消化不良和幽门螺杆菌感染管理的随机试验结果的脆弱性。

Q3 Medicine

International Journal of Evidence-Based Healthcare Pub Date : 2020-03-01 DOI:10.1097/XEB.0000000000000203

Chase Meyer, Aaron Bowers, Daniel Tritz, Kaleb Fuller, C. Wayant, Courtney Cook, Trevor Torgerson, M. Som, M. Vassar

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引用次数: 4

摘要

脆弱性指数通过将试验中的一个结果事件更改为非事件来计算，直到相关P值超过0.05。在这项研究中，我们评估了随机对照试验的稳健性、偏倚风险(RoB)和有效性，这些随机对照试验是美国胃肠病学学会(ACG)提出的治疗消化不良和幽门螺杆菌感染建议的基础。方法对指南中引用的所有文献进行筛选，确定纳入标准。然后计算符合条件的试验的脆弱性指数。采用Cochrane“RoB”工具2.0评估纳入试验的偏倚可能性和偏倚来源。结果52项试验的脆弱性指数中位数为3个事件。经统计分析，脆弱性指数为0的研究有5项(9.6%)。在52个试验中，12个(23.1%)处于低RoB, 15个(28.8%)有一些担忧，25个(48.1%)处于高RoB。高RoB最常见的原因是报告结果中的选择偏差(15.5%)。结论:在消化不良和幽门螺杆菌感染管理指南推荐的52项试验中，需要3个事件的中位数来消除统计学意义。此外，在这些试验中发现了对罗伯的担忧。

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The fragility of randomized trial outcomes underlying management of dyspepsia and Helicobacter pylori infections.

AIM The fragility index is calculated by changing one outcome event to a nonevent within a trial until the associated P value exceeds 0.05. In this study, we assessed the robustness, risk of bias (RoB), and power of randomized controlled trials that underlie recommendations set forth by the American College of Gastroenterology (ACG) on managing dyspepsia and Helicobacter pylori infections. METHODS All citations referenced in the guidelines were screened for inclusion criteria. The fragility indexes for eligible trials were then calculated. The likelihood and sources of bias in the included trials were evaluated by the Cochrane 'RoB' Tool 2.0. RESULTS The median fragility index for the 52 trials was three events. Five studies (9.6%) resulted in a fragility index of 0 when statistical analysis was applied. For the 52 trials, 12 (23.1%) were at a low RoB, 15 (28.8%) had some concerns, and 25 (48.1%) were at a high RoB. High RoB was most commonly due to bias of selection in the reported result (15.5%). CONCLUSION A median of three events was needed to nullify statistical significance in 52 trials that underpin guideline recommendations on the management of dyspepsia and H. pylori infections. In addition, concerns for RoB were found for these trials.

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来源期刊

International Journal of Evidence-Based Healthcare Medicine-Health Policy

CiteScore

1.80

自引率

0.00%

发文量

期刊介绍： The International Journal of Evidence-Based Healthcare is the official journal of the Joanna Briggs Institute. It is a fully refereed journal that publishes manuscripts relating to evidence-based medicine and evidence-based practice. It publishes papers containing reliable evidence to assist health professionals in their evaluation and decision-making, and to inform health professionals, students and researchers of outcomes, debates and developments in evidence-based medicine and healthcare. The journal provides a unique home for publication of systematic reviews (quantitative, qualitative, mixed methods, economic, scoping and prevalence) and implementation projects including the synthesis, transfer and utilisation of evidence in clinical practice. Original scholarly work relating to the synthesis (translation science), transfer (distribution) and utilization (implementation science and evaluation) of evidence to inform multidisciplinary healthcare practice is considered for publication. The journal also publishes original scholarly commentary pieces relating to the generation and synthesis of evidence for practice and quality improvement, the use and evaluation of evidence in practice, and the process of conducting systematic reviews (methodology) which covers quantitative, qualitative, mixed methods, economic, scoping and prevalence methods. In addition, the journal’s content includes implementation projects including the transfer and utilisation of evidence in clinical practice as well as providing a forum for the debate of issues surrounding evidence-based healthcare.