研究骨科研究中随机对照试验的可靠性:通过元分析进行系统性审查
Amandine Sénéquier1, Jerry Draper-Rodi2, Gerard Alvarez Bustins3
1National Council for Osteopathic Research, Health Sciences University, London, UK.
Journal of clinical epidemiology
|April 19, 2025
概括
骨科手动治疗随机对照试验 (RCT) 的可靠性需要改进. 许多RCT具有偏见和方法方面的担忧的高风险,影响基于证据的医疗保健决策.
科学领域:
- 整合和补充医学是整合和补充医学.
- 临床研究方法论 临床研究方法论
- 基于证据的实践.
背景情况:
- 临床试验的可靠性对于可靠的基于证据的决策至关重要.
- 骨科手动治疗 (OMT) 的研究越来越多,需要对其研究质量的严格评估.
- 之前对OMT试验可信度的评估是有限的.
研究的目的:
- 系统评估随机对照试验 (RCT) 的可靠性,调查骨科手动治疗.
- 评估OMT RCT中的方法严谨性,透明度,治理,研究诚信和不当行为.
- 确定需要改进的OMT研究实践领域.
主要方法:
- 2021年1月至2024年6月期间发表的OMT RCT的系统审查.
- 搜索了多个数据库,包括MEDLINE,EMBASE和PEDro.
- 使用Cochrane工具2评估偏差风险,使用专门的检查清单评估可信度 (Cochrane怀孕和分娩查工具,重新评估).
- 通过元分析评估了期刊的可靠性,抽象的"旋转"和结果的可信性.
主要成果:
- 在包括的61个OMTRC中,74%具有高偏差风险.
- 发现了重要的方法问题:缺乏数据处理 (31%),选择性分析 (38%),未承认的多重测试 (36%) 和结果切换 (12%).
- 只有12%的摘要没有"旋转",27%的作者回应了询问,表明透明度和参与问题.
结论:
- 在OMT RCT中遵守最佳实践是不理想的,可能会阻碍基于证据的实践,并增加研究浪费.
- 改进方法论的严谨性,透明度和报告是提高OMT研究可靠性的关键.
- 建议进行进一步的研究,以评估这些发现对其他资源不足的研究领域的概括性.
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