Commentary: Randomised trials of surgical and non-surgical treatment: a role model for the future
Commentary: Randomised trials of surgical and non-surgical treatment: a role model for the future
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评论：手术和非手术治疗的随机试验：未来的榜样
DOI：
10.1136/bmj.a2747
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
J. Donovan
中科院分区：
文献类型：
--
作者：
J. Blazeby;C. Barham;J. Donovan
胃酸倒流和胃灼热的症状越来越常见，医生在提供治疗时需要从患者的角度了解手术和药物治疗的好处和风险。然而，从随机对照试验中获得可靠的信息以充分告知患者是困难的，因为进行这种不同治疗的试验存在许多公认的障碍，包括招募和标准化治疗的困难以及无法提供盲法。在相关研究（doi：10.1136/bmj.a2664）中，Grant等人进行了一项多中心的实用随机试验，将最小入路手术（腹腔镜胃底折叠术）与慢性胃食管反流病（GORD）的优化医疗管理（标准质子泵抑制）进行比较。1结果很清楚：开始治疗后长达12个月，
Symptoms of acid reflux and heartburn are increasingly common, and doctors need to understand the benefits and risks of surgical and medical treatment from the patients’ perspective when offering treatment. Obtaining reliable information from randomised controlled trials to fully inform patients is difficult, however, because of the many recognised obstacles to undertaking such trials of diverse treatments, including difficulties with recruitment and standardising treatments and the inability to provide blinding. In the linked study (doi:10.1136/bmj.a2664), Grant et al carried out a multicentre pragmatic randomised trial of minimal access surgery (laparoscopic fundoplication) compared with optimised medical management (standard proton pump inhibition) for chronic gastro-oesophageal reflux disease (GORD).1 The results were clear: up to 12 months after starting treatment, surgery was …