妇女和老年人在心血管临床试验中仍然代表性不足

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一项新的研究发现,尽管妇女和老年人在心脏病人群中占很大比例,但在心血管临床试验中仍然代表性不足。杜克大学的科学家在最新一期的《美国医学会杂志》上撰文指出,因为治疗心脏病的药物的安全性和有效性可能因性别和年龄而异,“这些入组偏差破坏了为所有心脏病患者提供循证护理的努力。”

杜克大学团队检查了1966年1月至2000年3月期间发表的593项研究心脏病发作和不稳定型心绞痛的随机临床试验。尽管他们确实发现随着时间的推移,妇女和老年人在这些试验中的代表性有所增加,但这种趋势不大。老年人在这些试验中的纳入比例从1966年的2%上升到1990年后的9%。然而,这个群体占美国所有心脏病发作患者的近40%。同样地,尽管这些试验中女性受试者的百分比从1966年的20%上升到1995年后的29%,但女性占心脏病发作患者的43%。

团队成员埃里克·彼得森指出:“将试验结果从年轻、主要是男性的人群普遍推广到妇女和老年患者可能是不合适的。”“关于妇女和老年患者治疗的安全性和有效性的信息匮乏可能导致一些医生在这些亚组中不予治疗。”

The article "Understanding Clinical Trials," by Justin A. Zivin (大众科学, April 2000) is available for purchase at the 大众科学 Archive.

Kate Wong is an award-winning science writer and senior editor at 大众科学 focused on evolution, ecology, anthropology, archaeology, paleontology and animal behavior. She is fascinated by human origins, which she has covered for more than 25 years. Recently she has become obsessed with birds. Her reporting has taken her to caves in France and Croatia that Neandertals once called home, to the shores of Kenya's Lake Turkana in search of the oldest stone tools in the world, to Madagascar on an expedition to unearth ancient mammals and dinosaurs, to the icy waters of Antarctica, where humpback whales feast on krill, and on a "Big Day" race around the state of Connecticut to find as many bird species as possible in 24 hours. Kate is co-author, with Donald Johanson, of Lucy's Legacy: The Quest for Human Origins. She holds a bachelor of science degree in biological anthropology and zoology from the University of Michigan. Follow Wong on X (formerly Twitter) @katewong

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