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随机对照试验中的常见设计概念。

Common Design Concepts in Randomized Controlled Trials.

作者信息

Egbewale Bolaji Emmanuel

机构信息

Department of Community Medicine, Ladoke Akintola University of Technology, Ogbomoso, Nigeria.

出版信息

Niger Med J. 2020 Mar-Apr;61(2):51-54. doi: 10.4103/nmj.NMJ_112_19. Epub 2020 May 7.

DOI:10.4103/nmj.NMJ_112_19
PMID:32675894
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7357810/
Abstract

It is a known fact that Randomized Controlled Trials (RCTs) are the gold standard design methods in medical investigations particularly when the aim is comparison of medical therapies or effectiveness of intervention between treatment groups. This design method, once carefully followed, presents the highest level of evidence attainable in the measurement of treatment effect. Oftentimes, researchers confuse concepts related to the design of RCTs and thereby jeopardizing its benefits. Furthermore, in resource-poor settings, a very limited access to educational materials on design, conduct, and reporting of clinical trials exists. This among other reasons explains why most studies in such settings are observational in nature as RCTs are not as popular. This review adopted a narrative synthesis approach to aggregate current knowledge scattered in literatures in respect of selected common design concepts in RCTs so as to elucidate on their meaning and demands. Overall, 25 literatures drawn majorly from the PubMed database including 8 textbook materials were involved in examining the following concepts; Study Population in RCTs Setting, Primary and Secondary Outcome Measures, Single and Multicenter Trials, Pragmatic and Explanatory trials, and Blinding. Appropriate search terms for each of the concepts were entered into the PubMed database and relevant articles accessed. This review article, intended for educational purposes could also serve as a guide, especially for new entrants, in the design of RCTs. It is hoped that this educational material would contribute immensely toward maximizing the benefits of this all-important design method.

摘要

众所周知,随机对照试验(RCTs)是医学研究中的金标准设计方法,尤其是当目的是比较医学疗法或治疗组之间干预效果时。这种设计方法一旦被严格遵循,就能在测量治疗效果方面提供可达到的最高证据水平。然而,研究人员常常混淆与RCT设计相关的概念,从而损害其益处。此外,在资源匮乏的环境中,关于临床试验设计、实施和报告的教育材料获取非常有限。这以及其他原因解释了为什么在这种环境下大多数研究本质上是观察性的,因为RCT并不那么流行。本综述采用叙述性综合方法,汇总文献中分散的关于RCT选定常见设计概念的现有知识,以阐明其含义和要求。总体而言,主要从PubMed数据库中选取的25篇文献,包括8篇教材,参与了对以下概念的研究:RCT设置中的研究人群、主要和次要结局指标、单中心和多中心试验、实用性和解释性试验以及盲法。将每个概念的适当检索词输入PubMed数据库并获取相关文章。这篇旨在用于教育目的的综述文章也可作为RCT设计的指南,特别是对新进入者而言。希望这份教育材料将极大地有助于最大化这种极其重要的设计方法的益处。

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本文引用的文献

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The design of multicentre trials.多中心试验的设计。
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Pragmatic clinical trials.实用临床试验。
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