循证迷雾101课件.pptVIP

In the interests of transparency and objectivity, the study protocol was published online before analysis. We have made our full raw dataset freely availabl1. e to anyone who would like to replicate and check our analyses. * * Flexibility increases the potential for transforming what would be “negative” results into “positive” results, i.e., bias, u. For several research designs, e.g., randomized controlled trials [18–20] or meta-analyses [21,22], there have been efforts to standardize their conduct and reporting. Adherence to common standards is likely to increase the proportion of true fi ndings. The same applies to outcomes. True fi ndings may be more common when outcomes are unequivocal and universally agreed (e.g., death) rather than when multifarious outcomes are devised (e.g., scales for schizophrenia outcomes) [23]. Similarly, fi elds that use commonly agreed, stereotyped analytical methods (e.g., Kaplan- Meier plots and the log-rank test) [24] may yield a larger proportion of true fi ndings than fi elds where analytical methods are still under experimentation (e.g., artifi cial intelligence methods) and only “best” results are reported. Regardless, even in the most stringent research designs, bias seems to be a major problem. For example, there is strong evidence that selective outcome reporting, with manipulation of the outcomes and analyses reported, is a common problem even for randomized trails [25]. Simply abolishing selective publication would not make this problem go away. * * Most antidepressant trials have limited duration of follow- up, typically 6 weeks, and rarely exceeding 8 weeks. Some trials even last only 3–4 weeks. Even with such short follow-up, attrition (losses to follow-up, and/or discontinuation of study medication) is very common in these trials [26]. Imputing outcomes when information is missing due to attrition is not easy and leaves room for bias * * 为什么临床医生如此看重药物的起效呢？对于有自杀风险的抑郁症病人来说，快速起效不言而喻能够降低患者的自杀风险。更快的起效也能够避免患者由于对治疗失去信心而中止治疗，