Bobbio M, Demichelis B, Giustetto G
Divisione Universitaria di Cardiologia, Ospedale Mollnette, Torino, Italy.
Lancet. 1994 May 14;343(8907):1209-11. doi: 10.1016/s0140-6736(94)92407-4.
Clinical trials may lead to conflicting results. We studied how different ways of reporting results affected physicians' recommendations. A questionnaire distributed to 148 general practitioners presented results of a clinical trial where a reduction of cardiac events and an increase of mortality was reported. Results were shown in four different ways--relative risk reduction, absolute risk reduction, percentages of event-free patients, number needing to be treated to prevent an event--as if they derived from different trials. A fifth presentation was the reduced rate of cardiac events along with the increased rate of mortality. Physicians were asked to estimate how much they would be willing to prescribe each drug. The mean agreement of physicians' decisions was 77 (28)% for relative risk reduction, 24 (28)% for absolute risk reduction, 37 (37)% for different percentages event-free patients, 34 (34)% for number need to treat, and 23 (28)% for events reduction and mortality for increase (p < 0.001 relative risk vs others). The method of reporting trial results and the completeness of information in the case of controversial results affects physicians willingness to prescribe.
临床试验可能会得出相互矛盾的结果。我们研究了不同的结果报告方式如何影响医生的建议。向148名全科医生发放的一份调查问卷展示了一项临床试验的结果,该试验报告了心脏事件减少和死亡率增加的情况。结果以四种不同方式呈现——相对风险降低、绝对风险降低、无事件患者百分比、预防一个事件所需治疗的人数——就好像它们来自不同的试验一样。第五种呈现方式是心脏事件发生率降低以及死亡率增加。医生们被要求估计他们愿意开每种药物的程度。医生决策的平均一致性在相对风险降低方面为77(28)%,绝对风险降低方面为24(28)%,不同无事件患者百分比方面为37(37)%,所需治疗人数方面为34(34)%,事件减少和死亡率增加方面为23(28)%(相对风险与其他方式相比,p < 0.001)。报告试验结果的方法以及有争议结果情况下信息的完整性会影响医生开药的意愿。