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中医药观察性研究可能提供与随机对照试验近乎一致的证据:一项Meta流行病学研究。

Observational studies of traditional Chinese medicine may provide evidence nearly consistent with the randomized controlled trials: A meta-epidemiological study.

作者信息

Song Haiqi, Li Nian, Yang Wenjie, Wu Miaomiao, Liao Xiaoyang, Zhang Yonggang

机构信息

General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, PR China.

Department of Medical Administration, West China Hospital, Sichuan University, Chengdu, PR China.

出版信息

Integr Med Res. 2022 Dec;11(4):100889. doi: 10.1016/j.imr.2022.100889. Epub 2022 Oct 9.

Abstract

BACKGROUND

In traditional Chinese medicine (TCM) field, the benefits of observational studies was more significant. Whether the evidence from observational studies agreed with RCTs in the field of TCM was still unclear.

METHODS

A meta-epidemiological study was conducted. Meta-analyses and systematic reviews including cohort studies and case-control studies of TCM were included. Ratio of odds ratio (ROR) of randomized controlled trials and observational studies were calculated individually and intercomparisons were conducted by pool analysis.

RESULTS

A total of 11 studies and 30 outcome pairs were included in the pool analysis. Using results from the observational studies as the reference group, the polled ROR comparing randomized controlled trials with observational studies was 1.23 (95% confidence interval 1.05 to 1.44, and 95% prediction interval 0.90 to 1.68). The ROR by subgroup analysis were 1.15 (95% confidence interval 0.96 to 1.38; 95% prediction interval 0.95 to 1.39) and 1.12 (95% confidence interval 0.86 to 1.46; 95% prediction interval 0.51 to 2.47) for cohort studies and case-control studies, respectively.

CONCLUSIONS

There is difference in pooled results between randomized controlled studies and observational studies on TCM. However, the prediction interval shows the difference is small, which suggests observational studies of TCM can be included in data analysis to provide evidence for TCM. Future studies are needed to verify the above conclusion.

摘要

背景

在中医领域,观察性研究的益处更为显著。观察性研究的证据是否与中医领域的随机对照试验一致仍不明确。

方法

进行了一项元流行病学研究。纳入了包括中医队列研究和病例对照研究的元分析和系统评价。分别计算随机对照试验和观察性研究的比值比(ROR),并通过合并分析进行相互比较。

结果

合并分析共纳入11项研究和30对结局。以观察性研究的结果为参照组,将随机对照试验与观察性研究进行比较的合并ROR为1.23(95%置信区间1.05至1.44,95%预测区间0.90至1.68)。队列研究和病例对照研究的亚组分析ROR分别为1.15(95%置信区间0.96至1.38;95%预测区间0.95至1.39)和1.12(95%置信区间0.86至1.46;95%预测区间0.51至2.47)。

结论

中医随机对照研究和观察性研究的合并结果存在差异。然而,预测区间显示差异较小,这表明中医观察性研究可纳入数据分析以提供中医证据。未来需要进一步研究验证上述结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ad7/9636547/b3ee2351ce84/gr1.jpg

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