在针对COVID-19治疗的试验中分配隐藏和盲目的影响:一项方法研究
American journal of epidemiology
|May 31, 2023
概括
在COVID-19试验中,分配隐藏至关重要. 缺乏分配隐藏的试验可能会高估治疗益处,同时使人失明.
科学领域:
- 临床试验方法论 临床试验方法论
- 传染病研究 传染病研究
- 基于证据的医学基于证据的医学.
背景情况:
- 方法学偏见可能会影响临床试验结果.
- 确保2019年冠状病毒病 (COVID-19) 治疗试验结果的可靠性至关重要.
研究的目的:
- 评估分配隐藏和盲目化如何影响COVID-19随机试验的结果.
- 通过不充分的方法严谨性来识别引入的潜在偏见.
主要方法:
- 来自世界卫生组织COVID-19数据库的488个随机试验的分析 (截至2022年2月).
- 随机效应元回归比较具有和没有分配隐藏和盲目的试验.
- 评估结果,包括死亡率,机械通风和住院治疗.
主要成果:
- 没有分配隐藏的试验可能会高估治疗对死亡率,机械通风和住院结果的疗效.
- 缺失失明并没有持续改变死亡率,机械通风和住院时间的结果.
- 没有盲装的试验显示,对住院治疗和机械通风持续时间的益处的潜在高估.
结论:
- 分配隐藏是防止COVID-19试验中偏见估计的一个比盲目的更关键的因素.
- 证据的使用者应该小心COVID-19试验的结果缺乏分配隐.
- 虽然遮很重要,但它缺少可能并不总是带来显著的偏见.
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