Jpa. Ioannidis et J. Lau, Completeness of safety reporting in randomized trials - An evaluation of 7medical areas, J AM MED A, 285(4), 2001, pp. 437-443
Citations number
22
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Context Randomized trials with adequate sample size offer an opportunity to
assess the safety of new medications in a controlled setting; however, gen
eralizable data on drug safety reporting are sparse,
Objective To scrutinize the completeness of safety reporting in randomized
trials.
Design, Setting, and Patients Survey of safety reporting in 192 randomized
drug trials 7 diverse topics with sample sizes of at least 100 patients and
at least 50 patients in a study arm (N =130 074 patients). Trial reports w
ere identified from comprehensive meta-analyses in 7 medical areas.
Main Outcome Measures Adequate reporting of specific adverse effects and fr
equency and reasons for withdrawals due to toxic effects; article space all
ocated to safety reporting and predictors of such reporting.
Results Severity of clinical adverse effects and laboratory-determined toxi
city was adequately defined in only 39% and 29% of trial reports, respectiv
ely. Only 46% of trials stated the frequency of specific reasons for discon
tinuation of study treatment due to toxicity. For these 3 parameters, there
was significant heterogeneity in rates of adequate reporting across topics
(P=.003, P<.001, and P=.02, respectively). Over all, the median space allo
cated to safety results was 0.3 page. A similar amount of space was devoted
to contributor names and affiliations (P=.16). On average, the percentage
of space devoted to safety in the results section was 9.3% larger in trials
involving dose comparisons than in those that did not (P<.001) and 3.8% sm
aller in trials reporting statistically significant results for efficacy ou
tcomes (P=.047),
Conclusions The quality and quantity of safety reporting vary across medica
l areas, study designs, and settings but they are largely inadequate. Curre
nt standards for safety reporting in randomized trials should be revised to
address this inadequacy.