Challenges of using external data in clinical trials- an illustration in patients with COVID-19.
BMC Med Res Methodol
; 22(1): 321, 2022 Dec 15.
Artículo
en Inglés
| MEDLINE | ID: covidwho-2162296
ABSTRACT
BACKGROUND:
To improve the efficiency of clinical trials, leveraging external data on control and/or treatment effects, which is almost always available, appears to be a promising approach.METHODS:
We used data from the experimental arm of the Covidicus trial evaluating high-dose dexamethasone in severely ill and mechanically ventilated COVID-19 patients, using published data from the Recovery trial as external data, to estimate the 28-day mortality rate. Primary approaches to deal with external data were applied.RESULTS:
Estimates ranged from 0.241 ignoring the external data up to 0.294 using hierarchical Bayesian models. Some evidence of differences in mortality rates between the Covidicus and Recovery trials were observed, with an matched adjusted odds ratio of death in the Covidicus arm of 0.41 compared to the Recovery arm.CONCLUSIONS:
These indirect comparisons appear sensitive to the method used. None of those approaches appear robust enough to overcome randomized clinical trial data. TRIAL REGISTRATION Covidicus Trial NCT04344730, First Posted 14/04/2020; Recovery trial NCT04381936.
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Tipo de estudio:
Estudio experimental
/
Estudio pronóstico
/
Ensayo controlado aleatorizado
Idioma:
Inglés
Revista:
BMC Med Res Methodol
Asunto de la revista:
Medicina
Año:
2022
Tipo del documento:
Artículo
País de afiliación:
S12874-022-01769-5
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