Lessons from Randomised Clinical Trials for Triiodothyronine Treatment of Hypothyroidism: Have They Achieved Their Objectives?
المؤلفون المشاركون
Midgley, John E. M.
Larisch, Rolf
Dietrich, Johannes W.
Hoermann, Rudolf
المصدر
العدد
المجلد 2018، العدد 2018 (31 ديسمبر/كانون الأول 2018)، ص ص. 1-9، 9ص.
الناشر
Hindawi Publishing Corporation
تاريخ النشر
2018-07-16
دولة النشر
مصر
عدد الصفحات
9
التخصصات الرئيسية
الملخص EN
Randomised controlled trials are deemed to be the strongest class of evidence in evidence-based medicine.
Failure of trials to prove superiority of T3/T4 combination therapy over standard LT4 monotherapy has greatly influenced guidelines, while not resolving the ongoing debate.
Novel studies have recently produced more evidence from the examination of homeostatic equilibria in humans and experimental treatment protocols in animals.
This has exacerbated a serious disagreement with evidence from the clinical trials.
We contrasted the weight of statistical evidence against strong physiological counterarguments.
Revisiting this controversy, we identify areas of improvement for trial design related to validation and sensitivity of QoL instruments, patient selection, statistical power, collider stratification bias, and response heterogeneity to treatment.
Given the high individuality expressed by thyroid hormones, their interrelationships, and shifted comfort zones, the response to LT4 treatment produces a statistical amalgamation bias (Simpson’s paradox), which has a key influence on interpretation.
In addition to drug efficacy, as tested by RCTs, efficiency in clinical practice and safety profiles requires reevaluation.
Accordingly, results from RCTs remain ambiguous and should therefore not prevail over physiologically based counterarguments.
In giving more weight to other forms of valid evidence which contradict key assumptions of historic trials, current treatment options should remain open and rely on personalised biochemical treatment targets.
Optimal treatment choices should be guided by strict requirements of organizations such as the FDA, demanding treatment effects to be estimated under actual conditions of use.
Various improvements in design and analysis are recommended for future randomised controlled T3/T4 combination trials.
نمط استشهاد جمعية علماء النفس الأمريكية (APA)
Hoermann, Rudolf& Midgley, John E. M.& Larisch, Rolf& Dietrich, Johannes W.. 2018. Lessons from Randomised Clinical Trials for Triiodothyronine Treatment of Hypothyroidism: Have They Achieved Their Objectives?. Journal of Thyroid Research،Vol. 2018, no. 2018, pp.1-9.
https://search.emarefa.net/detail/BIM-1203062
نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)
Hoermann, Rudolf…[et al.]. Lessons from Randomised Clinical Trials for Triiodothyronine Treatment of Hypothyroidism: Have They Achieved Their Objectives?. Journal of Thyroid Research No. 2018 (2018), pp.1-9.
https://search.emarefa.net/detail/BIM-1203062
نمط استشهاد الجمعية الطبية الأمريكية (AMA)
Hoermann, Rudolf& Midgley, John E. M.& Larisch, Rolf& Dietrich, Johannes W.. Lessons from Randomised Clinical Trials for Triiodothyronine Treatment of Hypothyroidism: Have They Achieved Their Objectives?. Journal of Thyroid Research. 2018. Vol. 2018, no. 2018, pp.1-9.
https://search.emarefa.net/detail/BIM-1203062
نوع البيانات
مقالات
لغة النص
الإنجليزية
الملاحظات
Includes bibliographical references
رقم السجل
BIM-1203062
قاعدة معامل التأثير والاستشهادات المرجعية العربي "ارسيف Arcif"
أضخم قاعدة بيانات عربية للاستشهادات المرجعية للمجلات العلمية المحكمة الصادرة في العالم العربي
تقوم هذه الخدمة بالتحقق من التشابه أو الانتحال في الأبحاث والمقالات العلمية والأطروحات الجامعية والكتب والأبحاث باللغة العربية، وتحديد درجة التشابه أو أصالة الأعمال البحثية وحماية ملكيتها الفكرية. تعرف اكثر