数量[OR=1.277,95%CI(0.975,1.672),p=0.076]和呈现参与者流程图[OR=55.358,95%CI(0.914,3351.765),p=0.055]接近显著。探索性分析显示,摘要和文章对 CONSORT 指南的依从性之间存在显著、强烈、正相关(r=0.851,p<0.001)。VTE 中 NOACs 的 RCT 报告质量中等。需要提高报告质量,特别是与随机化和盲法有关的报告质量。

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