Purpose Clinicians may read only the abstract of an article to keep abreast of newly published randomized controlled trials (RCTs). However, discordances have been noticed in summary conclusions in the abstracts and the main body of some articles. This article evaluated such discordances in detail.
Methods RCTs of systemic therapy for lung cancer published between 2004 and 2009 were considered. Conclusions in the body of the articles and those in the abstracts were graded by using a 7-point Likert scale; 1 for strong endorsement of the control arm, 4 for a neutral statement, and 7 for strong endorsement of the experimental arm. Conclusions were classified as discordant if the difference in scores was ≥ 2. χ2 tests and logistic regression were used to identify factors associated with discordance.
Results From among 114 eligible RCTs identified (90 for non–small-cell and 24 for small-cell lung cancer), 11 (10%) articles presented discordant conclusions in the abstract and in the body of the articles. Discordance was most common when the experimental arm was strongly supported in the abstract but not in the body of the article (nine of 11; 82%); however, the converse was much less common (two of 11; 18%; P < .001). Intraclass correlations for the two reviewers were ≥ 0.9. The discordances were found to be independent of trial-related factors.
Conclusion Conclusive statements in the abstract can differ from those in the full text. Clinicians should use caution when they consider making changes in their practice on the basis of reading only the abstract of a published RCT.
Reference: http://jco.ascopubs.org/content/early/2012/05/29/JCO.2012.41.8319
메일 서비스를 받아보는 JCO 에서 이런 글이 있는 것을 보게 되었다. 대부분의 사람이 그렇겠지만, 논문을 고를 때에는 제목을 보고 마음에 다는 주제를 다루는 것 같으면 초록을 보고, 괜찮다 싶으면 본문을 볼 것이다. 폐암에 관한 논문들 중 RCT 를 대상으로만 하였을 때 약 10% 에서 초록과 본문의 결론이 다르다고 한다. 특히, 실험군이 좋은 결과를 보일 때 잘 나타난다고 한다. 최근 경향이나 정보를 얻기 위한 논문을 살펴 보기 위함이라면 초록만 봐도 시간 절약의 측면에서 나쁘지는 않다고 생각하지만, 중요한 결정에 영향을 미치는 것이라면 논문을 꼼꼼히 읽어봐야겠다는 생각이 들었다.
이 논문의 볼거리라고 한다면..
1. 정작 논문의 인용 논문의 숫자는 114개에 훨씬 못미치고 있음.
2. 많은 논문이 실린 저널에서 많은 불일치 논문이 나타나는 것은 아니었음. NEJM은 6개중 0개, JCO는 42개 중 2개, JNCI는 4개중 1개 이런 식임.
3. Overall survival 이 특히 잘 불일치함.