The importance of allocation concealment and patient blinding in osteoarthritis trials: a meta-epidemiologic study.

摘要: OBJECTIVE: To evaluate the association of adequate allocation concealment and patient blinding with estimates treatment benefits in osteoarthritis trials. METHODS: We performed a meta-epidemiologic study 16 meta-analyses 175 trials that compared therapeutic interventions placebo or nonintervention control patients hip knee osteoarthritis. calculated effect sizes from differences means pain intensity between groups at end followup divided by pooled SD without methodology. RESULTS: Effect tended to be less beneficial 46 112 inadequate unclear (difference -0.15; 95% confidence interval [95% CI] -0.31, 0.02). Selection bias associated was most pronounced large estimated (P for interaction < 0.001), high between-trial heterogeneity = 0.009), complementary medicine 0.019). 64 58 CI -0.39, 0.09), but were consistent disappeared after accounting concealment. Detection lack nonpharmacologic 0.001). CONCLUSION: Results may affected selection detection bias. Adequate attempts blind will minimize these biases.