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Mikelis F, Karamalaki D, Mikeli A, Tzanetakis GN, Koletsi D. Data sharing and transparency indicators in published RCTs in Oral Health between 2017 and 2023. J Dent 2024; 149:105263. [PMID: 39047892 DOI: 10.1016/j.jdent.2024.105263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Revised: 07/20/2024] [Accepted: 07/22/2024] [Indexed: 07/27/2024] Open
Abstract
OBJECTIVES To record the proportion of data sharing reporting in terms of primary data and/or statistical code of Randomized Controlled Trials (RCTs), published across 12 high impact journals in Dentistry, covering 6 specialty domains. Associations with certain journal, publication and outcome characteristics were examined. Transparency indicators such as registration or funding statements were assessed. METHODS We identified and included all RCTs published from January 1st, 2017 to December 31st, 2023 in journals of high impact of the following domains: Periodontology, Endodontics, Restorative Dentistry/Prosthodontics, Orthodontics, Pediatric Dentistry, Oral/Maxillofacial Surgery. The primary outcome was the proportion of RCTs reporting their intent to share or openly shared primary data and we tested for associations with potential predictors. Funding, registration, and statistical code/script sharing practices were also examined. RESULTS A total of 752 RCTs were included, of which only 119 (15.8%) either openly provided their data or included a statement of intention to share upon request. Only one study openly provided the statistical code underlying the analysis used. RCTs in periodontology more frequently included statements about positive intent to share (57/210;27.1%), followed by Orthodontics (35/157;22.3%). Significant effects of year, dentistry domain and continent of authorship on data sharing practices were identified (p < 0.001 in all cases). There was evidence that registered RCTs had 2.04 times higher odds for intention to share data (95%confidence interval: 1.06, 3.92;p = 0.03). CONCLUSIONS Overall, in oral health RCTs, empirical evidence suggested very low prevalence of positive data sharing practices. Enhancing transparency is pivotal in promoting reproducibility and credibility of research findings. CLINICAL SIGNIFICANCE The findings of this empirical report bring attention to key transparency indicators in randomized controlled trials. These largely impact on the credibility and reproducibility of the evidence base for clinical decision making.
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Affiliation(s)
- Filippos Mikelis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitra Karamalaki
- School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Aikaterini Mikeli
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Giorgos N Tzanetakis
- Department of Endodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Despina Koletsi
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Meta- Research Innovation Center at Stanford (METRICS), Stanford University, California, USA.
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Šaler F, Viđak M, Puljak L. Methodology of clinical trials on sodium-glucose cotransporter 2 inhibitors registered on ClinicalTrials.gov: a cross-sectional study. BMC Med Res Methodol 2024; 24:164. [PMID: 39080564 PMCID: PMC11289909 DOI: 10.1186/s12874-024-02292-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 07/18/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND/OBJECTIVE The research on sodium-glucose cotransporter 2 (SGLT2) inhibitors has been increasing rapidly in the last decade, as well as indications for their use. This study aimed to analyze the methodological characteristics of clinical trials on SGLT2 inhibitors registered on ClinicalTrials.gov. DESIGN We conducted a cross-sectional study of trials on SGLT2 inhibitors registered on ClinicalTrials.gov up to November 11, 2022. We included clinical trials that tested SGLT2 inhibitors for any clinical condition, as a single or combined SGLT2 therapy, compared to any other medication or placebo and mapped their characteristics. RESULTS We identified 1102 eligible trials on 14 different SGLT2 inhibitors. The first trial registration was in 2005. There were 993 (90%) interventional and 109 (10%) observational trials. Most trials were in Phase 1 (29%), Phase 3 (23%), or Phase 4 (24%). Interventional trials were mostly randomized (85%); almost half of them did not use masking (44%). Trials on empagliflozin, dapagliflozin, and canagliflozin accounted for 75% of all trials. More than 60% of trials included patients with diabetes mellitus, 13% included only healthy subjects, and 12% included patients with heart diseases. Overall, these trials included more than 9.5 million participants (~ 312,000 of which in interventional studies). Almost 65% of all clinical trials were industry-funded. Most trials were completed (60%) and 35% of those reported results. For trials that are obligated to report results by the Food and Drugs Administration (FDA), 88% of them did so. Trials fully or partially funded by industry more frequently published results compared to non-industry funded trials (46.1% vs. 11.2%; p < 0.001). CONCLUSIONS The number of registered trials on SGLT2 inhibitors is increasing progressively along with expanding indications for its use, shifting from diabetes mellitus to cardiovascular and renal diseases. Public reporting of trial results improved with time but remains suboptimal.
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Affiliation(s)
- Fran Šaler
- Department of Cardiovascular Medicine, Clinical Hospital Dubrava, Zagreb, Croatia
| | - Marin Viđak
- Department of Cardiovascular Medicine, Clinical Hospital Dubrava, Zagreb, Croatia
| | - Livia Puljak
- Center for Evidence-Based Medicine and Healthcare, Catholic University of Croatia, Zagreb, Croatia.
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3
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Milojevic M, Nikolic A, Bakaeen FG, Myers PO. Clinical practice guidelines: ensuring quality through international collaboration. Eur J Cardiothorac Surg 2024; 66:ezae237. [PMID: 38958045 DOI: 10.1093/ejcts/ezae237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 06/15/2024] [Indexed: 07/04/2024] Open
Affiliation(s)
- Milan Milojevic
- Department of Cardiac Surgery and Cardiovascular Research, Dedinje Cardiovascular Institute, Belgrade, Serbia
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Aleksandar Nikolic
- Department of Cardiac Surgery, Acibadem Sistina Hospital, Skopje, North Macedonia
| | - Faisal G Bakaeen
- Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Patrick O Myers
- Division of Cardiac Surgery, CHUV-Lausanne University Hospital, Lausanne, Switzerland
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Olivier T, Haslam A, Burke P, Boutron I, Naudet F, Ioannidis JPA, Prasad V. A novel framework to assess haematology and oncology registration trials: The THEOREMM project. Eur J Clin Invest 2024:e14267. [PMID: 38934596 DOI: 10.1111/eci.14267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Methodological limitations affect a significant number of oncology and haematology trials, raising concerns about the applicability of their results. For example, a suboptimal control arm or limited access to best care upon progression may skew the trial results toward a benefit in the experimental arm. Beyond the fact that such limitations do not prevent drugs reaching the market, other assessment tools, such as those developed by professional societies-ESMO-MCBS and ASCO Value Framework-do not integrate these important shortcomings. METHODS We propose creating a novel framework with the scope of assessing registration cancer clinical trials in haematology and oncology (randomized or single arm)-that is trials leading to a marketing authorization. The main steps of the methods are (1) assembling a scientific board; (2) defining the scope, goal and methods through pre-specified, pre-registered and protocolized methodology; (3) preregistration of the protocol; (4) conducting a scoping review of limitations and biases affecting oncology trials and assessing existing scores or methods; (5) developing a list of features to be included and assessed within the framework; (6) assessing each feature through a questionnaire sent to highly cited haematologists and oncologists involved in clinical trials; and (7) finalizing the first version of framework. RESULTS Not applicable. CONCLUSIONS Our proposal emerged in response to the lack of consideration for key limitations in current trial assessments. The goal is to create a framework specifically designed to assess single trials leading to marketing authorization in the field of oncology and haematogy.
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Affiliation(s)
- Timothée Olivier
- Department of Oncology, Geneva University Hospital, Geneva, Switzerland
| | - Alyson Haslam
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | | | - Isabelle Boutron
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAe, Centre for Research in Epidemiology and Statistics (CRESS), Paris, France
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Paris, France
- Cochrane France, Paris, France
| | - Florian Naudet
- Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes), Rennes 1 University, Rennes, France
- Inserm, Irset (Institut de recherche en santé, environnement et travail), Rennes 1 University, Rennes, France
- Institut Universitaire de France, Paris, France
| | - John P A Ioannidis
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA
| | - Vinay Prasad
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
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Sturmberg JP, Martin JH, Tramonti F, Kühlein T. The need for a change in medical research thinking. Eco-systemic research frames are better suited to explore patterned disease behaviors. Front Med (Lausanne) 2024; 11:1377356. [PMID: 38887671 PMCID: PMC11180740 DOI: 10.3389/fmed.2024.1377356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 05/14/2024] [Indexed: 06/20/2024] Open
Abstract
Many practicing physicians struggle to properly evaluate clinical research studies - they either simply do not know them, regard the reported findings as 'truth' since they were reported in a 'reputable' journal and blindly implement these interventions, or they disregard them as having little pragmatic impact or relevance to their daily clinical work. Three aspects for the latter are highlighted: study populations rarely reflect their practice population, the absolute average benefits on specific outcomes in most controlled studies, while statistically significant, are so small that they are pragmatically irrelevant, and overall mortality between the intervention and control groups are unaffected. These observations underscore the need to rethink our research approaches in the clinical context - moving from the predominant reductionist to an eco-systemic research approach will lead to knowledge better suited to clinical decision-making for an individual patient as it takes into account the complex interplay of multi-level variables that impact health outcomes in the real-world setting.
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Affiliation(s)
- Joachim P. Sturmberg
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
- International Society for Systems and Complexity Sciences for Health, Waitsfield, VT, United States
| | - Jennifer H. Martin
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - Francesco Tramonti
- Department of Mental Health, Azienda USL Toscana Nordovest & Istituto di Psicoterapia Relazionale, Pisa, Italy
| | - Thomas Kühlein
- Allgemeinmedizinisches Institut, Universitätsklinikum Erlangen, Erlangen, Germany
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Mintzes B. Information on medicines: Does independence from industry influence matter? Afr J Prim Health Care Fam Med 2024; 16:e1-e2. [PMID: 38572857 PMCID: PMC11019035 DOI: 10.4102/phcfm.v16i1.4522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/05/2024] [Indexed: 04/05/2024] Open
Abstract
No abstract available.
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Affiliation(s)
- Barbara Mintzes
- School of Pharmacy and Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney.
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Bauchner H, Rivara FP. The Status of Pediatric Randomized Clinical Trials. J Pediatr 2024; 266:113862. [PMID: 38043678 DOI: 10.1016/j.jpeds.2023.113862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 11/27/2023] [Indexed: 12/05/2023]
Affiliation(s)
- Howard Bauchner
- Chobanian and Avedisian School of Medicine, Boston University, Boston, Massachusetts.
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Storme G. Are We Losing the Final Fight against Cancer? Cancers (Basel) 2024; 16:421. [PMID: 38275862 PMCID: PMC10814389 DOI: 10.3390/cancers16020421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 01/27/2024] Open
Abstract
Despite our increasing understanding of the biology and evolution of the cancer process, it is indisputable that the natural process of cancer creation has become increasingly difficult to cure, as more mutations are found with age. It is significantly more difficult to challenge the curative method when there is heterogeneity within the tumor, as it hampers clinical and genetic categorization. With advances in diagnostic technologies and screening leading to progressive tumor shrinkage, it becomes more difficult over time to evaluate the effects of treatment on overall survival. New treatments are often authorized based on early evidence, such as tumor response; disease-free, progression-free, meta-static-free, and event-free survival; and, less frequently, based on clinical endpoints, such as overall survival or quality of life, when standard guidelines are not available to approve pharmaceuticals. These clearances usually happen quite rapidly. Although approval takes longer, relative survival demonstrates the genuine worth of a novel medication. Pressure is being applied by pharmaceutical companies and patient groups to approve "new" treatments based on one of the above-listed measures, with results that are frequently insignificantly beneficial and frequently have no impact on quality of life.
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Affiliation(s)
- Guy Storme
- Department Radiation Oncology, UZ Brussel, Asfilstraat 20, 9031 Drongen, Belgium
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Muharremi G, Meçani R, Muka T. The Buzz Surrounding Precision Medicine: The Imperative of Incorporating It into Evidence-Based Medical Practice. J Pers Med 2023; 14:53. [PMID: 38248754 PMCID: PMC10820165 DOI: 10.3390/jpm14010053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/17/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
Precision medicine (PM), through the integration of omics and environmental data, aims to provide a more precise prevention, diagnosis, and treatment of disease. Currently, PM is one of the emerging approaches in modern healthcare and public health, with wide implications for health care delivery, public health policy making formulation, and entrepreneurial endeavors. In spite of its growing popularity and the buzz surrounding it, PM is still in its nascent phase, facing considerable challenges that need to be addressed and resolved for it to attain the acclaim for which it strives. In this article, we discuss some of the current methodological pitfalls of PM, including the use of big data, and provide a perspective on how these challenges can be overcome by bringing PM closer to evidence-based medicine (EBM). Furthermore, to maximize the potential of PM, we present real-world illustrations of how EBM principles can be integrated into a PM approach.
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Affiliation(s)
| | - Renald Meçani
- Epistudia, 3008 Bern, Switzerland; (G.M.); (R.M.)
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8010 Graz, Austria
| | - Taulant Muka
- Epistudia, 3008 Bern, Switzerland; (G.M.); (R.M.)
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