癌症临床试验中的不良事件报告:纳入患者报告方法。系统性范围界定综述

Minna Grahvendy, Bena Brown, Laurelie R. Wishart
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摘要

背景和目的临床试验的历史充满了不道德的做法。自 1945 年以来,为规范安全性数据的收集和报告,已经形成了一些强有力的框架,其中最著名的是美国国家癌症研究所制定的《不良事件通用术语标准》(CTCAE);研究人员使用该标准报告参与者所经历的副作用。随着医学向 "以患者为中心 "的模式转变,人们对直接从参与者那里收集不良事件数据(患者报告的不良事件)的兴趣与日俱增。本系统性范围界定综述旨在调查将患者报告的不良事件数据纳入安全性/耐受性分析的情况,并探讨患者报告的不良事件数据的收集和报告。分析共纳入 68 项研究。纳入患者报告的不良事件数据的研究数量逐年增加。收集患者报告的不良事件数据共使用了 70 种工具,不同研究的召回时间、方式、频率和给药部位各不相同;数据收集时间从 28 天到 6 年不等。这些细节信息经常在出版物中被省略。结论尽管纳入患者报告的不良事件的呼声越来越高,但尚未转化为发表的报告。这些数据的收集和报告方式各不相同,使用的工具也并非为特定目的而设计。为了解决这些不一致的问题,需要使用专门设计的验证工具对数据收集和报告进行标准化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Adverse Event Reporting in Cancer Clinical Trials: Incorporating Patient-Reported Methods. A Systematic Scoping Review

Background and objective

The history of clinical trials is fraught with unethical practices. Since 1945, robust frameworks have evolved to standardise the collection and reporting of safety data, most notably, the Common Terminology Criteria for Adverse Events (CTCAE) from the National Cancer Institute; used by investigators to report side effects experienced by participants. As medicine moves into the patient-centred model, interest has been growing to collect data on adverse events directly from participants (patient-reported adverse events). The aim of this systematic scoping review was to investigate the inclusion of patient-reported adverse event data within safety/tolerability analyses and explore the collection and reporting of patient-reported adverse event data.

Methods and results

A database search was undertaken and the Covidence platform was used to manage the review; results were analysed descriptively. Sixty-eight studies were included in the analysis. An increase in the number of studies that incorporate patient-reported adverse event data was seen by year. Seventy instruments were used for the collection of patient-reported adverse event data with recall period, mode, frequency and site of administration varying across studies; the duration of data collection ranged from 28 days to 6 years. Frequently, information on these details was omitted from publications. The number of instruments used by studies to collect patient-reported adverse event data ranged from one to seven instruments.

Conclusions

Despite growing calls for the inclusion of patient-reported adverse events, this has not yet translated into published reports. The collection and reporting of these data were variable and conducted using instruments that were not designed for purpose. To address these inconsistencies, standardisation of data collection and reporting using a purpose-built validated instrument is required.

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