Abstract:
BACKGROUND:Pharmaceutical companies and other trial sponsors must submit certain trial results to ClinicalTrials.gov. The validity of these results is unclear. PURPOSE:To validate results posted on ClinicalTrials.gov against publicly available U.S. Food and Drug Administration (FDA) reviews on Drugs@FDA. DATA SOURCES:ClinicalTrials.gov (registry and results database) and Drugs@FDA (medical and statistical reviews). STUDY SELECTION:100 parallel-group, randomized trials for new drug approvals (January 2013 to July 2014) with results posted on ClinicalTrials.gov (15 March 2015). DATA EXTRACTION:2 assessors extracted, and another verified, the trial design, primary and secondary outcomes, adverse events, and deaths. RESULTS:Most trials were phase 3 (90%), double-blind (92%), and placebo-controlled (73%) and involved 32 drugs from 24 companies. Of 137 primary outcomes identified from ClinicalTrials.gov, 134 (98%) had corresponding data at Drugs@FDA, 130 (95%) had concordant definitions, and 107 (78%) had concordant results. Most differences were nominal (that is, relative difference <10%). Primary outcome results in 14 trials could not be validated. Of 1927 secondary outcomes from ClinicalTrials.gov, Drugs@FDA mentioned 1061 (55%) and included results data for 367 (19%). Of 96 trials with 1 or more serious adverse events in either source, 14 could be compared and 7 had discordant numbers of persons experiencing the adverse events. Of 62 trials with 1 or more deaths in either source, 25 could be compared and 17 were discordant. LIMITATION:Unknown generalizability to uncontrolled or crossover trial results. CONCLUSION:Primary outcome definitions and results were largely concordant between ClinicalTrials.gov and Drugs@FDA. Half the secondary outcomes, as well as serious events and deaths, could not be validated because Drugs@FDA includes only "key outcomes" for regulatory decision making and frequently includes only adverse event results aggregated across multiple trials. PRIMARY FUNDING SOURCE:National Library of Medicine.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Schwartz LM,Woloshin S,Zheng E,Tse T,Zarin DAdoi
10.7326/M15-2658subject
Has Abstractpub_date
2016-09-20 00:00:00pages
421-30issue
6eissn
0003-4819issn
1539-3704pii
2529054journal_volume
165pub_type
杂志文章abstract::As a result of important advances in medical imaging, the oral cholecystogram is no longer the primary test of gallbladder function and anatomy. Real-time ultrasonography and cholescintigraphy, both highly sensitive and specific tests, are the two major methods for assessing gallbladder pathology. Oral cholecystograph...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-109-9-722
更新日期:1988-11-01 00:00:00
abstract:OBJECTIVE:To determine whether the detection of tuberculostearic acid (TBSA) in bronchial aspirate and bronchoalveolar lavage specimens is useful for the rapid diagnosis of active pulmonary tuberculosis in patients suspected of having the disease. SETTING:A pulmonary clinic in a teaching hospital. PATIENTS:Forty pati...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-111-8-650
更新日期:1989-10-15 00:00:00
abstract:BACKGROUND:Lack of awareness of hypoglycemia is a major limiting factor in the management of type 1 diabetes. OBJECTIVE:To examine whether reduction in the number of episodes of hypoglycemia restores hypoglycemia awareness by influencing beta-adrenergic sensitivity in patients with type 1 diabetes. DESIGN:Controlled ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-134-9_part_1-200105010-00009
更新日期:2001-05-01 00:00:00
abstract::Amantadine HCl administration has resulted in accelerated resolution of influenza A illness. Prolonged abnormalities in pulmonary function have been described in uncomplicated influenza A. To study the effect of amantadine on these changes, we evaluated young adults with documented natural influenza A with clear chest...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-85-2-177
更新日期:1976-08-01 00:00:00
abstract:BACKGROUND:Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) are anti-inflammatory but have been linked in some studies to Crohn disease (CD) and ulcerative colitis (UC). OBJECTIVE:To assess the association between aspirin and NSAID use and incident CD and UC. DESIGN:Prospective cohort study. SETTING:Nurses'...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-156-5-201203060-00007
更新日期:2012-03-06 00:00:00
abstract::The management of asymptomatic hyperuricemia is controversial. Reported benefits from treatment prevention of acute gouty arthritis, chronic tophaceous gout, urolithiasis, or gouty nephropathy. A review of experimental and clinical data suggests that the risks of asymptomatic hyperuricemia are small or unknown and the...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-88-5-666
更新日期:1978-05-01 00:00:00
abstract::Three patients with polymyositis had elevated serum levels of creatine kinase MB isoenzyme. The presence of this isoenzyme is used extensively to diagnose myocardial infarction, but the isoenzyme is also found in sera of patients with primary muscular and neuromuscular disorders. We studied cardiac function in two of ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-94-3-341
更新日期:1981-03-01 00:00:00
abstract::Thyroid antibodies were found significantly more often in insulin-dependent diabetics than in their spouses or in non-insulin-dependent diabetics. The poor correlation between presence of thyroid autoimmunity and duration of disease and the significantly increased prevalence of thyroid antibodies in first-degree relat...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-83-2-170
更新日期:1975-08-01 00:00:00
abstract::A prospective pretreatment staging evaluation was done on 49 consecutive patients with mycosis fungoides or the Sézary syndrome to study patterns of disease spread and prognostic factors. Routine staging procedures included complete blood count, blood chemistries, chest roentgenogram, lymphangiogram, radionuclide scan...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-93-2-223
更新日期:1980-08-01 00:00:00
abstract::A model of activation, proliferation, and differentiation of human lymphocyte responses is described, and the complex immunoregulatory modulation of this system discussed with regard to normal immune function and the aberrancies expressed in diseases characterized by abnormalities of immune function. Recent advances i...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-99-1-61
更新日期:1983-07-01 00:00:00
abstract::Identical male twins had alveolar cell carcinoma with nearly synchronous onset and similar histopathologic features, both metastatic to the brain. The hypothesis is advanced that there are genes shared by these twins that determine not only the susceptibility of pulmonary cells to malignant transformation but also the...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-87-4-447
更新日期:1977-10-01 00:00:00
abstract::We surveyed the faculty, fellows, and residents of a department of medicine to determine the relative importance of each of eight personal characteristics evaluated during the interview of house staff candidates. A booklet containing all possible pairings of the eight characteristics was distributed to 219 participant...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-97-1-108
更新日期:1982-07-01 00:00:00
abstract:BACKGROUND:Lack of confidence in postpolypectomy surveillance guidelines may be a factor in the observed low adherence rates among providers. OBJECTIVE:To assess the 2006 postpolypectomy colonoscopy surveillance guidelines, which recommend 3-year follow-up colonoscopy for individuals with high-risk adenomas (defined a...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-148-6-200803180-00004
更新日期:2008-03-18 00:00:00
abstract:BACKGROUND:An outbreak of seven cases (in six patients and one health care worker, all of whom had AIDS) of multidrug-resistant tuberculosis occurred in a hospital in Chicago. The hospital had a respirator-fit testing program but no acid-fast bacilli isolation rooms. OBJECTIVE:To identify risk factors for transmission...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-127-1-199707010-00006
更新日期:1997-07-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the sensitivity of herpes simplex virus isolates to acyclovir and the importance of resistant isolates in hospitalized patients. DESIGN:Retrospective incidence cohort study. SETTING:All herpes simplex virus isolates cultured over 1 year from patients followed at a tertiary care center. P...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-76-3-112-6-416
更新日期:1990-03-15 00:00:00
abstract::In patients with end-stage renal disease, nervous system dysfunction remains a major cause of disability. Patients with chronic renal failure who have not yet received dialysis may have symptoms ranging from mild sensorial clouding to delirium and coma. Dialysis itself is associated with at least three distinct disord...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-109-2-143
更新日期:1988-07-15 00:00:00
abstract:OBJECTIVE:To examine the relation of obesity and weight loss to the formation of gallstones according to pertinent clinical and research issues. DATA SOURCES AND EXTRACTION:Original reports obtained through a MEDLINE search from 1966 to 1992 on gallstones plus obesity or reducing diets, supplemented by a manual search...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-119-10-199311150-00010
更新日期:1993-11-15 00:00:00
abstract:BACKGROUND:When deep venous thrombosis is suspected, objective testing is required to confirm or refute the diagnosis. OBJECTIVE:To determine whether the combination of a low clinical suspicion and a normal D -dimer result rules out deep venous thrombosis. DESIGN:Prospective cohort study. SETTING:Three tertiary care...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-135-2-200107170-00011
更新日期:2001-07-17 00:00:00
abstract:DESCRIPTION:Update of the 2005 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for abdominal aortic aneurysm (AAA). METHODS:The USPSTF commissioned a systematic review that assessed the evidence on the benefits and harms of screening for AAA and strategies for managing small (3.0 to 5.4 cm) sc...
journal_title:Annals of internal medicine
pub_type: 杂志文章,实务指引
doi:10.7326/M14-1204
更新日期:2014-08-19 00:00:00
abstract::Prospective data at Framingham and elsewhere have shown conclusively that risk of coronary heart disease in persons younger than age 50 is strikingly related to the serum total cholesterol level. Within so-called normal limits risk has been found to mount over a five-fold range. The impact has been found to be augment...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-90-1-85
更新日期:1979-01-01 00:00:00
abstract::Physicians are often asked to make prognostic assessments but often worry that their assessments will prove inaccurate. Prognostic systems were developed to enhance the accuracy of such assessments. This paper describes an approach for evaluating prognostic systems based on the accuracy (calibration and discrimination...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-130-6-199903160-00016
更新日期:1999-03-16 00:00:00
abstract:BACKGROUND:Few treatments exist for coronavirus disease 2019 (COVID-19). PURPOSE:To evaluate the effectiveness and harms of remdesivir for COVID-19. DATA SOURCES:Several databases, tables of contents of journals, and U.S. Food and Drug Administration and company websites were searched from 1 January through 31 August...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M20-5752
更新日期:2020-10-05 00:00:00
abstract:BACKGROUND:In previous open-label noncomparative clinical trials, both fluconazole and itraconazole were effective therapy for progressive forms of coccidioidomycosis. OBJECTIVE:To determine whether fluconazole or itraconazole is superior for treatment of nonmeningeal progressive coccidioidal infections. DESIGN:Rando...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-133-9-200011070-00009
更新日期:2000-11-07 00:00:00
abstract:OBJECTIVE:To determine whether laboratory findings showing antibodies to hepatitis C virus (HCV) in patients with autoimmune hepatitis represent false-positive results and to identify possible explanations for true-positive results in these patients. DESIGN:Cross-sectional. SETTING:University-based hospital. PATIENT...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-116-1-21
更新日期:1992-01-01 00:00:00
abstract::During the past quarter century, general internal medicine has emerged as a vital discipline. In the realm of patient care, it is the integrating discipline par excellence. Ironically, as general internists face the challenge of integrating advances of dizzying speed and complexity, and as their clinical practice beco...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-134-10-200105150-00013
更新日期:2001-05-15 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the tolerance and safety of oral dextran sulfate (UA001), a potent in-vitro inhibitor of human immunodeficiency virus (HIV) in patients with the acquired immunodeficiency syndrome (AIDS) and AIDS-related complex. DESIGN:Unblinded, dose-escalation 8-week trial. SETTING:An AIDS outpatient cl...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-110-3-183
更新日期:1989-02-01 00:00:00
abstract:Background:Implantable cardioverter-defibrillators (ICDs) have a role in preventing cardiac arrest in patients at risk for life-threatening ventricular arrhythmias. Purpose:To compare ICD therapy with conventional care for the primary prevention of death of various causes in adults with ischemic or nonischemic cardiom...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/M17-0120
更新日期:2017-07-18 00:00:00
abstract:BACKGROUND:Health care-associated infections from invasive medical devices in the intensive care unit (ICU) are a major threat to patient safety. Most published studies of ICU-acquired infections have come from industrialized western countries. In a Centers for Disease Control and Prevention (CDC) National Nosocomial I...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/0003-4819-145-8-200610170-00007
更新日期:2006-10-17 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy and safety of fluconazole for prevention of fungal infections. DESIGN:A randomized, placebo-controlled, double-blind, multicenter trial. PATIENTS:Adults (257) undergoing chemotherapy for acute leukemia. INTERVENTION:Patients were randomly assigned to receive either fluconazole (400...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-118-7-199304010-00003
更新日期:1993-04-01 00:00:00
abstract:Background:The benefits of pay-for-performance (P4P) programs are uncertain. Purpose:To update and expand a prior review examining the effects of P4P programs targeted at the physician, group, managerial, or institutional level on process-of-care and patient outcomes in ambulatory and inpatient settings. Data Sources...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/M16-1881
更新日期:2017-03-07 00:00:00