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Comprender la heterogeneidad de la respuesta al tratamiento utilizando ensayos controlados aleatorios cruzados: una
Lorenzo Lolli1, Javi Gonzalez2, Oliver Shannon3
1Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom.
International journal of sport nutrition and exercise metabolism
|August 28, 2025
Resumen
Los ensayos controlados aleatorios cruzados (ECA) pueden revelar la heterogeneidad de la respuesta al tratamiento. Los ECA cruzados replicados, un tipo de ensayo n-de-1, son cruciales para la medicina de precisión al cuantificar los efectos del tratamiento individual.
Área de la Ciencia:
- Ciencias del ejercicio y la nutrición
- Estadísticas biológicas
- Medicina de precisión
Sus antecedentes:
- Los ensayos controlados aleatorios cruzados (ECA) se utilizan ampliamente en la investigación del ejercicio y la nutrición.
- Estos ensayos son poderosos para detectar los efectos medios del tratamiento.
- Comprender la heterogeneidad de la respuesta al tratamiento es clave para la medicina personalizada.
Objetivo del estudio:
- Revisar la información de los ECA cruzados con respecto a la heterogeneidad de la respuesta al tratamiento.
- Describir los componentes de variación subyacentes a los datos observados en los ECA cruzados.
- Explorar la utilidad de los ECA cruzados y los ensayos n-de-1 para la medicina de precisión.
Principales métodos:
- Describir las cuestiones fundamentales de diseño de los ECA cruzados.
- Cuantificación del componente de variación por persona por tratamiento mediante ECA cruzados repetidos (ciclos múltiples).
- Comparación de varios enfoques de análisis de datos para sintetizar los hallazgos de seis ECA cruzados publicados.
Principales resultados:
- Se encontró un acuerdo general entre los diferentes enfoques de análisis de datos para ECA cruzados replicados.
- Existe un vínculo entre la consistencia de la respuesta dentro de la persona y la detección de interacciones persona-tratamiento.
- Las comparaciones de varianza emparejadas pueden ofrecer información preliminar sobre la heterogeneidad de la respuesta, pero requieren ECA n-de-1 o ECA cruzados de replicación para su confirmación.
Conclusiones:
- Los ensayos de ciclo múltiple n-de-1 y los ECA cruzados replicados se utilizan insuficientemente, pero son informativos para la heterogeneidad de la respuesta al tratamiento.
- Estos diseños de ensayo son componentes esenciales para predecir la magnitud de la respuesta individual al tratamiento.
- Se necesitan más investigaciones y la aplicación de estos diseños de ensayos para avanzar en las estrategias de tratamiento personalizado.
Palabras clave:
Efectos de trasladoPruebas cruzadasPruebas n-de-1persona por interacción con el tratamientoMedicina de precisiónComparación de la varianzaComponentes de la varianzaPeríodo de lavadoMás Videos Relacionados
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