Design of treatment trials for functional gastrointestinal disorders

S J Veldhuyzen van Zanten, N J Talley, P Bytzer, K B Klein, P J Whorwell, A R Zinsmeister, S J Veldhuyzen van Zanten, N J Talley, P Bytzer, K B Klein, P J Whorwell, A R Zinsmeister

Abstract

Until recently many clinical trials of functional gastrointestinal disorders (FGIDs) suffered from important weaknesses in trial design, study execution, and data analysis. This makes it difficult to determine whether truly efficacious therapies exist for these disorders. One of the important methodologic problems is the absence of validated outcome measures and lack of consensus among stakeholders on how to measure outcome. Currently much of the effort is being put into the development of validated outcome measures for several of the FGIDs. The randomized, controlled trial with parallel groups is the design of choice. In this report, guidelines are given for the basic architecture of intervention studies of FGIDs. Further studies on design issues are required to ensure the recommendations will become evidence based in the future.

References

    1. Gastroenterology. 1993 Nov;105(5):1378-86
    1. Ann Intern Med. 1993 Apr 15;118(8):622-9
    1. Scand J Gastroenterol. 1995 Nov;30(11):1046-52
    1. Am J Gastroenterol. 1996 Apr;91(4):660-73
    1. JAMA. 1996 Aug 28;276(8):637-9
    1. Aliment Pharmacol Ther. 1996 Feb;10(1):91-5
    1. Eur J Gastroenterol Hepatol. 1996 Oct;8(10):967-71
    1. Aliment Pharmacol Ther. 1997 Jun;11(3):547-52
    1. Gastroenterology. 1998 Mar;114(3):582-95
    1. Dig Dis Sci. 1998 Feb;43(2):400-11
    1. BMJ. 1998 Apr 18;316(7139):1236-8
    1. J Clin Epidemiol. 1993 Mar;46(3):273-9
    1. Pain. 1975 Sep;1(3):277-99
    1. N Engl J Med. 1978 Sep 28;299(13):690-4
    1. Lancet. 1978 Nov 4;2(8097):955-7
    1. N Engl J Med. 1983 Nov 24;309(21):1291-9
    1. Br Med J (Clin Res Ed). 1986 Jan 4;292(6512):40-3
    1. Ann Intern Med. 1986 Sep;105(3):429-35
    1. Scand J Gastroenterol. 1987 Mar;22(2):161-4
    1. Am J Med. 1987 Sep;83(3):545-50
    1. Gastroenterology. 1988 Jul;95(1):232-41
    1. Ann Intern Med. 1989 Apr 1;110(7):560-6
    1. CMAJ. 1989 Jun 15;140(12):1441-8
    1. Control Clin Trials. 1989 Dec;10(4):407-15
    1. Control Clin Trials. 1990 Feb;11(1):43-51
    1. BMJ. 1991 Jun 22;302(6791):1481-2
    1. Ann Intern Med. 1992 Jan 1;116(1):78-84
    1. BMJ. 1992 Jul 4;305(6844):20-2
    1. Dig Dis Sci. 1993 Jan;38(1):147-54
    1. JAMA. 1995 Dec 27;274(24):1935-8

Source: PubMed

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