J Chronic Dis. 1983;36(6):467-79. doi: 10.1016/0021-9681(83)90138-8.
The Coronary Primary Prevention Trial (CPPT), a double-blind, randomized clinical trial being conducted by 12 Lipid Research Clinics in North America, was initiated in 1973 to test whether long-term reduction of plasma total cholesterol in individuals with Type II hyperlipoproteinemia would reduce the incidence of coronary heart disease. The trial is scheduled to conclude in 1983. Here we document that a major requirement of the CPPT--the comparability of the control and experimental groups prior to cholesterol-lowering treatment--has been achieved. The 3810 men participating in the CPPT were allocated to either treatment group at each clinic on the basis of low density lipoprotein cholesterol, S-T segment response to graded exercise testing, and the logistic risk function of age, smoking and diastolic blood pressure. Randomization was performed separately within each of the 96 cells thereby defined. An extensive battery of tests and questionnaires also yielded other laboratory measurements, data on health habits and family history, and sociodemographic information. Mean plasma total cholesterol levels were 291.8 mg/dl for the placebo group, and 291.5 mg/dl for the cholestyramine group. The other lipid and lipoprotein cholesterol levels were very similar in the two treatment groups. Among the 83 variables examined, only five differed significantly (P less than 0.05)--height, weight, albumin, 2-hr-post-challenge glucose, and serum aspartate amino-transferase (AST, SGOT)--and these differences were deemed to be so small as to have little or no clinical importance. Inasmuch as chance alone could produce four statistically different variables, we concluded that it seemed highly likely that the observed differences were attributable to random fluctuation. Thus, we have determined that the randomization process has resulted in two very nearly identical groups.
冠状动脉一级预防试验(CPPT)是一项由北美12家脂质研究诊所进行的双盲随机临床试验,于1973年启动,旨在测试II型高脂蛋白血症患者长期降低血浆总胆固醇水平是否会降低冠心病的发病率。该试验计划于1983年结束。在此我们记录到,CPPT的一项主要要求——即降胆固醇治疗前对照组和试验组的可比性——已经实现。参与CPPT的3810名男性在每家诊所根据低密度脂蛋白胆固醇、分级运动试验的S-T段反应以及年龄、吸烟和舒张压的逻辑风险函数被分配到两个治疗组之一。随机化在由此定义的96个单元格中的每一个内分别进行。一系列广泛的测试和问卷调查还产生了其他实验室测量结果、健康习惯和家族史数据以及社会人口统计学信息。安慰剂组的平均血浆总胆固醇水平为291.8mg/dl,消胆胺组为291.5mg/dl。两个治疗组的其他脂质和脂蛋白胆固醇水平非常相似。在检查的83个变量中,只有5个变量有显著差异(P<0.05)——身高、体重、白蛋白、口服葡萄糖耐量试验2小时后血糖以及血清天冬氨酸转氨酶(AST,SGOT)——而且这些差异被认为非常小,几乎没有临床意义。由于仅靠随机因素就可能产生4个统计学上不同的变量,我们得出结论,观察到的差异很可能归因于随机波动。因此,我们确定随机化过程产生了两个几乎完全相同的组。