An assessment of randomized controlled trials (RCTs) for non-communicable diseases (NCDs): more and higher quality research is required in less developed countries.
An assessment of randomized controlled trials (RCTs) for non-communicable diseases (NCDs): more and higher quality research is required in less developed countries.
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DOI：
10.1038/srep13221
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发表时间：
2015-08-14
影响因子：
4.6
通讯作者：
Song F
中科院分区：
文献类型：
--
作者：
Fan H;Song F
研究对于实施以证据为基础的卫生干预措施以控制非传染性疾病至关重要。本研究旨在评估用于控制非传染性疾病的随机对照试验（rct）的主要特征，并确定高收入国家和欠发达国家在非传染性疾病临床研究方面的差距。该研究纳入了82篇Cochrane系统综述（CSRs）中的1177项随机对照试验，并评估了对高血压、糖尿病、中风或心脏病患者的干预措施。对纳入的随机对照试验进行多因素logistic回归分析，探讨与偏倚风险相关的因素。我们发现78.2%的主要非传染性疾病干预的随机对照试验招募了高收入国家的患者。纳入CSRs的随机对照试验的数量随着时间的推移而增加，在中等收入国家进行的随机对照试验的增加速度更为明显。在欠发达国家进行的随机对照试验往往是最近发表的，不太可能用英语发表，样本量较小，偏倚风险较高。总之，欠发达国家仍然缺乏控制非传染性疾病的研究证据。为了应对不断上升的非传染性疾病并避免浪费稀缺的研究资源，低收入和中等收入国家不仅需要更多、而且需要更高质量的临床试验。
Research is crucial to implement evidence-based health interventions for control of non-communicable diseases (NCDs). This study aims to assess main features of randomized controlled trials (RCTs) for control of NCDs, and to identify gaps in clinical research on NCDs between high-income and less developed countries. The study included 1177 RCTs in 82 Cochrane Systematic reviews (CSRs) and evaluated interventions for adults with hypertension, diabetes, stroke, or heart diseases. Multivariate logistic regression analyses were conducted to explore factors associated with risk of bias in included RCTs. We found that 78.2% of RCTs of interventions for major NCDs recruited patients in high-income countries. The number of RCTs included in the CSRs was increasing over time, and the increasing speed was more noticeable for RCTs conducted in middle-income countries. RCTs conducted in less developed countries tended to be more recently published, less likely to be published in English, with smaller sample sizes, and at a higher risk of bias. In conclusion, there is still a lack of research evidence for control of NCDs in less developed countries. To brace for rising NCDs and avoid waste of scarce research resources, not only more but also higher quality clinical trials are required in low-and-middle-income countries.