Trials | |
Quality of reporting of clinical non-inferiority and equivalence randomised trials - update and extension | |
Meinhard Kieser1  Michael Niestroj1  Nicole Burchardi2  Petra Schiller1  | |
[1] Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, Im Neuenheimer Feld 305, Heidelberg, D-69120, Germany;Coordinating Center for Clinical Trials (KKS), Marburg, Germany | |
关键词: Randomised clinical trials; Equivalence; Non-inferiority; Methodological quality; Reporting quality; | |
Others : 1095191 DOI : 10.1186/1745-6215-13-214 |
|
received in 2012-06-27, accepted in 2012-10-30, 发布年份 2012 | |
【 摘 要 】
Background
Non-inferiority and equivalence trials require tailored methodology and therefore adequate conduct and reporting is an ambitious task. The aim of our review was to assess whether the criteria recommended by the CONSORT extension were followed.
Methods
We searched the Medline database and the Cochrane Central Register for reports of randomised non-inferiority and equivalence trials published in English language. We excluded reports on bioequivalence studies, reports targeting on other than the main results of a trial, and articles of which the full-text version was not available. In total, we identified 209 reports (167 non-inferiority, 42 equivalence trials) and assessed the reporting and methodological quality using abstracted items of the CONSORT extension.
Results
Half of the articles did not report on the method of randomisation and only a third of the trials were reported to use blinding. The non-inferiority or equivalence margin was defined in most reports (94%), but was justified only for a quarter of the trials. Sample size calculation was reported for a proportion of 90%, but the margin was taken into account in only 78% of the trials reported. Both intention-to-treat and per-protocol analysis were presented in less than half of the reports. When reporting the results, a confidence interval was given for 85% trials. A proportion of 21% of the reports presented a conclusion that was wrong or incomprehensible. Overall, we found a substantial lack of quality in reporting and conduct. The need to improve also applied to aspects generally recommended for randomised trials. The quality was partly better in high-impact journals as compared to others.
Conclusions
There are still important deficiencies in the reporting on the methodological approach as well as on results and interpretation even in high-impact journals. It seems to take more than guidelines to improve conduct and reporting of non-inferiority and equivalence trials.
【 授权许可】
2012 Schiller et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150130181925400.pdf | 832KB | download | |
Figure 2. | 43KB | Image | download |
Figure 1. | 90KB | Image | download |
【 图 表 】
Figure 1.
Figure 2.
【 参考文献 】
- [1]Fleming TR: Current issues in non-inferiority trials. Stat Med 2008, 27:317-322.
- [2]D’Agostinio RB: Non-inferiority trials: advances in concepts and methodology. Stat Med 2003, 22:165-167.
- [3]Jones B, Jarvis P, Lewis JA, Ebbutt AF: Trials to assess equivalence: the importance of rigorous methods. BMJ 1996, 313:36-39.
- [4]ICH Steering Committee: Statistical Principles for Clinical Trials (E9). International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use, Geneva, Switzerland; 1998. http://www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/Efficacy/E9/Step4/E9_Guideline.pdf webcite
- [5]US Food and Drug Administration: Guidance for Industry Non-Inferiority Clinical Trials. . US Department of Health and human Services; 2010; available at, Rockville, USA; http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM202140.pdf webcite
- [6]Moher D, Schulz KF, Altman DG, The CONSORT Group: The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials. Lancet 2001, 357:1191-1194.
- [7]Schulz KF, Altman DG, Moher D, CONSORT Group: CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. Trials 2010, 24:11-32.
- [8]Plint AC, Moher D, Morrison A, Schulz K, Altman DG, Hill C, Gaboury I: Does the CONSORT checklist improve the quality of reports of randomised controlled trials? A systematic review. Med J Aust 2006, 185:263-267.
- [9]Hopewell S, Dutton S, Yu LM, Chan AW, Altman DG: The quality of reports of randomised trials in 2000 and 2006: comparative study of articles indexed in PubMed. BMJ 2010, 340:c723.
- [10]Le Henanff A, Giraudeau B, Baron G, Ravaud P: Quality of reporting non-inferiority and equivalence randomised trials. JAMA 2006, 295:1147-1151.
- [11]Ivers NM, Taljaard M, Dixon S, Bennett C, McRae A, Taleban J, Skea Z, Brehaut JC, Boruch RF, Eccles MP, Grimshaw JM, Weijer C, Zwarenstein M, Donner A: Impact of CONSORT extension for cluster randomised trials on quality of reporting and study methodology: review of random sample of 300 trials, 2000–8. BMJ 2011, 343:d5886.
- [12]Piaggio G, Elbourne DR, Altman DG, Pocock SJ, Evans SJ, CONSORT Group: Reporting of non-inferiority and equivalence randomised trials: an extension of the CONSORT statement. JAMA 2006, 295:1152-1160.
- [13]Eyawo O, Lee CW, Rachlis B, Mills EJ: Reporting of noninferiority and equivalence randomized trials for major prostaglandins: a systematic survey of the ophthalmology literature. Trials 2008, 3(9):69.
- [14]Wangge G, Klungel OH, Roes KC, de Boer A, Hoes AW, Knol MJ: Room for improvement in conducting and reporting non-inferiority randomized controlled trials on drugs: a systematic review. PLoS One 2010, 5(10):e13550.
- [15]European Medicine Agency: Guideline on the choice of the non-inferiority margin. Committee for Medicinal Products for Human Use; 2005; available at, London, UK; http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2009/09/WC500003636.pdf webcite
- [16]Ghimire S, Kyung E, Kang W, Kim E: Assessment of adherence to the CONSORT statement for quality of reports on randomized controlled trial abstracts from four high-impact general medical journals. Trials 2012. BioMed Central Full Text
- [17]Fleiss JL: Measuring nominal scale agreement among many raters. Psychol Bull 1971, 76:378-382.
- [18]Hopewell S, Altman DG, Moher D, Schulz KF: Endorsement of the CONSORT Statement by high impact factor medical journals: a survey of journal editors and journal ‘Instructions to Authors’. Trials 2008, 18:20.
- [19]Partsinevelou A, Zintzaras E: Quality of reporting of randomized controlled trials in polycystic ovary syndrome. Trials 2009, 20:106.
- [20]Balasubramanian SP, Wiener M, Alshameeri Z, Tiruvoipati R, Elbourne D, Reed MW: Standards of reporting of randomized controlled trials in general surgery: can we do better? Ann Surg 2006, 244:663-667.
- [21]Wang JL, Sun TT, Lin YW, Lu R, Fang JY: Methodological reporting of randomized controlled trials in major hepato-gastroenterology journals in 2008 and 1998: a comparative study. BMC Med Res Methodol 2011, 11:110. BioMed Central Full Text
- [22]Parsons N, Hiskens R, Price CL, Costa ML: A systematic survey of the quality of research reporting in general orthopaedic journals. J Bone Joint Surg Br 2011, 93:1154-1159.
- [23]Hirst A, Altman DG: Are peer reviewers encouraged to use reporting guidelines? A survey of 116 health research journals. PLoS One 2012, 7:e35621.
- [24]Simera I, Moher D, Hirst A, Hoey J, Schulz KF, Altman DG: Transparent and accurate reporting increases reliability, utility, and impact of your research: reporting guidelines and the EQUATOR Network. BMC Medicine 2010, 8:24. BioMed Central Full Text