薬剤の比較効果に関する公表された研究の特徴
Michael Hochman1, Danny McCormick
1Department of Medicine, Cambridge Health Alliance, Cambridge and Harvard Medical School, Boston, Massachusetts, USA. mhochman@usc.edu
JAMA
|March 11, 2010
まとめ
トップジャーナルに掲載されている医薬品研究の約3分の1は,比較有効性 (CE) 研究である. ほとんどのCE研究は非商業的に資金提供され,安全性や費用対効果に焦点を当てることはめったにありませんでした.
科学分野:
- 薬理学 薬理学とは
- 医療サービス 研究 医療サービス
- クリニック・トライアル 臨床試験
背景:
- 医学における比較有効性 (CE) 研究に対する需要が高まっている.
- 既存のCE研究の特徴に関する理解は限られている.
研究 の 目的:
- 医薬品を評価する最近発表されたCE研究を特徴づける.
- CE研究における比較の種類,結果,資金調達,研究デザインを分析する.
主な方法:
- ランダム化試験,観察研究,および医薬品のメタ分析の分析.
- 2008年6月から2009年9月までの6つのインパクトの高い一般医学および内科医学雑誌に掲載されました.
- CE研究 (活性治療を比較する) と非CE研究 (新規治療法または非活性対照) を区別する.
主要な成果:
- 328件の医薬品研究のうち104件がCE研究として特定されました.
- CE研究では,主に異なる薬剤 (43%) や薬理学的戦略 (31%) を比較した.
- 安全性 (19%) や費用対効果 (2%) に焦点を当てたCE研究はほとんどありませんでした.
- CEの研究は,商業的資金 (13%) に比べて非商業的資金 (87%) を受ける可能性が高くなりました.
- アクティブ比較器によるランダム化試験は,非アクティブ対照試験よりもポジティブな結果を報告する可能性が低い.
結論:
- 大手ジャーナルの医薬品研究の約3分の1はCE研究である.
- CE研究の少数派は,薬理学的対非薬理学的治療法,安全性,またはコストを調査した.
- 非商業的資金,特に政府の助成金は,主にCE研究を支援しました.
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