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两项网状meta 分析中随机对照试验的选择性报告偏倚:临床试验注册与出版物的比较。

Selective reporting bias in randomised controlled trials from two network meta-analyses: comparison of clinical trial registrations and their respective publications.

机构信息

Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.

Department of Geriatric Medicine, University of Toronto, Toronto, Ontario, Canada.

出版信息

BMJ Open. 2019 Sep 5;9(9):e031138. doi: 10.1136/bmjopen-2019-031138.

Abstract

OBJECTIVE

To determine (i) the difference in the frequency of serious adverse events (SAEs) reported in trial registrations and their respective primary publications and (ii) the effect of adding SAE data from registries to a network meta-analysis (NMA) in changing the surface under the cumulative ranking (SUCRA) curve values of interventions.

DESIGN

Secondary analysis of primary publications from two NMAs.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

We included randomised trials published in English after 2005 that were included in two NMAs of pharmacological interventions for Alzheimer's disease and chronic obstructive pulmonary disease.

DATA EXTRACTION

Two reviewers independently searched multiple international trial registries for registration status and abstracted data from the included study publications and ClinicalTrials.gov.

RESULTS

Of the 203 randomised trials included, 140 (69.0%) were registered with a trial registry and 72 (35.5%) posted results in the registry. The proportion of registered trials increased over time (38.5% in 2005 vs 78.6% in 2014). Of the publications with results posted in a trial registry, 14 (19.4%) had inconsistent reporting of overall SAEs; 7 (10.4%) studies did not report SAEs in the publication but did in the registry. In the 134 randomised trials with a prespecified primary outcome in the registry, 19 studies (9.4%) had a change in the primary outcome in the publication. Adding SAEs reported in registries to the NMAs did not affect the ranking of interventions.

CONCLUSION

We identified inconsistent reporting of SAEs in randomised trials that were included in two NMAs. Findings highlight the importance of including trial registries in the grey literature search and verifying safety data before incorporating it into NMAs.

STUDY REGISTRATION

osf.io/mk6dr.

摘要

目的

确定(i)试验注册和相应主要出版物中报告的严重不良事件(SAE)频率的差异,以及(ii)将来自注册中心的 SAE 数据添加到网络荟萃分析(NMA)中对改变干预措施累积排序(SUCRA)曲线值的影响。

设计

对两项 NMA 的主要出版物进行二次分析。

纳入研究的选择标准

我们纳入了 2005 年后发表的、以英文发表的随机试验,这些试验被纳入了两项治疗阿尔茨海默病和慢性阻塞性肺疾病的药理学干预的 NMA。

数据提取

两位审查员独立搜索了多个国际试验注册中心,以获取注册状态,并从纳入研究的出版物和 ClinicalTrials.gov 中提取数据。

结果

在纳入的 203 项随机试验中,140 项(69.0%)在试验注册中心注册,72 项(35.5%)在注册中心发布结果。注册试验的比例随时间增加(2005 年为 38.5%,2014 年为 78.6%)。在有结果发布在试验注册中心的出版物中,14 项(19.4%)有总体 SAE 的不一致报告;7 项(10.4%)研究在出版物中未报告 SAE,但在注册中心报告了 SAE。在注册中心有预设主要结局的 134 项随机试验中,19 项(9.4%)在出版物中的主要结局发生了变化。将注册中心报告的 SAE 添加到 NMA 中并没有影响干预措施的排名。

结论

我们发现纳入两项 NMA 的随机试验中存在 SAE 的不一致报告。研究结果强调了在纳入 NMA 之前,在灰色文献搜索中包括试验注册中心和验证安全性数据的重要性。

研究注册

osf.io/mk6dr。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7978/6731894/6d8e4b8dace8/bmjopen-2019-031138f01.jpg

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