Universidade Federal de São João del Rei, Divinópolis, MG, Brazil.
Universidade de Itaúna, Itaúna, MG, Brazil.
Einstein (Sao Paulo). 2022 May 6;20:eAO6859. doi: 10.31744/einstein_journal/2022AO6859. eCollection 2022.
To identify and analyze the quality of scientific evidence from clinical efficacy studies present in the package inserts of coagulation factors, used in the treatment of hemophilia A and B.
Documentary study developed in two stages. The first stage consisted of identifying the medicine packages inserts electronically registered in the Brazilian Health Regulatory Agency, and analyzing the availability of the bibliographic references cited therein. This analysis was conducted in the PubMed, SciELO, Google Scholar, and Web of Science databases. The second step was the analysis of the methodological quality of the efficacy studies. Two trained researchers used the Cochrane Collaboration Risk of Bias version 5.1.0 tools for methodological quality analysis, and Review Manager 5.4 software to generate the risk of bias graph.
Of the 17 medicines listed, 7 had referenced package inserts. Of these, 10 studies were eligible for analysis of methodological quality. More than half of the analyzed studies did not control for selection, performance, and detection bias. A total of 100% controlled attrition and reporting biases, and 50% had a high risk of conflict of interest.
The biases present are significant and may have influenced the overestimation of the effects of the outcomes of each of the studies.
识别和分析血友病 A 和 B 治疗用凝血因子的药品说明书中临床疗效研究的科学证据质量。
文献研究分两个阶段进行。第一阶段包括电子检索巴西卫生监管机构注册的药品说明书,并分析其中引用的文献参考的可用性。这一分析在 PubMed、SciELO、Google Scholar 和 Web of Science 数据库中进行。第二步是对疗效研究的方法学质量进行分析。两名经过培训的研究人员使用 Cochrane 协作风险偏倚评估工具 5.1.0 对方法学质量进行分析,并使用 Review Manager 5.4 软件生成风险偏倚图。
在所列出的 17 种药物中,有 7 种有参考药品说明书。在这些说明书中,有 10 项研究符合方法学质量分析的条件。分析中超过一半的研究没有控制选择、表现和检测偏倚。总共 100%控制了失访和报告偏倚,50%存在高利益冲突风险。
存在的偏倚是显著的,可能影响了每个研究结果的效应的高估。