Bothner U, Seeling W, Schwilk B, Pfenninger E, Georgieff M
Universitätsklinik für Anästhesiologie, Klinikum der Universität Ulm.
Anasthesiol Intensivmed Notfallmed Schmerzther. 1995 Jun;30(4):220-5. doi: 10.1055/s-2007-996479.
This article was written to give researchers and clinicians a short synopsis of ethical and thorough design, conduct, analysis, publication, and interpretation of randomised controlled clinical trials according to the European quality standards of Good Clinical Practice (GCP). The paper consists of two parts. In the first part we introduce important elements of study design, especially study hypothesis, criteria of inclusion and study population, sample size calculation, validity considerations, bias and confounding, randomisation, stratification, and masking of treatment assignment. Different treatment allocation like multiple parallel groups, factorial experiment, cross-over, and sequential design are presented. Requirements of ethical standards according to the Declaration of Helsinki are discussed for their necessity in any experimentation in humans. Principles of informed consent are demonstrated with emphasis on special conditions in anaesthesia, emergency medicine, and intensive care research. In the second part of this article we explain issues of baseline assessment, experimental intervention, data recording, and data monitoring, particularly of negative or hazardous treatment effects. Topics of data analysis and reporting of trial results in publications are illustrated with regard to their influence on subsequent interpretation.
本文旨在根据欧洲药品临床试验质量管理规范(GCP)的质量标准,为研究人员和临床医生提供一份关于随机对照临床试验的伦理及全面设计、实施、分析、发表和解读的简短概述。本文分为两部分。在第一部分中,我们介绍研究设计的重要要素,特别是研究假设、纳入标准和研究人群、样本量计算、有效性考量、偏倚和混杂因素、随机化、分层以及治疗分配的设盲。还介绍了不同的治疗分配方式,如多个平行组、析因试验、交叉试验和序贯设计。讨论了《赫尔辛基宣言》中伦理标准的要求在任何人体实验中的必要性。阐述了知情同意原则,重点强调了麻醉、急诊医学和重症监护研究中的特殊情况。在本文的第二部分,我们解释基线评估、实验干预、数据记录和数据监测等问题,特别是关于负面或有害治疗效果的问题。阐述了数据分析主题以及出版物中试验结果的报告对后续解读的影响。