横断面分析:康复随机对照临床试验中无统计学意义结果的解释

Caterina Mugnai, Luca Falsiroli Maistrello, Giacomo Fiacca, Michele Perucchini, Noemi Corbetta, Federico Amateis, Stefano Salvioli
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引用次数: 0

摘要

引言 尽管 CONSORT 指导方针旨在提高研究质量,但作者往往根据 P 值的二分法得出结论,宣布 "统计学上有意义 "和 "无意义 "之间的差异。这种方法混淆了对所研究疗法实际疗效的识别。为了解决这个问题,CONSORT 指南建议使用置信区间,因为置信区间能更全面地反映可能的效果。然而,作者的结论往往仍基于二元方法,混淆了无证据和有证据的无证据。这种错误会影响临床实践和未来的研究,导致根据统计不显著性(statistical insignificance)确定 "阴性 "治疗,而这反映的是缺乏证据,而不是没有证据。目的 评估2019年至2023年期间在5种影响因子(IF)最高的康复类期刊上发表的所有随机对照试验(RCT)中,在摘要和文章中对非统计显著性结果的误读发生率,并评估是否按照CONSORT指南报告了主要结果结果。方法 我们将对 2019 年至 2023 年间在 5 种影响因子最高的普通康复期刊上发表的、主要结果无统计学意义的所有 Rct 进行横断面分析。我们将确定摘要和文章结论中将非显著性解释为无证据、无证据或建议在临床实践中使用干预措施的试验的普遍性,以及遵守 CONSORT 指南报告主要结果的试验的普遍性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CROSS-SECTIONAL ANALYSIS: INTERPRETATION OF NON-STATISTICALLY SIGNIFICANT RESULTS IN RANDOMISED CONTROLLED CLINICAL TRIALS IN REHABILITATION
Introduction Despite the CONSORT guidelines, which aim to improve the quality of studies, authors often formulate conclusions based on the dichotomous distinction of the p-value, declaring differences between ′statistically significant′ and ′non-significant′. This approach confuses the identification of the real efficacy of the studied treatment. To solve this problem, CONSORT guidelines recommend using confidence intervals, which offer a more complete view of possible effects. However, authors′ conclusions often remain based on a binary approach, confusing the absence of evidence with the evidence of absence. This error can influence clinical practice and future research, leading to the identification of ′negative′ treatments based on ′statistical insignificance′, which reflects a lack of evidence of absence, not the absence of evidence. Objectives To assess the prevalence of misinterpretation of non-statistically significant results, both in the abstract and in the article, in a sample of all randomised controlled trials (RCTs) with non-statistically significant primary outcomes published in 5 rehabilitation journals with the highest impact factor (IF) published between 2019 and 2023 and to assess whether the primary outcome result is reported according to CONSORT guidelines. Methods We will conduct a cross-sectional analysis of all Rcts with non-statistically significant primary outcomes in 5 general rehabilitation journals with the highest IF published between 2019 and 2023. We will determine the prevalence of trials in which non-significance is interpreted as absence of evidence, evidence of absence, or advice to use the intervention in clinical practice in the abstract and article conclusions, and the prevalence of trials that adhered to CONSORT guidelines for reporting the primary outcome.
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