Kang Hyun
Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Anesth Pain Med (Seoul). 2021 Apr;16(2):138-150. doi: 10.17085/apm.21038. Epub 2021 Apr 30.
Systematic reviews and meta-analyses rank the highest in the evidence hierarchy. However, they still have the risk of spurious results because they include too few studies and participants. The use of trial sequential analysis (TSA) has increased recently, providing more information on the precision and uncertainty of meta-analysis results. This makes it a powerful tool for clinicians to assess the conclusiveness of meta-analysis. TSA provides monitoring boundaries or futility boundaries, helping clinicians prevent unnecessary trials. The use and interpretation of TSA should be based on an understanding of the principles and assumptions behind TSA, which may provide more accurate, precise, and unbiased information to clinicians, patients, and policymakers. In this article, the history, background, principles, and assumptions behind TSA are described, which would lead to its better understanding, implementation, and interpretation.
系统评价和荟萃分析在证据等级体系中排名最高。然而，它们仍有得出虚假结果的风险，因为纳入的研究和参与者数量过少。试验序贯分析（TSA）的应用近来有所增加，它能提供更多关于荟萃分析结果的精确性和不确定性的信息。这使其成为临床医生评估荟萃分析结论性的有力工具。TSA提供监测界限或无效界限，帮助临床医生避免不必要的试验。TSA的使用和解读应基于对其背后原理和假设的理解，这可为临床医生、患者和政策制定者提供更准确、精确且无偏倚的信息。本文描述了TSA背后的历史、背景、原理和假设，这将有助于更好地理解、实施和解读TSA。
