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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 BMC+Med+Res+Methodol
2017 ; 17
(1
): 32
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Research waste in diagnostic trials: a methods review evaluating the reporting of
test-treatment interventions
#MMPMID28231757
Ferrante di Ruffano L
; Dinnes J
; Taylor-Phillips S
; Davenport C
; Hyde C
; Deeks JJ
BMC Med Res Methodol
2017[Feb]; 17
(1
): 32
PMID28231757
show ga
BACKGROUND: The most rigorous method for evaluating the effectiveness of
diagnostic tests is through randomised trials that compare test-treatment
interventions: complex interventions comprising episodes of testing,
decision-making and treatment. The multi-staged nature of these interventions,
combined with the need to relay diagnostic decision-making and treatment
planning, has led researchers to hypothesise that test-treatment strategies may
be very challenging to document. However, no reviews have yet examined the
reporting quality of interventions used in test-treatment RCTs. In this study we
evaluate the completeness of intervention descriptions in a systematically
identified cohort of test-treatment RCTs. METHODS: We ascertained all
test-treatment RCTs published 2004-2007, indexed in CENTRAL. Included trials
randomized patients to diagnostic tests and measured patient outcomes after
treatment. Two raters examined the completeness of test-treatment intervention
descriptions in four components: 1) the test, 2) diagnostic decision-making, 3)
management decision-making, 4) treatments. RESULTS: One hundred and three trials
compared 105 control with 119 experimental interventions, most commonly in
cardiovascular medicine (35, 34%), obstetrics and gynecology (17%),
gastroenterology (14%) or orthopedics (10%). A broad range of tests were
evaluated, including imaging (50, 42%), biochemical assays (21%) and clinical
assessment (12%). Only five (5%) trials detailed all four components of
experimental and control interventions, none of which also provided a complete
care pathway diagram. Experimental arms were missing descriptions of tests,
diagnostic-decision making, management planning and treatments (36%, 51%, 55% and
79% of trials respectively); control arms were missing the same details in 61%,
66%, 67% and 84% of trials. CONCLUSION: Reporting of test-treatment interventions
is very poor, inadequate for understanding the results of these trials, and for
comparing or translating results into clinical practice. Reporting needs to
improve, with greater emphasis on describing the decision-making components of
care pathways in both pragmatic and explanatory trials. Please see the companion
paper to this article:
http://bmcmedresmethodol.biomedcentral.com/articles/10.1186/s12874-016-0287-z .
|Biomedical Research/*methods
[MESH]
|Guidelines as Topic
[MESH]
|Humans
[MESH]
|Outcome Assessment, Health Care/methods/standards
[MESH]
|Randomized Controlled Trials as Topic/*methods/*standards
[MESH]