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系统评价随机分组方法在 RCT 中的应用,以及试验设计特征与方法选择的相关性。

A systematic review of randomisation method use in RCTs and association of trial design characteristics with method selection.

机构信息

Nottingham Clinical Trials Unit, University of Nottingham, Applied Health Research Building, Nottingham, NG7 2RD, UK.

出版信息

BMC Med Res Methodol. 2022 Dec 7;22(1):314. doi: 10.1186/s12874-022-01786-4.

Abstract

BACKGROUND

When conducting a randomised controlled trial, there exist many different methods to allocate participants, and a vast array of evidence-based opinions on which methods are the most effective at doing this, leading to differing use of these methods. There is also evidence that study characteristics affect the performance of these methods, but it is unknown whether the study design affects researchers' decision when choosing a method.

METHODS

We conducted a review of papers published in five journals in 2019 to assess which randomisation methods are most commonly being used, as well as identifying which aspects of study design, if any, are associated with the choice of randomisation method. Randomisation methodology use was compared with a similar review conducted in 2014.

RESULTS

The most used randomisation method in this review is block stratification used in 162/330 trials. A combination of simple, randomisation, block randomisation, stratification and minimisation make up 318/330 trials, with only a small number of more novel methods being used, although this number has increased marginally since 2014. More complex methods such as stratification and minimisation seem to be used in larger multicentre studies.

CONCLUSIONS

Within this review, most methods used can be classified using a combination of simple, block stratification and minimisation, suggesting that there is not much if any increase in the uptake of newer more novel methods. There seems to be a noticeable polarisation of method use, with an increase in the use of simple methods, but an increase in the complexity of more complex methods, with greater numbers of variables included in the analysis, and a greater number of strata.

摘要

背景

在进行随机对照试验时,存在许多不同的方法来分配参与者,并且有大量基于证据的观点认为哪种方法最有效,从而导致这些方法的使用方式不同。还有证据表明,研究特征会影响这些方法的性能,但尚不清楚研究设计是否会影响研究人员选择方法时的决策。

方法

我们对 2019 年五本期刊上发表的论文进行了综述,以评估哪些随机化方法最常用,并确定研究设计的哪些方面(如果有的话)与随机化方法的选择有关。随机化方法的使用与 2014 年进行的类似综述进行了比较。

结果

在本次综述中,最常用的随机化方法是在 330 项试验中的 162 项中使用的分组分层法。简单随机化、分组随机化、分层和最小化的组合构成了 330 项试验中的 318 项,只有少数较新的方法被使用,尽管自 2014 年以来,这种方法的数量略有增加。更复杂的方法,如分层和最小化,似乎在更大的多中心研究中使用。

结论

在本次综述中,大多数使用的方法可以用简单、分组分层和最小化的组合来分类,这表明如果有任何新方法的采用率增加,也不会太多。方法的使用似乎出现了明显的两极分化,简单方法的使用有所增加,但更复杂方法的复杂性也有所增加,分析中包含的变量更多,分层也更多。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2460/9727841/f576f0196d63/12874_2022_1786_Fig1_HTML.jpg

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