Applicability of trials in rheumatoid arthritis and osteoarthritis: A systematic review and meta-analysis of trial populations showing adequate proportion of women, but underrepresentation of elderly people
Applicability of trials in rheumatoid arthritis and osteoarthritis: A systematic review and meta-analysis of trial populations showing adequate proportion of women, but underrepresentation of elderly people
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DOI：
10.1016/j.semarthrit.2018.10.017
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发表时间：
2019-06-01
影响因子：
5
通讯作者：
Buttgereit, Frank
中科院分区：
文献类型：
--
作者：
Palmowski, Andriko;Buttgereit, Thomas;Buttgereit, Frank
目的：评价老年人和女性在类风湿关节炎（RA）和骨关节炎（OA）的随机对照试验（RCT）中是否有充分的代表性。方法：在MEDLINE中进行四次系统搜索，获得2016年和2017年发表的RA和OA干预措施的RCT，以及2013年至2017年发表的RA和OA基于人群的研究（PBS）。随机效应荟萃分析估计老年人（定义为>= 65岁）的合并比例、平均年龄、其标准差（SD）以及按疾病（RA和OA）和研究类型（RCT和PBS）分层的女性比例。随后比较分层估计。结果：265项RCT包括51,240名参与者，53项PBS包括523,630名参与者。在RA和OA中，RCT纳入的老年人比例低于PBS: RA -0.18(95%可信区间- 0.22至-0.13)；OA -0.20 (-030 ~ -0.09)；平均年龄较低：RA -5.2岁（-6.8 - -3.5）；OA - 4.7岁（-7.5 - -2.0）；较小的SD: RA -1.9年（-2.6至-13）；OA -2.7年（-4.2至-1.2）；(所有比较：p
Objectives: To evaluate whether elderly people and women are adequately represented in randomized controlled trials (RCT) in rheumatoid arthritis (RA) and osteoarthritis (OA).Methods: Four systematic searches in MEDLINE yielded RCT in RA and OA on any intervention published in 2016 and 2017 and population-based studies (PBS) in RA and OA published between 2013 and 2017. Random effects meta-analyses estimated the pooled proportion of elderly people (defined as being >= 65 years old), the mean age, its standard deviation (SD), and the proportion of women stratified by disease (RA and OA) and study type (RCT and PBS). Stratified estimates were subsequently compared.Results: 265 RCT comprising 51,240 participants and 53 PBS comprising 523,630 participants were included. In both RA and OA, RCT included lower proportions of elderly people than PBS: RA -0.18 (95% confidence interval - 0.22 to -0.13); OA -0.20 (-030 to -0.09); had lower mean ages: RA -5.2 years (-6.8 to -3.5): OA - 4.7 years (-7.5 to -2.0); and smaller SD: RA -1.9 years (-2.6 to -13); OA -2.7 years (-4.2 to -1.2); (all comparisons: p