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与非药物试验相比,药物试验更有可能披露完整的安慰剂对照信息:一项对安慰剂对照试验参与者信息手册的横断面研究。

Drug trials are more likely to disclose full placebo control information than non-drug trials: A cross-sectional study of participant information leaflets of placebo-controlled trials.

作者信息

Won Jiyoon, Han Ji-Yeon, Ji Yu-Jin, Ha Dohyung, Han Bong Jae, Lee Hyangsook

机构信息

Department of Meridian & Acupoint, College of Korean Medicine, Dong-eui University, Busan, South Korea.

Department of Medical Science of Meridian, College of Korean Medicine, Kyung Hee University, Seoul, South Korea.

出版信息

Integr Med Res. 2024 Jun;13(2):101043. doi: 10.1016/j.imr.2024.101043. Epub 2024 Apr 17.

Abstract

BACKGROUND

This study aimed to investigate whether placebo control is differently disclosed in drug and non-drug randomised clinical trial (RCT) participant information leaflets (PILs) and how this might affect participant blinding and direction of study outcomes.

METHODS

PILs were obtained from trials registered in the International Standard Randomised Controlled Trial Number database via email. Placebo descriptions in PILs were categorised as Full Disclosure (FD), Partial Disclosure (PD), or Missing Information (MI). Associations between intervention type (drug or non-drug)/placebo disclosure (FD or PD/MI) and participant blinding success/trial outcome direction (positive or non-positive) were examined using a two-sided Fisher's exact test.

RESULTS

Of 116 collected PILs, 56 % were for drug trials and 44 % were for non-drug trials. Among them, 88 PILs had the corresponding publications available and 68 reports specified primary outcomes. Drug trials were more likely to fully disclose placebo information than non-drug trials (92.3 % vs. 74.5 %, < 0.05). However, the success rate of blinding was only reported in 3 out of 88 trial publications (3.4 %), precluding further analysis. Furthermore, there was no significant association between the direction of trial results and the type of intervention or placebo disclosure.

CONCLUSION

Our study findings suggest that drug and non-drug RCTs might differ in the way they reveal placebo control information. Further research is warranted to understand what leads to more common PD of placebo information in non-drug trials than drug trials and to determine the optimal placebo control disclosure in specific trial context.

摘要

背景

本研究旨在调查在药物和非药物随机临床试验(RCT)参与者信息手册(PIL)中,安慰剂对照的披露方式是否存在差异,以及这可能如何影响参与者的盲法和研究结果的方向。

方法

通过电子邮件从国际标准随机对照试验编号数据库中注册的试验获取PIL。PIL中的安慰剂描述分为完全披露(FD)、部分披露(PD)或信息缺失(MI)。使用双侧Fisher精确检验检查干预类型(药物或非药物)/安慰剂披露(FD或PD/MI)与参与者盲法成功/试验结果方向(阳性或非阳性)之间的关联。

结果

在收集的116份PIL中,56%用于药物试验,44%用于非药物试验。其中,88份PIL有相应的出版物,68份报告指定了主要结局。与非药物试验相比,药物试验更有可能完全披露安慰剂信息(92.3%对74.5%,<0.05)。然而,在88份试验出版物中,只有3份报告了盲法成功率(3.4%),无法进行进一步分析。此外,试验结果的方向与干预类型或安慰剂披露之间没有显著关联。

结论

我们的研究结果表明,药物和非药物RCT在揭示安慰剂对照信息的方式上可能存在差异。有必要进行进一步的研究,以了解导致非药物试验中安慰剂信息的部分披露比药物试验更常见的原因,并确定在特定试验背景下的最佳安慰剂对照披露方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/859b/11109310/28b440747470/gr1.jpg

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