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对急性胰腺炎随机试验的数量和方法质量的系统审查
Nejo Joseph, Gordon Liu, Chris Varghese
1Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
Pancreas
|February 10, 2025
概括
这次审查发现,随着时间的推移,急性胰腺炎 (AP) 管理的更多随机对照试验 (RCT). 虽然质量有所提高,但方法上的缺陷仍然存在,需要更好的试验进行和报告,以获得更强大的证据基础.
科学领域:
- 胃肠病学和肝病学 胃肠学和肝病学
- 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.
背景情况:
- 急性胰腺炎 (AP) 管理研究依赖于随机对照试验 (RCT).
- 评估RCT体积和方法严格性的演变对于理解AP护理中的证据质量至关重要.
研究的目的:
- 系统地审查有关急性胰腺炎管理的RCT的数量和方法质量.
- 分析不同出版期的RCT质量趋势.
主要方法:
- 在PubMed,MEDLINE和CENTRAL数据库中对三个时间段 (<1996,1996-2008,>2008) 的RCT进行系统搜索.
- 使用柯克兰偏差风险 (RoB) 2工具进行质量评估,评估样本大小计算和检测旋转.
- 对试验数量和方法质量指标趋势的分析.
主要成果:
- 总共包括了263个RCT,涉及23232名AP患者.
- 每年公布的RCT数量随着时间的推移显著增加.
- 虽然选择性报告偏差有所改善,样本大小计算报告增加,但24%的RCT显示偏差风险很高,26%包含了旋转.
结论:
- 对AP管理的RCT的数量和质量得到了改善.
- 重要的方法缺陷,包括偏见和旋转的风险,继续影响证据基础.
- 加强RCT的进行和报告的严格性对于推进AP管理研究至关重要.
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