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看到关于双重失明的真相
Donald A Redelmeier1,2,3,4, Jonathan S Zipursky5,6,7,8,9
1Department of Medicine, University of Toronto, Toronto, ON, Canada. dar@ices.on.ca.
Journal of general internal medicine
|July 16, 2024
概括
在临床试验中不充分的盲目化可以引入偏见,影响患者的结果. 了解这些陷对于准确地从盲目的随机试验中解释基于证据的医学至关重要.
科学领域:
- 临床试验方法论 临床试验方法论
- 基于证据的医学 基于证据的医学
- 研究诚信研究诚信
背景情况:
- 随机临床试验 (RCT) 依赖于混因子的基线平衡和有效的失明来控制外在因素.
- 不充分的盲目可能会损害RCT的内部有效性,导致结果有偏见.
- 解释基于证据的医学RCT需要仔细考虑解盲引入的潜在偏见.
研究的目的:
- 在临床试验中出现的常见陷的三部分分类,这些陷来自临床试验中不充分的盲目.
- 为读者引入一个谨慎的框架,以批判性地评估盲目的RCT.
- 用与组分配知识相关的例子来说明潜在的偏见.
主要方法:
- 将令人眼花乱的陷分为三个类别:研究进行,数据分析和监督.
- 使用说明性示例来展示对小组分配的知识如何引入偏见.
- 在以证据为基础的医学中解释盲目的RCT的框架的开发.
主要成果:
- 在研究进行过程中发现了陷,包括对参与者,对照者和临床医生的不充分盲目.
- 突出了数据分析的陷,例如没有证据的盲目声明和受损的盲目测试.
- 描述了与监督相关的陷,包括揭开道德委员会和审稿人的盲目性.
结论:
- 意识到特定的盲目陷对于准确解释RCT至关重要.
- 这些警告可能导致对干预措施与患者结果之间的关系的误解.
- 了解和解决盲目的问题提高了基于证据的医疗护理RCT的可靠性.
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