CUMULATIVE METAANALYSIS OF CLINICAL-TRIALS - BUILDS EVIDENCE FOR EXEMPLARY MEDICAL-CARE
CUMULATIVE METAANALYSIS OF CLINICAL-TRIALS - BUILDS EVIDENCE FOR EXEMPLARY MEDICAL-CARE
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DOI：
10.1016/0895-4356(94)00106-z
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发表时间：
1995-01-01
影响因子：
7.2
通讯作者：
CHALMERS, TC
中科院分区：
文献类型：
--
作者：
LAU, J;SCHMID, CH;CHALMERS, TC
临床试验的累积荟萃分析(对积累证据的贝叶斯解释)将通过总结技术创新评估中的证据、将该技术应用于链激酶治疗急性心肌梗死的随机对照试验(RCT)、通过抗生素预防降低围手术期死亡率以及防止消化性溃疡出血死亡等方面的证据，深刻地影响医疗保健。根据对照中的事件发生率、效果大小、试验质量或根据感兴趣的协变量安排试验提供了独特的信息。如果前瞻性地实施，该技术提供了关于另一项试验的适应症、确定过去趋势的有效性所需的患者数量以及可能受益的患者类型的宝贵信息。以累积方式对以前的试验进行仔细检查可以减少对未来大型试验的需要。
Cumulative meta-analysis of clinical trials (a Bayesian interpretation for accumulating evidence) will profoundly affect medical care by summarizing evidence in the assessment of technology innovations, Application of the technique to the randomized control trials (RCTs) of streptokinase treatment of acute myocardial infarction, reduction of peri-operative mortality by antibiotic prophylaxis; and prevention of death from bleeding peptic ulcers has revealed efficacy years before it was suspected by any other means. Arrangement of the trials according to event rate in the controls, effect sizes, quality of the trials or according to covariables of interest has supplied unique information. If carried out prospectively the technique supplies invaluable information regarding indications for another trial, the number of patients necessary to determine the validity of past trends, and the type of patients who might be benefitted. Careful examination in a cumulative manner of the prior trials can reduce the need for future large trials.