TY - JOUR
T1 - How study design affects outcomes in comparisons of therapy. II
T2 - Surgical
AU - Miller, James N.
AU - Colditz, Graham A.
AU - Mosteller, Frederick
PY - 1989/4
Y1 - 1989/4
N2 - We analysed the results of 221 comparisons of an innovation with a standard treatment in surgery published in six leading surgery journals in 1983 to relate features of study design to the magnitude of gain. For each comparison we measured the gain attributed to the innovation over the standard therapy by the Mann—Whitney statistic and the difference in proportion of treatment successes. For primary treatments (aimed at curing or ameliorating a patient's principal disease), an average gain of 0.56 was produced by 20 randomized controlled trials. This was less than the 0.62 average for four non‐randomized controlled trials, 0.63 for 19 externally controlled trials, and 0.57 for 73 record reviews (0.50 represents a toss‐up between innovation and standard). For secondary therapies (used to prevent or treat complications of therapy), the average gain was 0.53 for 61 randomized controlled trials, 0.58 for eleven non‐randomized controlled trials, 0.54 for eight externally controlled trials, and 0.55 for 18 record reviews. Readers of studies evaluating new treatments, particularly for primary treatments, may consider adjustment of the gain according to the study type.
AB - We analysed the results of 221 comparisons of an innovation with a standard treatment in surgery published in six leading surgery journals in 1983 to relate features of study design to the magnitude of gain. For each comparison we measured the gain attributed to the innovation over the standard therapy by the Mann—Whitney statistic and the difference in proportion of treatment successes. For primary treatments (aimed at curing or ameliorating a patient's principal disease), an average gain of 0.56 was produced by 20 randomized controlled trials. This was less than the 0.62 average for four non‐randomized controlled trials, 0.63 for 19 externally controlled trials, and 0.57 for 73 record reviews (0.50 represents a toss‐up between innovation and standard). For secondary therapies (used to prevent or treat complications of therapy), the average gain was 0.53 for 61 randomized controlled trials, 0.58 for eleven non‐randomized controlled trials, 0.54 for eight externally controlled trials, and 0.55 for 18 record reviews. Readers of studies evaluating new treatments, particularly for primary treatments, may consider adjustment of the gain according to the study type.
KW - Bias
KW - Evaluation of therapy
KW - Research design
UR - http://www.scopus.com/inward/record.url?scp=0024503177&partnerID=8YFLogxK
U2 - 10.1002/sim.4780080409
DO - 10.1002/sim.4780080409
M3 - Article
C2 - 2727469
AN - SCOPUS:0024503177
SN - 0277-6715
VL - 8
SP - 455
EP - 466
JO - Statistics in medicine
JF - Statistics in medicine
IS - 4
ER -