Sackett D L, Cook D J
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Ann N Y Acad Sci. 1993 Dec 31;703:25-31; discussion 31-2. doi: 10.1111/j.1749-6632.1993.tb26331.x.
In summary, then, we can learn three useful things from small clinical trials. First, we can learn when to challenge conventional but untested therapeutic wisdom. Second, because the patient number in any trial is the number of events, rather than the number of study patients, some small trials are so definitively positive that they are sufficient to identify the best therapy. And third, small trials, even when individually inconclusive, can serve as the basis for convincingly conclusive overviews and meta-analyses that carry, and deserve, greater credibility than a single large trial of similar size to their sum.
总之,我们可以从小型临床试验中学到三件有用的事情。第一,我们可以了解何时对传统但未经检验的治疗理念提出挑战。第二,由于任何试验中的事件数量而非研究患者数量才是关键,所以一些小型试验结果非常明确且积极,足以确定最佳治疗方法。第三,小型试验即使单独来看尚无定论,也可作为令人信服的确定性综述和荟萃分析的基础,这些综述和荟萃分析所具有的可信度高于将它们加起来规模相当的单个大型试验,且当之无愧。