方法与临床研究雷达（2026-08-31）
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1. Application of competing risks models in cardiovascular mortality research: findings from the Tehran lipid and glucose study.
主题：生存与复杂事件结局方法
相关性分数：6
期刊：Journal of diabetes and metabolic disorders
公开日期：2026-07-21（电子公开）
期刊卷期日期：2026-Dec
内容状态：待评估
为什么值得看：包含可供初筛的摘要；已识别电子公开日期；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
PURPOSE: Cardiovascular diseases (CVD) are a leading cause of mortality in Iran and globally. This study aimed to provide more accurate estimates of associations between risk factors and CVD mortality by applying competing risk models within the Tehran Lipid and Glucose Study cohort.
METHODS: In this prospective analysis, 7,529 individuals aged ≥ 30 years without prevalent CVD were followed for a median of 19.87 years. The primary outcome was CVD mortality (n = 311), with non-CVD death as the competing event (n = 592). Analyses were stratified by sex and age (< 65 vs. ≥65 years). Cause-specific and Fine-Gray models estimated hazard ratios for diabetes, hypertension, hypercholesterolemia, smoking, and body mass index.
RESULTS: Diabetes and hypertension were the strongest predictors of CVD mortality across most subgroups. In the Fine-Gray model, diabetes showed the greatest impact in women < 65 years (HR: 4.83, p < 0.001), while hypertension showed the strongest association in women ≥ 65 years (HR: 3.32, p < 0.001). Hypercholesterolemia was associated with increased CVD mortality exclusively in women < 65 years (HR: 1.79, p = 0.02). Body mass index showed no significant association.
CONCLUSION: Diabetes and hypertension are the predominant risk factors for CVD mortality in the presence of competing risks, with effect magnitudes varying by sex and age. Applying competing risk models is essential for accurate risk estimation and targeted prevention in populations with high competing mortality burden.
2. A pragmatic randomized trial to evaluate the vaccine effectiveness of bivalent RSV prefusion F vaccine for preventing RSV hospitalizations in adults (DAN-RSV): Trial design update.
主题：临床试验方法与统计实践
相关性分数：6
期刊：American heart journal
公开日期：2026-06-01（电子公开）
期刊卷期日期：2026-Oct
内容状态：待评估
为什么值得看：包含可供初筛的摘要；已识别电子公开日期；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
BACKGROUND: Respiratory syncytial virus (RSV) is a major cause of respiratory morbidity in adults, particularly among older individuals and those with comorbidities. The DAN-RSV trial was initiated to evaluate bivalent RSV prefusion F (RSVpreF) vaccine effectiveness in preventing RSV-related hospitalizations.
METHODS: DAN-RSV is a large-scale, pragmatic, randomized clinical trial that enrolled participants during the 2024/2025 (Danish adults aged ≥60 years) and 2025/2026 (adults aged ≥18 years in Denmark and Galicia, Spain) Northern hemisphere winter seasons. In Denmark, nationwide registries and the national electronic messaging system were used to identify and recruit eligible citizens; individuals could provide electronic informed consent remotely or in-person. In Galicia, participants were recruited via text message invitations and consented on-site.
RESULTS: During the initial 2024/2025 season, 131,379 Danish adults aged ≥60 years were enrolled. Following lower-than-expected event accrual and expansion of the EU indication to adults 18 years and older, the trial was extended to continue enrollment of adults aged ≥18 years across Denmark and Galicia, Spain during the 2025/2026 RSV season. Key protocol updates include expansion of the eligibility criteria to adults aged ≥18 years, inclusion of an additional study site within the integrated public healthcare infrastructure of Galicia, Spain, and an increase in the planned sample size to up to approximately 690,000 participants across both seasons. The randomization strategy (1:1 to RSVpreF vaccine or no vaccine), primary endpoint (RSV-related respiratory tract disease hospitalization), and statistical framework, including intention-to-treat analyses and hierarchical testing, remain unchanged.
CONCLUSION: The extension of the DAN-RSV trial is expected to improve statistical precision, enhance generalizability, and strengthen the robustness of the effect estimates. The updated design will provide reliable randomized evidence on bivalent RSVpreF vaccine effectiveness to inform clinical and public health decision-making.
3. Clinico-genomic risk stratification for biomarker-enriched trial design in poor-prognosis metastatic castrate-resistant prostate cancer (mCRPC).
主题：临床试验方法与统计实践
相关性分数：5
期刊：The journal of liquid biopsy
公开日期：2026-08-14（电子公开）
期刊卷期日期：2026-Sep
内容状态：待评估
为什么值得看：包含可供初筛的摘要；已识别电子公开日期；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
BACKGROUND: An integrated prognostic risk-score (RS) based on prognostic clinical factors and plasma copy number alterations (CNAs) across independent metastatic castration-resistant prostate cancer (mCRPC) cohorts was applied as a classifier to guide development of biomarker-enriched clinical trial designs.
DESIGN: Plasma CNAs prognostic for survival were combined into a prognostic score and integrated with clinical prognostic factors to derive an integrated RS in three independent mCRPC cohorts. Biomarker-enrichment trial designs were simulated across a spectrum of enrichment fractions and enrichment thresholds for the RS to consider 1:1 randomization of high RS patients to a study treatment arm or to receive standard treatment, with either a two or a three-year follow-up. The enrichment strategy was applied to improve the trial’s ability to detect survival benefit at a Hazard Ratio 0.70; 80% power. Design trade-offs were assessed between the number of “high-risk” patients screened versus enrolled under varying enrichment thresholds and degrees of enrichment of the RS.
RESULTS: Pooled mCRPC patients (N = 561) showed RS values from 0.243 to 3.924 and a RS ≥ 1 (60th percentile) was associated with shorter survival. Elastic net models for 2- and 3-year survival were developed. At a threshold ≥1 with 2-year follow-up, a hybrid biomarker-enriched design (50% unselected, 50% high-risk) required screening 768 patients to enroll 219 per arm (n = 438), while maintaining adequate power.
CONCLUSION: An integrated clinico-genomic classifier can guide an mCRPC enrichment strategy by enriching a cohort with 50% short-survival patients balancing sample size and screening needs to achieve adequate power in a biomarker-enriched design.
4. Cost-effectiveness of perioperative pembrolizumab plus enfortumab vedotin for cisplatin-ineligible or cisplatin-declining patients with muscle-invasive bladder cancer in the United States.
主题：因果推断、RWE 与卫生经济学
相关性分数：5
期刊：Journal of medical economics
公开日期：2026-08-18（电子公开）
期刊卷期日期：2026-Dec
内容状态：待评估
为什么值得看：包含可供初筛的摘要；已识别电子公开日期；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
AIMS: In the KEYNOTE 905/EV 303 study, perioperative enfortumab vedotin plus pembrolizumab (EV+Pem) improved event-free survival (EFS), overall survival (OS), and pathological complete response in a predominantly cisplatin-ineligible muscle-invasive bladder cancer (MIBC) population, compared with surgery alone with or without adjuvant nivolumab, as indicated (surgery ± adjuvant nivolumab). This study assessed the cost-effectiveness of perioperative EV+Pem for cisplatin-ineligible or declining patients with MIBC from a US third-party payer perspective.
METHODS: This cost-utility analysis used a state-transition Markov model with event-free (EF), progressed or recurrent disease (PRD), and death health states. The target population included cisplatin-ineligible or cisplatin-declining adults with MIBC. Transitions from EF were estimated using parametric multistate survival models based on trial data, with extrapolation beyond follow-up. Survival following PRD was modeled using a treatment-mix approach reflecting US clinical practice. Costs were derived from US sources, and utilities from KEYNOTE-905 EQ-5D-5L data. Scenario analyses explored alternative extrapolations and structural assumptions, and sensitivity analyses assessed parameter uncertainty.
RESULTS: In the base case, EV+Pem increased life-years by 3.08 (7.70 vs 4.62) and quality-adjusted life-years (QALYs) by 2.56 (6.19 vs 3.62) versus surgery ± adjuvant nivolumab. EV+Pem was associated with higher initial treatment costs, increasing total costs by $133,661 ($546,831 vs $413,171), partially offset by lower costs of treatment for PRD ($34,636 vs $129,813), yielding an incremental cost-effectiveness ratio (ICER) of $52,117 per QALY gained. Across scenario analyses, ICERs ranged from $50,363 to $69,703 per QALY gained. Probabilistic sensitivity analysis showed that EV+Pem had a 99.1% probability of being cost-effective at a $100,000 per QALY threshold.
LIMITATIONS: Results are subject to uncertainty in long-term survival extrapolation and evolving treatment patterns following PRD.
CONCLUSIONS: EV+Pem is cost-effective versus surgery ± adjuvant nivolumab for cisplatin-ineligible or cisplatin-declining patients with MIBC from a US third-party payer perspective at a willingness-to-pay threshold of $100,000 per QALY.
5. Cost-effectiveness analysis of finotonlimab in the treatment of advanced recurrent metastatic head and neck squamous cell carcinoma in China.
主题：因果推断、RWE 与卫生经济学
相关性分数：5
期刊：Human vaccines & immunotherapeutics
公开日期：2026-08-10（电子公开）
期刊卷期日期：2026-Dec
内容状态：待评估
为什么值得看：包含可供初筛的摘要；已识别电子公开日期；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
The SCT-I10A-B301 trial demonstrated efficacy and safety of finotonlimab combined with chemotherapy in patients with recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). However, the economics of this therapy are unknown. This study aims to assess the cost-effectiveness of incorporating finotonlimab into chemotherapy regimens for R/M HNSCC from the viewpoint of the Chinese healthcare system. A Markov model was developed to evaluate the treatment costs and outcomes of finotonlimab combined with chemotherapy for R/M HNSCC. Survival data were obtained from the SCT-I10A-B301 trial. Considering only direct medical costs, survival data, and utilities. The principal result measures employed were the incremental cost-effectiveness ratio (ICER). To identify how parameter uncertainty affected the model, one-way sensitivity analyses, probabilistic sensitivity analysis (PSA), and scenario studies were carried out. The results showed that the financial burden of finotonlimab, when administered concomitantly with chemotherapy ($36,996.99) was $26,072.18 higher than chemotherapy ($10,924.81) but also increased by 0.23QALY (0.89QALY vs. 0.66QALY), with an ICER of $112,384.47/QALY, which was higher than the willingness to pay (WTP) of $40,744/QALY. The model’s sensitivity to three factors was particularly pronounced: the utility of PFS, the utility of PD, and the cost of finotonlimab. Scenario analysis showed that a price reduction for finotonlimab could significantly reduce the ICER to near the WTP threshold. Compared with chemotherapy alone, finotonlimab combined with chemotherapy has been determined to be an ineffective, cost-effective therapeutic strategy for the first-line medical treatment of R/M HNSCC in China, and the price discount of finotonlimab can improve its cost-effectiveness.
6. Sample Size Reduction by Applying ML Based Causal Inference Methods.
主题：临床试验方法与统计实践
相关性分数：5
期刊：Pharmaceutical statistics
公开日期：2026
内容状态：待评估
为什么值得看：包含可供初筛的摘要；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
We conducted a comprehensive comparative analysis of causal machine learning (ML) methods to assess their utility in improving the efficiency of clinical trial designs with or without historical data. Specifically, we compared standard ANCOVA analysis used in a Randomized Controlled Trial (RCT) with several causal ML methods, including PROCOVA, TMLE, DML, and GRF. PROCOVA is gaining popularity in RCT design and requires a historical data for prognostic scores, but other methods can be applied with or without such data. Our primary focus was on strict RCT setting without borrowing historical control data, though we also explored the impact of borrowing data. The historical data used consisted of placebo data from two Phase 3 Ophthalmology studies with a continuous primary endpoint. We employed a generative AI approach, specifically Generative Adversarial Networks (GANs), to simulate RCT data from the historical data under various scenarios, varying treatment effects with and without treatment effect heterogeneity, RCT sizes, and bias. Results showed that causal ML methods can increase power even without borrowing historical data. For example, TMLE increased effective sample size by 21% in one scenario. In scenarios with borrowing of controls, PROCOVA increased power while controlling type 1 error, showing robustness to model misspecification.
7. Cost-effectiveness of finotonlimab plus bevacizumab versus sorafenib as first-line therapy in unresectable hepatocellular carcinoma in China.
主题：因果推断、RWE 与卫生经济学
相关性分数：5
期刊：Human vaccines & immunotherapeutics
公开日期：2026-07-27（电子公开）
期刊卷期日期：2026-Dec-31
内容状态：待评估
为什么值得看：包含可供初筛的摘要；已识别电子公开日期；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
Hepatocellular carcinoma (HCC) imposes a substantial health burden in China. Finotonlimab plus bevacizumab recently prolonged progression-free survival (PFS) and overall survival (OS) vs. sorafenib, but its economic value remains unknown. Here we evaluated the cost-effectiveness of finotonlimab plus bevacizumab vs. sorafenib from the Chinese healthcare system perspective. Parametric survival models were fitted to extrapolate PFS and OS. Total costs, life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), incremental net monetary benefit (INMB), and incremental net health benefit (INHB) were estimated at a willingness-to-pay (WTP) threshold of $27,906 per QALY. Uncertainty was evaluated by one-way and two-way sensitivity analyses, probabilistic sensitivity analysis (PSA), subgroup analyses, scenario analyses, and price simulations. In the base-case analysis, sorafenib yielded 1.74 LYs and 1.25 QALYs at a total cost of $10,303.10, whereas finotonlimab plus bevacizumab yielded 3.01 LYs and 2.18 QALYs at a total cost of $58,595.49. Compared with sorafenib, the combination increased costs by $48,292.39 and generated gains of 1.27 LYs and 0.93 QALYs, resulting in ICERs of $38,203.46 per LY and $51,899.31 per QALY. INMB (-$22,325.82) and INHB (-0.80 QALYs) were negative. Sensitivity analyses identified PFS utility and bevacizumab cost as key drivers, but all ICERs remained above the WTP threshold. In PSA, the mean ICER was $50561.81 per QALY, and the probability of cost-effectiveness was 0% at the prespecified threshold. Based on the assumptions and inputs used in the present model, finotonlimab plus bevacizumab was unlikely to be cost-effective compared with sorafenib at the prespecified WTP in China.
8. A multi-center, open-labelled, randomized controlled extended phase III non-inferiority clinical trial to evaluate the immunogenicity and tolerability of poliomyelitis vaccine (Vero cells), inactivated, Sabin strains administered with or without routine infant vaccines.
主题：临床试验方法与统计实践
相关性分数：4
期刊：Vaccine
公开日期：2026-08-27（电子公开）
期刊卷期日期：2026-Aug-27
内容状态：待评估
为什么值得看：包含可供初筛的摘要；已识别电子公开日期；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
BACKGROUND: Oral poliovirus vaccine (OPV) has been reported to cause vaccine-derived poliovirus and vaccine-associated paralytic poliomyelitis, and the limited global supply of conventional IPV has led many countries to rely on fractional-dose IPV regimens alongside OPV. The current study aims to assess the sIPV safety and immunogenicity when given concurrently with or in a staggered manner with routine immunization.
METHODS: A multi-country, multi-center, open-label, randomized controlled, extended phase III non-inferiority clinical trial was conducted with 1442 healthy infants aged 6-8 weeks from Bangladesh and Pakistan enrolled and randomized into four groups, i.e., co-administration group 1 (group C1), co-administration group 2 (group C2), staggered administration group 1 (group S1) and staggered administration group 2 (group S2). Antibody levels were determined using the collected sera for immunogenicity evaluation. The difference in seroconversion rates between the coadministration group and the staggered administration group is compared using the Cochran-Mantel-Haenszel χ2 (CMH-χ2) test, stratified by study site. Non-inferiority is concluded if the lower bound of the 95% confidence interval (CI) for the rate difference (coadministration group minus staggered administration group) is greater than -10%. The trial was registered prior to patient enrollment at clinicaltrials.gov (NCT05850364), and the protocol and statistical analysis plan are available at https://clinicaltrials.gov/study/NCT05850364. The trial is closed to new participants.
FINDINGS: The post-vaccination seroconversion rates for PV I were 90.3% (306/339) in group C1 and 87.0% (261/300) in group S1, for PV II, 91.7% (311/339) in group C1 and 91.3% (274/300) in group S1 and for PV III, 86.4% (293/339) in group C1 and 92.3% (277/300) in group S1. Among adverse reactions (ARs) reported within 7 days of vaccination, the incidence was similarly high in both the co-administration and staggered vaccination groups (92.8% vs. 95.5%).
INTERPRETATION: Our results demonstrated favorable safety and immunogenicity of co-administration of sIPV with other routine infant vaccines according to a 3-dose primary immunization schedule.
9. Brain-computer interface clinical trial design considerations and clinical outcome assessments in pivotal studies: a summary of the 11th BCI society meeting 2025 workshop.
主题：临床试验方法与统计实践
相关性分数：4
期刊：Journal of neural engineering
公开日期：2026-08-26（电子公开）
期刊卷期日期：2026-Aug-26
内容状态：待评估
为什么值得看：包含可供初筛的摘要；已识别电子公开日期；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
The Brain Computer Interface (BCI) Society Meeting 2025 held a workshop in collaboration with the Implantable BCI Collaborative Community (iBCI-CC) to discuss the selection, development and validation of clinical trial outcome assessments (COAs) for pivotal studies of BCIs. The iBCI-CC Clinical Study Endpoints Workgroup aims to build consensus on a COA framework that can meet the demands of emerging iBCI trials. Approach: The workshop brought together diverse stakeholders from the iBCI-CC community and beyond, including industry, academic and government institutions to engage in pre-competitive collaborative discussion. Main results: Through presentations, panel discussions and breakout groups, workshop participants highlighted meaningful aspects of health (MAHs) relevant to iBCI users, clarified the need to define corresponding concepts of interest (COIs) and to identify or adapt clinical outcome assessments (COAs) capable of capturing both functional impact and real-world use. Key challenges highlighted during the workshop are patient heterogeneity, the lack of widely validated and fit-for-purpose COAs, and the need to capture meaningful outcomes in home and daily-life environments. Lessons drawn from trials such as ADAPT-PD underscore the value of capturing device performance in home and daily-life settings, highlighting the need for context-sensitive and flexible metrics that reflect patient priorities. Significance: This workshop lays a foundation for the iBCI-CC Clinical Study Endpoints Workgroup to establish a transparent process for identifying MAHs and COIs that are suitable for specific iBCI technologies, patient-informed, and conducive to regulatory approval and reimbursement. By combining rigorous, quantitative assessment with patient-informed goals, iBCI clinical trials can advance toward safe, effective, and accessible neurotechnologies that enhance how a person with a severe motor impairment feels, functions and survives.
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10. Cost-effectiveness analysis of disitamab vedotin plus toripalimab versus chemotherapy as first-line treatment for HER2-expressing advanced urothelial cancer.
主题：因果推断、RWE 与卫生经济学
相关性分数：4
期刊：Human vaccines & immunotherapeutics
公开日期：2026-08-18（电子公开）
期刊卷期日期：2026-Dec
内容状态：待评估
为什么值得看：包含可供初筛的摘要；已识别电子公开日期；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
The RC48-C016 trial conducted in China demonstrated that disitamab vedotin plus toripalimab (DV+Torip) significantly extended overall survival and progression-free survival in comparison to chemotherapy for patients with HER2-expressing advanced urothelial cancer. However, the economic value of this combination regimen remains uncertain. This study aimed to assess the cost-effectiveness of DV+Torip vs. chemotherapy as a first-line treatment for HER2-expressing advanced urothelial cancer from the Chinese healthcare system perspective. A partitioned survival model with a 10 y time horizon was developed to evaluate the cost-effectiveness. The primary outcomes included costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs). Sensitivity, subgroup, and scenario analyses were employed to examine the uncertainty associated with the model results. The ICER of DV+Torip vs. chemotherapy was estimated at $18,448.74 per QALY, which was below the willingness-to-pay (WTP) threshold of $40,334 per QALY. In the majority of sensitivity, subgroup, and scenario analyses, the ICER values remained below the WTP threshold, thereby affirming the robustness of these findings. However, in one scenario analysis, where treatment durations were not aligned with the median treatment cycles and subsequent drug treatment costs were excluded, the economic advantage of the DV+Torip group was nullified, resulting in an ICER of $66,303.62 per QALY. These results suggest that DV+Torip is cost-effective, though its economic advantage may be influenced by treatment duration and subsequent therapy costs.
11. Efficacy and safety of semaglutide injection in Indian patients with type 2 diabetes mellitus inadequately controlled on metformin: A phase 3, randomized, active-controlled, multicenter, non-inferiority trial (WIN-IND study).
主题：临床试验方法与统计实践
相关性分数：4
期刊：Metabolism open
公开日期：2026-08-05（电子公开）
期刊卷期日期：2026-Sep
内容状态：待评估
为什么值得看：包含可供初筛的摘要；已识别电子公开日期；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
BACKGROUND: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder with a rapidly rising global burden. Present study established the non-inferiority and evaluated the safety of Intas semaglutide (test) compared to Innovator semaglutide (reference) in patients with T2DM inadequately controlled on metformin.
METHODS: This prospective, randomized, open-label, multicenter phase 3 trial, conducted between July-2025 and February-2026, enrolled adult patients (18-65 years) with T2DM and HbA1c level ≥7%-<10.5% at baseline, who had been on diet, exercise and metformin (≥1500 mg/day). Randomized (1:1) patients received either test or reference product, once weekly from 1 to 24 weeks. Primary endpoint was the change in HbA1c level. Secondary endpoints were the change in fasting blood glucose (FBG) level, post-prandial blood glucose (PPBG) level, bodyweight, body mass index (BMI), and lipid parameters. Safety assessment included monitoring of treatment emerged adverse events (TEAEs).
RESULTS: Study analyzed 223 (safety set) and 217 (ITT set) patients. Baseline characteristics were comparable between treatment groups. In the ITT (LOCF) set, at week-24, LSM change in HbA1c was -1.50 vs. -1.65 in test vs. reference group, respectively; LSM difference was 0.16 (95% CI: -0.16 to 0.47, P = 0.3266), confirming non-inferiority of the test product. Other efficacy parameters (FBG and PPBG levels, bodyweight and BMI) were also similarly reduced in the test group. The incidence, severity, and pattern of TEAEs were similar, without new safety signals identified.
CONCLUSION: Intas semaglutide showed non-inferiority to reference semaglutide with comparable efficacy, immunogenicity, and safety which may provide a cost-effective alternative treatment option to Indian patients with T2DM.
CLINICAL TRIAL REGISTRATION NUMBER: CTRI/2025/06/089290.
12. Comparison of the efficacy and safety of acetaminophen versus NSAIDs for the treatment of chronic pain in older adults with osteoarthritis of the hip and knee: Findings from the randomized, double-blind, parallel-group, non-inferiority RETHINK study.
主题：临床试验方法与统计实践
相关性分数：4
期刊：Osteoarthritis and cartilage open
公开日期：2026-07-06（电子公开）
期刊卷期日期：2026-Sep
内容状态：待评估
为什么值得看：包含可供初筛的摘要；已识别电子公开日期；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
OBJECTIVE: This study aimed to evaluate the non-inferiority of acetaminophen compared with non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of chronic osteoarthritis-related pain in older adults.
DESIGN: This multicenter, randomized, double-blind, parallel-group study enrolled patients aged 65 years or older with osteoarthritis-related pain. Participants were randomly assigned to receive acetaminophen (1800 mg/day) or NSAIDs (loxoprofen 180 mg/day or celecoxib 200 mg/day). The primary endpoint was the change in Brief Pain Inventory (BPI) item 3 (worst pain) score from baseline to week 8. The secondary endpoints included the change in BPI item 3 score from baseline to week 4, quality of life, gastrointestinal disorders, and renal and liver function parameters.
RESULTS: Of the 400 patients enrolled, 191 and 197 were in the acetaminophen (mean age 73.6 years; 83.2% female) and NSAID groups (mean age 73.3 years; 74.6% female), respectively. The least-squares mean change in BPI item 3 scores at 8 weeks was -1.79 in the acetaminophen group and -1.94 in the NSAIDs group. The between-group difference in BPI item 3 scores change was 0.14 (95% CI, -0.33 to 0.61). No major safety concerns were identified; however, gastrointestinal disorders occurred more frequently with NSAIDs and were the most common cause of treatment discontinuation.
CONCLUSIONS: In this RETHINK study, acetaminophen achieved a similar reduction in osteoarthritis-related pain to NSAIDs in older adults after eight weeks; however, non-inferiority was not demonstrated. In terms of adverse events, acetaminophen was associated with fewer gastrointestinal disorders. These findings suggest that treatment choice may depend on the balance between analgesic efficacy and safety considerations.
TRIAL REGISTRATION NUMBER: The study is registered in the Japan Registry of Clinical Trials (jRCTs071200112).
13. Benefit of Linked-Color Imaging in Artificial Intelligence-Assisted Diagnosis of Early Gastric Cancer: A Pilot Study With Propensity Score Adjustment.
主题：因果推断、RWE 与卫生经济学
相关性分数：4
期刊：DEN open
公开日期：2026-07-28（电子公开）
期刊卷期日期：2027-Apr
内容状态：待评估
为什么值得看：包含可供初筛的摘要；已识别电子公开日期；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
BACKGROUND AND AIMS: Artificial intelligence (AI)-assisted endoscopy represents a promising approach for lesion detection, yet frequent false-positive detections impair clinical utility by disrupting examinations and diminishing physician confidence. Linked-color imaging (LCI), an image-enhanced endoscopy technique that amplifies mucosal and vascular contrast, may address this limitation. This investigation evaluated whether LCI reduces false-positive AI detections compared with white-light imaging (WLI).
METHODS: This retrospective study analyzed consecutive AI-assisted upper endoscopies performed between March 2024 and June 2025. WLI and LCI were performed sequentially within the same endoscopic session in each patient. False-positive AI detections were compared between modalities using two computer-aided detection (CAD) versions. Propensity score adjustment was used as a sensitivity analysis for baseline differences between CAD Versions I and II.
RESULTS: Of 66 initially screened cases, 63 remained after excluding patients with prior gastric surgery. LCI reduced false-positive AI detections compared with WLI (median 2 vs. 5; p < 0.001). In CAD version-stratified sensitivity analyses, LCI reduced false-positive AI detections in both Version I (5 to 2; p = 0.01) and Version II (2 to 0; p = 0.03). This reduction remained consistent across atrophic grades. Both imaging modalities identified all gastric lesions, achieving 100% detection sensitivity.
CONCLUSIONS: LCI assessment performed after WLI observation yielded fewer false-positive CAD-EYE detections while maintaining lesion detection sensitivity. However, because the observation sequence was fixed, these findings should be interpreted cautiously and require confirmation in prospective or counterbalanced studies.
UNLABELLED: Trial Registration: N/A (retrospective study).
14. Transcutaneous auricular vagus nerve stimulation combined with ciprofol for sedation in patients undergoing same-session bidirectional endoscopy: a randomized, double-blind, placebo-controlled, three-arm non-inferiority trial protocol.
主题：临床试验方法与统计实践
相关性分数：4
期刊：Annals of medicine
公开日期：2026-07-01（电子公开）
期刊卷期日期：2026-Dec
内容状态：待评估
为什么值得看：包含可供初筛的摘要；已识别电子公开日期；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
BACKGROUND: Transcutaneous auricular vagus nerve stimulation (taVNS) provides targeted modulation of the autonomic nervous system and descending pain pathways, exerting analgesic potential. However, high-quality evidence remains insufficient to determine whether taVNS can effectively replace opioids in sedation regimens for same-session bidirectional endoscopy while maintaining the quality of early postoperative recovery.
DISCUSSION: This study is a single-center, prospective, randomized, double-blind, placebo-controlled, three-arm non-inferiority trial. A total of 181 patients scheduled for painless same-session bidirectional endoscopy will be enrolled and randomly assigned using dynamic block randomization to one of three groups: Group S (sufentanil 0.1 µg/kg plus sham taVNS), Group T (normal saline plus active taVNS), and Group P (normal saline plus sham taVNS). All participants will receive ciprofol for sedation induction and maintenance. The primary outcome will be the quality of recovery at 24 h postoperatively, assessed using the 15-item Quality of Recovery scale (QoR-15), with a predefined non-inferiority margin (δ) of 6 points, which corresponds to the minimal clinically important difference of the QoR-15 scale. Secondary outcomes will include perioperative adverse events (pre-, intra-, and postoperative, including taVNS-related events), QoR-15 score at 1 h postoperatively, procedural and recovery efficiency indices, sedative dosage, and patient and endoscopist satisfaction scores. Blinding effectiveness will be assessed in all participants, and statistical analyses will follow the modified intention-to-treat principle.
CONCLUSION: This study protocol will rigorously assess the effectiveness and safety of taVNS as an alternative to opioid analgesics for sedation during same-session bidirectional endoscopy using, to our knowledge, the first three-arm design.Trial registration: Chinese Clinical Trial Registry (ChiCTR2600117962).
This study will provide the first systematic evaluation of the feasibility and efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) as an opioid-sparing alternative to sufentanil for ciprofol-based sedation during same-session bidirectional endoscopy.A three-arm randomized design incorporating a prespecified trial-sensitivity analysis will be used to rigorously validate the effectiveness of the standard regimen, enhancing the interpretability and credibility of the non-inferiority conclusion.An “active placebo” taVNS stimulation model combined with an improved standardized questionnaire for blinding assessment will be employed to address the well-recognized limitations of inadequate blinding in taVNS research.
15. Resuscitation in paediatric septic shock using vitamin C and hydrocortisone (RESPOND): The RESPOND randomised controlled trial statistical analysis plan.
主题：临床试验方法与统计实践
相关性分数：4
期刊：Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine
公开日期：2026-06-16（电子公开）
期刊卷期日期：2026-Sep
内容状态：待评估
为什么值得看：包含可供初筛的摘要；已识别电子公开日期；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
BACKGROUND: The Resuscitation in Paediatric Septic Shock using Vitamin C and Hydrocortisone (RESPOND) trial is a multicentre randomised controlled trial exploring whether the use of hydrocortisone alone, or in combination with vitamin C, increases time alive and free of vasopressors for critically ill children.
OBJECTIVE: To present the prespecified statistical analysis plan (SAP) for the RESPOND trial prior to finalising recruitment and locking the trial dataset.
DESIGN SETTING AND PARTICIPANTS: The RESPOND trial is a three-arm, parallel group, open-label, randomised controlled trial, recruiting in paediatric intensive care units in Australia, New Zealand, India, and Brazil. The planned sample size is 384 participants.
MAIN OUTCOME MEASURES: The primary outcome is time alive and free of inotropes/vasopressors, censored at 7 days post-randomisation. Secondary outcomes include clinical (e.g. alive and free of multi-organ dysfunction, length of stay), safety, health economics (e.g. incremental costs, quality-adjusted life years), and long-term outcomes (measured at 6 months post-randomisation; e.g. health-related quality of life).
RESULTS AND CONCLUSIONS: The SAP was designed by the Chief Investigators and approved by the RESPOND Steering Committee. Statistical analyses are summarised. The primary outcome will be analysed using quantile regression adjusted for stratification variables. Appropriate statistical comparisons between groups were planned and described in a way that is transparent, available to the public, verifiable, and predetermined before completion of data collection. The trial statistician, RESPOND Steering Committee members, and SAP authors remain blind to treatment allocation throughout the study. Data Safety and Monitoring Board members were provided with safety data with masked group identifiers during interim analyses. The RESPOND trial commenced recruitment in December, 2021, and aims to complete recruitment by mid-2026.
TRIAL REGISTRATION: ACTRN12621000247875.
16. Endoscopic Surveillance in Serrated Polyposis Syndrome, Two or Three-Year Intervals: A Non-inferiority Randomized Trial.
主题：临床试验方法与统计实践
相关性分数：4
期刊：Digestive diseases and sciences
公开日期：2026-04-21（电子公开）
期刊卷期日期：2026-Sep
内容状态：待评估
为什么值得看：包含可供初筛的摘要；已识别电子公开日期；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
BACKGROUND: Serrated polyposis syndrome, the most prevalent colonic polyposis, confers an increased colorectal cancer risk. Guidelines recommend close colonoscopy surveillance, but recent data suggest low neoplasia rates, supporting longer colonoscopy intervals.
AIMS: Compare advanced neoplasia incidence between two- and three-year surveillance.
METHODS: A multicentre, randomized non-inferiority trial was conducted (May 2021-November 2024) in six Spanish hospitals. Patients fulfilling the 2019 WHO criteria for serrated polyposis syndrome, including newly diagnosed individuals and those already under surveillance, with no advanced neoplasia and fewer than five relevant polyps at their previous colonoscopy, were randomized to surveillance at 2 or 3 years. The primary endpoint was advanced neoplasia incidence.
RESULTS: A total of 131 patients with serrated polyposis syndrome were included (47.3% women; mean age 66.1). Seventy-two were assigned to 2-year and 59 to 3-year colonoscopy. Among 771 resected lesions, 2.4% were advanced adenomas or advanced serrated polyps; no colorectal cancer was detected. The proportion of patients with advanced neoplasia in the surveillance colonoscopy was 6.9% (2-year) vs 13.6% (3-year), with no statistical difference (p = 0.208) but with a risk difference of + 6.7% (95% CI -4.1 to 17.5%) exceeding the pre-specified non-inferiority margin of + 10%. Time since serrated polyposis syndrome diagnosis ≤ 3 years was associated with advanced neoplasia (OR 4.4; 95% CI 1.56-14.71; p = 0.024).
CONCLUSIONS: In patients with serrated polyposis syndrome, extending colonoscopy surveillance to a three-year compared with a two-year interval yielded inconclusive evidence regarding non-inferiority for advanced neoplasia incidence. The early years following serrated polyposis syndrome diagnosis were identified as a risk factor for advanced neoplasia.
TRIAL REGISTRATION: Clinical Trial Registry ClinicalTrials.gov (NCT04906343). Date: 5-10-2021.
17. Laryngeal mask airway use during liver transplantation: perioperative outcomes in a propensity score-matched cohort.
主题：因果推断、RWE 与卫生经济学
相关性分数：3
期刊：Annals of medicine
公开日期：2026-08-30（电子公开）
期刊卷期日期：2026-Dec
内容状态：待评估
为什么值得看：包含可供初筛的摘要；已识别电子公开日期；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
BACKGROUND: Whether a laryngeal mask airway (LMA) can be safely used during liver transplantation remains unclear. However, in clinical practice, the choice of an airway device may also reflect a broader recovery-oriented perioperative strategy rather than an isolated technical substitution.
METHODS: We retrospectively reviewed adult patients who underwent primary elective liver transplantation at our center between January 2024 and November 2025. The patients were grouped according to their primary intraoperative airway device (LMA or endotracheal tube [ETT]). Propensity score matching was used to reduce baseline imbalance. Intraoperative variables, postoperative airway-related events, postoperative pulmonary complications (PPCs), intensive care unit (ICU) stays, and postoperative hospital stays were compared.
RESULTS: After matching, 25 and 44 patients in the LMA and ETT groups, respectively, were analyzed. The LMA group showed a higher rate of immediate airway device removal, lower rocuronium use during anesthetic maintenance, less postoperative noninvasive ventilation, less postoperative sore throat, and a shorter postoperative hospital stay. PPCs were numerically less frequent in the LMA group, but the between-group difference was not statistically significant after matching. No increase in major airway-related adverse events was observed in the LMA group.
CONCLUSIONS: In carefully selected liver transplant recipients, use of LMA within a recovery-oriented perioperative context appeared feasible and was associated with several favorable early postoperative outcomes.
Laryngeal mask airway was feasible in carefully selected adult liver transplant recipients.Laryngeal mask airway increased immediate airway device removal after transplantation.Laryngeal mask airway reduced sore throat and noninvasive ventilation after surgery.Laryngeal mask airway was associated with shorter postoperative hospital stay.
18. The historical development of sample size estimation: from Huygens and Bernoulli to the present.
主题：临床试验方法与统计实践
相关性分数：3
期刊：Journal of the Royal Society of Medicine
公开日期：2026-08-29（电子公开）
期刊卷期日期：2026-Aug-29
内容状态：待评估
为什么值得看：包含可供初筛的摘要；已识别电子公开日期；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
This paper traces the historical development of frequentist sample size estimation from its philosophical origins to its present-day complexity. Preliminary concepts were identified by Christiaan Huygens’ work on expected value and Jacob Bernoulli’s law of large numbers, which first linked sample size and estimation accuracy. The 18th and 19th centuries brought major advances in probability theory through the work of Pierre-Simon de Laplace, Carl Friedrich Gauss and Siméon-Denis Poisson, yet explicit sample size planning remained uncommon. The early 20th century saw the emergence of methods for sample size calculations based on Jerzy Neyman and Egon Pearson’s hypothesis testing framework and Sir Ronald Aylmer Fisher’s experimental design principles. While Donald Mainland and Austin Bradford Hill referred indirectly to these as early as the 1930s, it took many decades before their explicit use became common. After the Second World War, contributions from figures such as Abraham Wald further embedded sample size planning with sequential methodologies. From the 1970s onward, standardised formulas, regulatory requirements, reporting standards such as CONSORT and statistical software consolidated frequentist sample size estimation as a routine component in applied research. In the 21st century, simulation-based, adaptive and Bayesian approaches, together with open-source computational ecosystems, have expanded the scope and accessibility of sample size methods. In contemporary research, sample size estimation has evolved into a multifaceted discipline; its methodological sophistication is contingent upon the underlying objective, illustrating the persistent divergence between explanatory inference and decision-oriented design.
19. Equipoise lost: Prioritizing patient safety and early access to promising cancer therapies in clinical trial design by reimagining crossover.
主题：临床试验方法与统计实践
相关性分数：3
期刊：The oncologist
公开日期：2026-08-28（电子公开）
期刊卷期日期：2026-Aug-28
内容状态：待评估
为什么值得看：暂缺摘要，需回到 PubMed 核验；已识别电子公开日期；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
20. Clinical and public health economic impact of rapid strain-matched vaccination in influenza pandemic mitigation: A UK-like population dynamic transmission model.
主题：因果推断、RWE 与卫生经济学
相关性分数：3
期刊：Human vaccines & immunotherapeutics
公开日期：2026-08-28（电子公开）
期刊卷期日期：2026-Dec
内容状态：待评估
为什么值得看：包含可供初筛的摘要；已识别电子公开日期；通过方法学信号门槛；仍需阅读全文评价适用性与证据质量。
Influenza A virus H5N1 has recently circulated at unprecedented levels in birds and mammals, causing sporadic human infections. Using a susceptible-exposed-infectious-recovered (SEIR) dynamic transmission model of a UK-like population, this study aimed to quantify reductions in morbidity, mortality, and healthcare utilization attributable to rapid deployment of a strain-matched pandemic influenza vaccine; to compare outcomes across egg-based and cell-based vaccine platforms; to evaluate the economic impact of nonpharmaceutical interventions (NPIs) and their interaction with vaccination timing; and to estimate the impact of earlier or delayed vaccine availability across a full spectrum of pandemic transmissibility and severity scenarios. In the absence of NPIs, a 16-week vaccination campaign starting 16 weeks post-pandemic declaration reduced infections by 3.0 million and deaths by 28,000, with greater benefits observed in low-transmissibility scenarios. A cell-based vaccine with equivalent timing further reduced deaths by 5.0%, with additional gains in scenarios involving faster vaccine production. NPIs (average cost, £208 billion) enhanced vaccine effectiveness across all pandemic types, most markedly in high-transmissibility events; cell-based vaccine additionally reduced NPI costs by 0.9% relative to egg-based vaccine. Conversely, delays in vaccine availability increased both mortality and economic costs. These findings highlight the need for robust and agile vaccine development, registration, and distribution infrastructures, as well as flexible response strategies adaptable to varying pandemic severity and transmissibility. Policymakers should consider adopting a comprehensive framework integrating health outcome metrics and the economic impact of NPIs to inform vaccine procurement and deployment decisions.