婦女和老年人在心血管臨床試驗中仍然代表性不足

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一項新的研究發現,儘管婦女和老年人在心臟病人群中佔很大比例,但在心血管臨床試驗中仍然代表性不足。杜克大學的科學家在最新一期的《美國醫學會雜誌》上撰文指出,因為治療心臟病的藥物的安全性和有效性可能因性別和年齡而異,“這些入組偏差破壞了為所有心臟病患者提供循證護理的努力。”

杜克大學團隊檢查了1966年1月至2000年3月期間發表的593項研究心臟病發作和不穩定型心絞痛的隨機臨床試驗。儘管他們確實發現隨著時間的推移,婦女和老年人在這些試驗中的代表性有所增加,但這種趨勢不大。老年人在這些試驗中的納入比例從1966年的2%上升到1990年後的9%。然而,這個群體佔美國所有心臟病發作患者的近40%。同樣地,儘管這些試驗中女性受試者的百分比從1966年的20%上升到1995年後的29%,但女性佔心臟病發作患者的43%。

團隊成員埃裡克·彼得森指出:“將試驗結果從年輕、主要是男性的人群普遍推廣到婦女和老年患者可能是不合適的。”“關於婦女和老年患者治療的安全性和有效性的資訊匱乏可能導致一些醫生在這些亞組中不予治療。”

The article "Understanding Clinical Trials," by Justin A. Zivin (大眾科學, April 2000) is available for purchase at the 大眾科學 Archive.

Kate Wong is an award-winning science writer and senior editor at 大眾科學 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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