Fahey T, Hyde C, Milne R, Thorogood M
Department of Social Medicine, University of Bristol.
J Public Health Med. 1995 Dec;17(4):469-74.
Randomized controlled trials (RCTs) are increasingly being used to evaluate the effectiveness of health care interventions. Systematic reviews of RCTs form the basis of the Cochrane Collaboration, which aims to synthesize all RCTs concerned with the provision of health care. This paper reports the quantity and methodological quality of RCTs published in five UK public health journals, which were searched as part of a planned register of RCTs in public health.
Five journals were hand searched: The International Journal of Epidemiology, Health Trends, Journal of Public Health Medicine, Public Health and The Journal of Epidemiology and Community Health. All RCTs were identified and their methodological characteristics reviewed.
Ninety-one trials were identified from the five journals. A wide variety of topics were covered, the most common being prevention strategies )46 percent of the trials). Although the actual number of reports of RCTs published increased over time, there was no detectable improvement in the quality of reports. The aspect of bias most well controlled was control of bias at entry (randomization), in 83 (91 per cent) of trials. However, even in these trials details about the process of randomization were poor.
These trials will form the basis of a register of RCTs in public health. The diversity of topics covered illustrates the broad-based nature of public health. For this reason, many other RCTs relevant to the practice of public health are likely to be found in non-public health journals.
随机对照试验(RCT)越来越多地用于评估卫生保健干预措施的有效性。对随机对照试验的系统评价构成了Cochrane协作网的基础,该协作网旨在综合所有与卫生保健提供相关的随机对照试验。本文报告了在英国五份公共卫生期刊上发表的随机对照试验的数量和方法学质量,这些期刊是作为公共卫生随机对照试验计划登记册的一部分进行检索的。
对五份期刊进行手工检索:《国际流行病学杂志》《健康趋势》《公共卫生医学杂志》《公共卫生》以及《流行病学与社区卫生杂志》。识别出所有随机对照试验并对其方法学特征进行审查。
从这五份期刊中识别出91项试验。涵盖了广泛的主题,最常见的是预防策略(占试验的46%)。尽管随机对照试验发表报告的实际数量随时间增加,但报告质量没有明显提高。控制得最好的偏倚方面是入组时的偏倚控制(随机化),在83项(91%)试验中做到了这一点。然而,即使在这些试验中,随机化过程的细节也很差。
这些试验将构成公共卫生随机对照试验登记册的基础。所涵盖主题的多样性说明了公共卫生的广泛性质。因此,很可能在非公共卫生期刊中找到许多与公共卫生实践相关的其他随机对照试验。