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阳性结果发表对正在进行的试验的影响。

Implications for trials in progress of publication of positive results.

作者信息

Fletcher A, Spiegelhalter D, Staessen J, Thijs L, Bulpitt C

机构信息

Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, UK.

出版信息

Lancet. 1993 Sep 11;342(8872):653-7. doi: 10.1016/0140-6736(93)91762-b.

Abstract

It is not easy to decide, when results from similar trials appear, whether a trial still underway should be stopped or not. The weight of the other evidence has to be taken into account--as indeed it has to be for decisions by clinicians and by health service managers outside the settings of a trial. Taking the Systolic Hypertension in the Elderly Trial (SHEP) as an example, we show how its results are not unequivocal (ie, there is no proof beyond reasonable doubt). This verdict justifies the continuation of similar trials in progress. More generally--but again for individual clinicians and for trial organisers and again with SHEP as the example--we illustrate a bayesian approach to trial-termination decisions.

摘要

当相似试验的结果出现时,很难决定一个仍在进行中的试验是否应该停止。必须考虑其他证据的权重——实际上,临床医生和医疗服务管理者在试验环境之外做决策时也必须考虑这一点。以老年收缩期高血压试验(SHEP)为例,我们展示了其结果并非确凿无疑(即没有排除合理怀疑的证据)。这一结论证明正在进行的类似试验继续进行是合理的。更普遍地说——但同样以SHEP为例,针对个体临床医生以及试验组织者——我们阐述一种用于试验终止决策的贝叶斯方法。

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