Olivier Timothée
Département d'oncologie, Hôpitaux universitaires de Genève, 1211 Genève 14.
Rev Med Suisse. 2024 May 15;20(874):954-959. doi: 10.53738/REVMED.2024.20.874.954.
The analysis of randomized clinical trials presents a challenge for clinicians. A set of critical elements can facilitate their interpretation. One must question whether the inclusion and exclusion criteria accurately mirror clinical practice. Does the control arm align with what is currently recognized as best practice? Do patients in the control group have access to the best options when the cancer progresses or recurs? The degree of confidence with which phase II trial results can be interpreted also warrants consideration. Finally, informative censoring can be searched for by comparing early censoring rates between treatment arms. Faced with the challenges of interpreting scientific literature, these keys can help the clinician and guide the eventual integration of new results into shared medical decision-making.
对随机临床试验进行分析给临床医生带来了挑战。一组关键要素有助于对其进行解读。必须质疑纳入和排除标准是否准确反映了临床实践。对照组是否与当前公认的最佳实践相符?当癌症进展或复发时,对照组的患者能否获得最佳选择?对II期试验结果的可解释置信度也值得考虑。最后,可以通过比较各治疗组的早期截尾率来寻找信息性截尾情况。面对解读科学文献的挑战,这些关键要素可以帮助临床医生,并指导最终将新结果纳入共同的医疗决策。