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多囊卵巢综合征核心结局指标发表前后的采用情况。

Uptake of the core outcome set on polycystic ovary syndrome before and after its publication.

机构信息

Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, People's Republic of China.

Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, People's Republic of China.

出版信息

Hum Reprod. 2023 Sep 5;38(9):1816-1824. doi: 10.1093/humrep/dead149.

Abstract

STUDY QUESTION

Does the core outcome set (COS) on polycystic ovary syndrome (PCOS) impact the selection of research outcomes?

SUMMARY ANSWER

Following the publication of the COS on PCOS, an increasing number of trials are reporting both the generic domain and body mass index; however, the uptake of this COS has not been as extensive as expected.

WHAT IS KNOWN ALREADY

The COS on PCOS included 33 core outcomes in the following seven domains: the generic (3), metabolic (8), reproductive (7), pregnancy (10), psychological (3), oncological (1), and long-term (1). This was done to improve consistency in outcome selection and definition. However, thus far, no studies have investigated the effectiveness of this COS in the above-mentioned tasks.

STUDY DESIGN, SIZE, DURATION: A methodological study based on the trial registries, including 395 eligible clinical trials registered between 1 January 2018 and 21 September 2022.

PARTICIPANTS/MATERIALS, SETTING, METHODS: A total of 1258 registered clinical studies on PCOS were retrieved from the World Health Organization International Clinical Trials Registry Platform. Of those, 395 were selected according to the inclusion and exclusion criteria, and divided into two groups based on the publication date of the COS on PCOS (4 February 2020): pre-publication and post-publication. The practical uptake of this COS was explored after data collation, assessment, comparison of the uptake of core outcomes or domains before and after the publication of this COS, and correlation analysis between the domains.

MAIN RESULTS AND THE ROLE OF CHANCE

There were 26 out of 33 core outcomes and five out of seven domains reported in the 395 trials. The highest uptake was observed for the reproductive domain and the reproductive hormonal profile (63.0% and 38.7%, respectively). After the publication of the COS on PCOS, the uptake of the generic domain and body mass index increased from 24.1% to 35.8% (P = 0.011) and 17.8% to 26.5% (P = 0.039), respectively. The total number of reported core outcomes in the generic domain met statistical significance (P = 0.012). Moreover, multivariable analyses still supported the above finding in the generic domain. Correlation analysis showed that most of the domains were positively correlated with each other. However, the pregnancy domain was negatively correlated with the metabolic domain. Reasons responsible for the unsatisfactory uptake may be the absence of specific definitions of core outcomes, as well as the lack of awareness among researchers regarding this COS.

LIMITATIONS, REASONS FOR CAUTION: Due to the lack of standardized definition of outcomes, it was difficult to avoid some subjectivity in the process of consistency assessment.

WIDER IMPLICATIONS OF THE FINDINGS

Two years after its publication, there was no substantial improvement in the uptake of the COS on PCOS. This suggests that this COS may require further revision, refinement, and promotion to improve the comparability of PCOS studies.

STUDY FUNDING/COMPETING INTEREST(S): This work was funded by Beijing Municipal Health Science and Technology Achievements and Appropriate Technology Promotion Project (BHTPP2022069), and the special fund of Beijing Key Clinical Specialty Construction Project. The authors do not have conflicts of interest to declare.

TRIAL REGISTRATION NUMBER

N/A.

摘要

研究问题

多囊卵巢综合征(PCOS)的核心结局集(COS)是否会影响研究结果的选择?

总结答案

在 PCOS 的 COS 发表后,越来越多的试验报告了通用领域和体重指数;然而,该 COS 的采用程度并没有预期的那么广泛。

已知情况

PCOS 的 COS 包括以下七个领域的 33 个核心结果:通用(3)、代谢(8)、生殖(7)、妊娠(10)、心理(3)、肿瘤学(1)和长期(1)。这是为了提高结果选择和定义的一致性。然而,迄今为止,尚无研究调查该 COS 在上述任务中的有效性。

研究设计、大小和持续时间:这是一项基于试验登记的方法学研究,包括 2018 年 1 月 1 日至 2022 年 9 月 21 日期间登记的 395 项合格临床试验。

参与者/材料、设置、方法:从世界卫生组织国际临床试验注册平台检索了 1258 项关于 PCOS 的注册研究。其中,根据纳入和排除标准选择了 395 项,并根据 PCOS COS 的发表日期(2020 年 2 月 4 日)分为两组:发表前和发表后。在数据整理、评估、比较该 COS 发表前后核心结果或领域的采用情况以及相关性分析之后,探讨了该 COS 的实际采用情况。

主要结果和机会的作用

在 395 项试验中,有 26 项核心结果和 7 个领域中的 5 项得到了报告。生殖领域和生殖激素谱的采用率最高(分别为 63.0%和 38.7%)。在 PCOS COS 发表后,通用领域和体重指数的采用率从 24.1%增加到 35.8%(P=0.011)和 17.8%增加到 26.5%(P=0.039)。通用领域报告的核心结果总数具有统计学意义(P=0.012)。此外,多变量分析仍然支持通用领域的上述发现。相关性分析表明,大多数领域彼此之间呈正相关。然而,妊娠领域与代谢领域呈负相关。采用不理想的原因可能是缺乏核心结果的具体定义,以及研究人员对该 COS 的认识不足。

局限性、谨慎的原因:由于结局的标准化定义缺失,在一致性评估过程中很难避免一些主观性。

研究结果的更广泛影响

在发表两年后,PCOS COS 的采用率并没有实质性提高。这表明该 COS 可能需要进一步修订、完善和推广,以提高 PCOS 研究的可比性。

研究资金/利益冲突:本工作得到北京市卫生科技成果和适宜技术推广项目(BHTPP2022069)和北京市重点临床专科建设项目专项资金的支持。作者没有利益冲突需要声明。

试验注册编号

无。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b7/10477939/328b2e43c704/dead149f1.jpg

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