School of Nursing, University of Auckland, New Zealand; National Institute for Health Innovation, University of Auckland, New Zealand.
School of Medicine, University of Auckland, New Zealand.
J Tissue Viability. 2020 Aug;29(3):155-160. doi: 10.1016/j.jtv.2019.09.005. Epub 2019 Sep 28.
To be in accord with the Consolidated Standards of Reporting Trials (CONSORT) Statement, all important adverse events in randomised controlled trials (RCTs) should be reported, as well as trial registration. Neither concern has been investigated in venous leg ulcer trials. We therefore aimed to quantify and explore compliance with adverse event reporting and trials registration in RCTs that reported interventions for treating venous leg ulceration.
We searched the Cochrane Controlled Trials Register, Medline, Embase, and CINAHL for studies reported between 2001 and 2017. Included studies must have been described as randomised controlled trials evaluating any intervention in a VLU population. Data was then extracted by one author into a standard form and checked by a second author.
We screened 3100 titles and identified 204 trials involving pharmaceuticals (82), medicated and non-medicated devices (102), organisational (5) or other interventions (15) published in 76 journals. Eighty-four trials reported adverse events (41.2%), while 18 reported no events occurred (8.8%) and 78 did not report adverse events (38.2%). Types of adverse events reported included all-cause (20.1%), ulcer-related only (38.2%), treatment-related only (11.3%) and serious adverse events only (1.0%). Only 38 trials were registered (18.6%). Trial registration was associated with reporting of any adverse events (Odds Ratio 3.0, 95%CI 1.1-7.9), as was the trial being a pharmaceutical trial (Odds Ratio 2.9, 95%CI 1.5-5.7) or a multicentre trial (Odds Ratio 4.2, 95%CI 2.2-8.1).
Adverse event reporting in VLU trials is variable with about one third of trials not reporting on adverse events at all. Trials registration is a the modifiable factor associated with better reporting of adverse events. Journal editors could explore how they can promote trials registration to enhance better reporting of harms in VLU trials.
为了符合《临床试验报告统一标准》(CONSORT)声明,所有随机对照试验(RCT)中的重要不良事件都应该报告,并且要进行试验注册。这两个问题在静脉溃疡试验中都没有得到调查。因此,我们旨在量化并探讨报告静脉溃疡治疗干预 RCT 中不良事件报告和试验注册的情况。
我们在 Cochrane 对照试验注册库、Medline、Embase 和 CINAHL 中搜索了 2001 年至 2017 年期间发表的研究。纳入的研究必须被描述为评估静脉溃疡人群中任何干预措施的随机对照试验。然后,一位作者将数据提取到一个标准表格中,并由第二位作者进行检查。
我们筛选了 3100 个标题,确定了 204 项涉及药物(82 项)、敷药和非敷药设备(102 项)、组织(5 项)或其他干预措施(15 项)的试验,这些试验发表在 76 种期刊上。84 项试验报告了不良事件(41.2%),18 项试验报告没有发生任何事件(8.8%),78 项试验没有报告不良事件(38.2%)。报告的不良事件类型包括全因(20.1%)、仅与溃疡相关(38.2%)、仅与治疗相关(11.3%)和仅与严重不良事件相关(1.0%)。只有 38 项试验进行了注册(18.6%)。试验注册与报告任何不良事件相关(优势比 3.0,95%CI 1.1-7.9),试验为药物试验(优势比 2.9,95%CI 1.5-5.7)或多中心试验(优势比 4.2,95%CI 2.2-8.1)也是如此。
静脉溃疡试验中的不良事件报告存在差异,约有三分之一的试验根本没有报告不良事件。试验注册是与更好地报告不良事件相关的可修改因素。期刊编辑可以探讨如何促进试验注册,以加强静脉溃疡试验中危害的报告。