Multiple outcomes and analyses in clinical trials create challenges for interpretation and research synthesis.

Published

Journal Article (Review)

To identify variations in outcomes and results across reports of randomized clinical trials (RCTs).Eligible RCTs examined gabapentin for neuropathic pain and quetiapine for bipolar depression, reported in public (e.g., journal articles) and nonpublic (e.g., clinical study reports) sources by 2015. We prespecified outcome domains. From each source, we collected "outcomes" (i.e., domain, measure, metric, method of aggregation, and time point); "treatment effect" (i.e., outcome plus the methods of analysis [e.g., how missing data were handled]); and results (i.e., numerical contrasts of treatment and comparison groups). We assessed whether results included sufficient information for meta-analysis.We found 21 gabapentin (68 public, 6 nonpublic reports) and seven quetiapine RCTs (46 public, 4 nonpublic reports). For four (gabapentin) and seven (quetiapine) prespecified outcome domains, RCTs reported 214 and 81 outcomes by varying four elements. RCTs assessed 605 and 188 treatment effects by varying the analysis of those outcomes. RCTs reported 1,230 and 661 meta-analyzable results, 305 (25%) and 109 (16%) in public reports.RCTs included hundreds of outcomes and results; a small proportion were in public reports. Trialists and meta-analysts may cherry-pick what they report from multiple sources of RCT information.

Full Text

Duke Authors

Cited Authors

  • Mayo-Wilson, E; Fusco, N; Li, T; Hong, H; Canner, JK; Dickersin, K; MUDS investigators,

Published Date

  • June 2017

Published In

Volume / Issue

  • 86 /

Start / End Page

  • 39 - 50

PubMed ID

  • 28529187

Pubmed Central ID

  • 28529187

Electronic International Standard Serial Number (EISSN)

  • 1878-5921

International Standard Serial Number (ISSN)

  • 0895-4356

Digital Object Identifier (DOI)

  • 10.1016/j.jclinepi.2017.05.007

Language

  • eng