运动疗法治疗慢性下腰痛的循证医学
Statistical Significance Versus Clinical Importance: Trials on Exercise Therapy for Chronic Low Back Pain as Example.
统计学意义与临床意义的比较：以运动疗法治疗慢性下腰痛的实验为例
Literature Review
Spine. 32(16):1785-1790, July 15, 2007.
van Tulder, Maurits PhD *+[S]; Malmivaara, Antti MD, PhD ++; Hayden, Jill DC [S]; Koes, Bart PhD [//]
Abstract:
摘要
Study Design. Critical appraisal of the literature.
研究设计：文献的严格评价
Objecives. The objective of this study was to assess if results of back pain trials are statistically significant and clinically important.
目的：该研究的目的是评估腰痛实验结果是否同时具有统计学意义与临床意义。
Summary of Background Data. There seems to be a discrepancy between conclusions reported by authors and actual results of randomized controlled trials. Little attention has been paid to the problem of over-reporting of conclusions.
背景资料：目前看来报告的实验结果与随机对照实验的实际结果之间有差异。对于过度夸大实验结果的现象没有引起足够重视。
Methods. All 43 trials of the Cochrane review on exercise therapy for low back pain were included. Descriptive analyses were conducted.
方法：选择43例运动疗法治疗下腰痛实验的Cochrane文献。（注：Cochrane系统评价资料库(CDSR)是公认的获取临床证据的最好的单一信息源，包括两种类型的文献即即Cochrane Reviews 及Cochrane.）结果进行描述性分析。
Results. Eighteen trials reported positive conclusions in favor of exercise. Only six of the 43 studies showed both clinically important and statistically significant differences in favor of the exercise groups on function, and 4 on pain.
结果：18项实验认为运动疗法可以治疗下腰痛。43例之中仅10例报告了临床和统计学结果不符，其中6例是由于运动疗法组的功能4例是由于疼痛的原因。
Conclusion. It seems that many conclusions of studies of exercise therapy for chronic low back pain have been based on statistical significance of results rather than on clinical importance and, consequently, may have been too positive. Authors of trials should report not only statistical significance of results but also clinical importance.
结论：对运动疗法治疗下腰痛的实验所下结论大多是依据其统计学意义而不是依据实际临床观察结果，因而就扩大了阳性结果。试验的作者不仅应该报告其实验的统计学意义，还应该报告其临床结果。
[ 本帖最后由 daike_ren 于 2008-6-29 08:22 编辑 ]
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