1.Study on endpoint determination method of tablet coating based on 3σ criteria and logic regression.
Zheng-Ji JIN ; Xiao-Jian LUO ; Qing TAO ; Guo-Ping ZHAN ; Yan HE ; Xiao-Yong RAO ; De-Cheng PAN
China Journal of Chinese Materia Medica 2021;46(16):4124-4130
This paper explores the statistical distribution characteristics of coating film thickness, so as to present a new method for determining coating endpoint based on 3σ criterion and logic regression. Firstly, the spectrum and thickness of 4 batch samples were collected. Secondly, the spectral range of normal products was obtained by 3σ criterion, with the spectral feature NI as the number of test spectrum in the above range. Then, the model based on 3σ criterion and logic regression was built according to the best condition in K-fold cross-validation and the determined threshold of qualified rate in the coating endpoint. Finally, the qualified rate of test set samples at different time points was calculated by the above model, and the above change trend and the threshold value were combined to determine the coating endpoint. The results of KS analysis showed the distribution of thickness of the qualified products followed the normal distribution(P=0.081>0.05). The accuracy of the coating endpoint determination was as high as 100% by the model based on 3σ criterion and logic regression when the determined threshold of qualified rate was 90%. Therefore, the 3σ criterion was feasible to the research of coating eligibility. This paper reveals certain random phenomena in the coating process, and the method features a high accuracy, quick analysis and a good interpretability, which provides a reference for online detection and qualify evaluation in future.
Endpoint Determination
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Logic
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Research Design
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Tablets
2.Methods for development of a core outcome set for clinical trials integrating traditional Chinese medicine and Western medicine.
Rui-Jin QIU ; Min LI ; Jia-Yuan HU ; Jing CHEN ; Hong-Cai SHANG
Journal of Integrative Medicine 2021;19(5):389-394
Clinical trial outcome reporting differs between studies integrating traditional Chinese medicine (TCM) and Western medicine, so that some clinical trials are not eligible for inclusion in a systematic review. The excluded studies are therefore less widely disseminated, and even valid studies are less likely to yield impact. This problem may be addressed by developing core outcome sets (COSs) for integrative medicine in specific healthcare areas. The first stage of development is to define the scope of the COS for integrative medicine, the second stage is to establish the need for such a COS, and the third stage is to develop a protocol and register the COS. The final stage involves three steps: (i) development of a comprehensive list of outcomes (including efficacy outcomes and safety outcomes and TCM syndromes) using systematic review, qualitative or cross-sectional research, and reviews of package inserts and medical records; (ii) merging and grouping of outcomes within domains; (iii) conducting two rounds of Delphi survey and consensus meetings with a range of stakeholders. The final COS will include a general COS and core TCM syndrome- set. Development of COSs for clinical trials of integrative medicine may help to standardize outcome reporting and reduce publication bias in the future.
Cross-Sectional Studies
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Delphi Technique
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Endpoint Determination
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Medicine, Chinese Traditional
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Research Design
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Treatment Outcome
3.Analysis of RCT outcome indicators of traditional Chinese medicine for essential hypertension in recent two years.
Rui-Xue HU ; Xing-Jiang XIONG ; Ren-Bo CHEN ; Wei YANG ; Hui ZHAO ; Yong-Yan WANG ; Xing LIAO
China Journal of Chinese Materia Medica 2021;46(6):1547-1557
To find the status of outcome indicators reported in published randomized controlled trial(RCT) of traditional Chinese medicine(TCM) for essential hypertension in the past two years, we searched for relevant information from four Chinese databases, three English databases and two clinical trial registries in this study, from January 2018 to September 2019. The outcome indicators of RCT were extracted and categorized from trials and the risk of bias was assessed by ROB tools from the Cochrane Collaboration. A total of 125 RCTs and 15 RCT protocols were finally included after study screening. The results showed that the RCT outcomes mainly included efficacy and safety outcomes. Efficacy indicators mainly included blood pressure measurement, quality of life assessment, blood biochemical indicators, urine analysis, arterial ultrasound, vascular endothelial function indicators, hematocrit, hemorheology indicators and other indicators. The safety indicators mainly included general physical examination items, heart, liver and kidney function tests, blood, urine, and stool routine examinations as well as adverse drug reactions/events. The current RCTs cannot distinguish primary and secondary outcomes, and the RCT protocols didn't report efficacy criteria clearly. They both didn't report health economic indicators and the methodological qualities were relatively low. In view of the current status on outcome indicators reported in TCM RCTs, constructing a core outcome set of TCM for essential hypertension and improving the methodology quality of RCTs will help to accurately reflect the actual efficacy of TCM intervention.
Endpoint Determination
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Essential Hypertension
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Humans
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Medicine, Chinese Traditional
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Quality of Life
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Randomized Controlled Trials as Topic
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Treatment Outcome
4.Application of restricted mean survival time in clinical follow-up study.
Z J YANG ; J J LYU ; Y W HOU ; Z CHEN
Chinese Journal of Epidemiology 2019;40(2):247-250
In clinical follow-up studies, hazard ratio (HR) is routinely used to quantify the differences between-groups, however, it is being estimated by the Cox procedure. HR, the ratio of two hazard functions has abstract meaning only and is in lack of the context to give an intuitive explanation of the survival of patients and the assumption of proportional hazards (PH) must be satisfied. Under this context, the restricted mean survival time (RMST) can be used as a relatively effective measure or index of statistics. This paper introduces the RMST-based statistical analysis methods, including estimation of RMST and its difference, hypothesis testing and regression analysis. The application of RMST in data analysis is also introduced. All the evidence demonstrates that RMST can be used as an effective analytical tool with straightforward interpretation. RMST is also more effective than HR in comparing differences between groups, when non-PH is observed. Therefore, RMST is suggested to be stated along with HR in the process of disease efficacy evaluation and prognosis analysis. Cooperation and complement of the two, a precise reflection on the characteristics of data can be expected.
Clinical Trials as Topic
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Endpoint Determination/methods*
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Follow-Up Studies
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Humans
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Kaplan-Meier Estimate
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Prognosis
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Proportional Hazards Models
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Regression Analysis
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Survival Rate/trends*
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Treatment Outcome
5.Is There a Sex-Related Difference in the Obesity Paradox in Systolic Heart Failure? Sex-Related Difference in the Obesity Paradox
Soonchang HONG ; Ji Hyun LEE ; Kyung Min KIM ; Jun Won LEE ; Young Jin YOUN ; Min Soo AHN ; Sung Gyun AHN ; Seung Hwan LEE ; Junghan YOON ; Kyung Hoon CHOE ; Byung Su YOO
Yonsei Medical Journal 2018;59(1):57-62
PURPOSE: Obesity is often associated with better clinical outcomes in heart failure (HF). This so-called obesity paradox remains controversial. The aim of present study was to investigate the prognostic value of obesity in patients hospitalized for systolic HF. MATERIALS AND METHODS: We performed a pooled analysis of data from two multicenter, observational HF studies. Patients hospitalized for systolic HF were eligible for the present study. We divided the subjects into two groups, a normal body mass index (BMI) group and a high BMI group. Study endpoints included all-cause mortality and any re-hospitalization within 1 year. RESULTS: We enrolled 3145 patients (male, 1824; female, 1321). The high BMI group was significantly associated with lower 1-year mortality rate [odds ratio (OR), 0.543; 95% confidence interval (CI), 0.355−0.832] after adjusting for age, hypertension, diabetes, ischemic HF, previous myocardial infarction, serum creatinine level, anemia, and ejection fraction in men. After adjustment for clinical characteristics, high BMI was not significantly associated with 1-year mortality (OR, 0.739; 95% CI, 0.450−1.216) or 1-year re-hospitalization (OR, 0.958; 95% CI, 0.696−1.319) in women. CONCLUSION: In pooled analysis of data from two Korean HF registries, the high BMI group was independently associated with lower 1-year mortality rate from systolic HF, especially in men.
Aged
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Body Mass Index
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Demography
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Endpoint Determination
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Female
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Heart Failure, Systolic/complications
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Heart Failure, Systolic/epidemiology
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Humans
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Incidence
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Kaplan-Meier Estimate
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Male
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Middle Aged
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Obesity/complications
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Obesity/epidemiology
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Sex Characteristics
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Treatment Outcome
6.Comparison of Aspirin and Naoxintong Capsule () with Adjusted-Dose Warfarin in Elderly Patients with High-Risk of Non-Valvular Atrial Fibrillation and Genetic Variants of Vitamin K Epoxide Reductase.
Huan WANG ; Xiao-Kai ZHOU ; Li-Fan ZHENG ; Xiao-Ying WU ; Hui CHEN
Chinese journal of integrative medicine 2018;24(4):247-253
OBJECTIVETo compared the therapeutic effect of a Chinese patent medicine Naoxintong Capsule (, NXT) and aspirin with adjusted-dose warfarin in Chinese elderly patients (over 65 years) with nonvalvular atrial fibrillation (NVAF) and genetic variants of vitamin K epoxide reductase (VKORC1), who are at high-risk of thromboembolism.
METHODSA total of 151 patients, with NVAF and AA genotype of VKORC1-1639 (a sensitive genotype to warfarin) and a CHADS-VASc clinical risk score of 2 or above, were chosen for this study. Patients were randomized into two groups and orally treated with a combination of aspirin (100 mg/day) and NXT (1.6 g thrice a day) or adjusted-dose warfarin [international normalized ratio 2.0-3.0). The primary end points including ischemic stroke and death as well as the secondary end points including hemorrhage events were followed up for at least 1 year.
RESULTSBaseline clinical data and the rates of primary end points were similar between groups. However, the rate of serious bleeding (secondary event) in the combination therapy group was lower than that in the adjusted-dose warfarin group (0% vs. 7.9%, odds ratio: 0.921, 95% confidence interval: 0.862-0.984, P=0.028).
CONCLUSIONSAspirin combined with NXT and warfarin displayed comparable rates of primary end point including ischemic stroke and all-cause death during the 1-year follow-up. However, as compared with warfarin, the combination therapy reduced the rate of serious bleeding. Therefore, aspirin combined with NXT might provide an alternative pharmacotherapy in preventing ischemic stroke for elderly patients with NAVF who cannot tolerate warfarin. (No. ChiCTR-TRC-13003596).
Aged ; Aspirin ; therapeutic use ; Atrial Fibrillation ; drug therapy ; enzymology ; genetics ; Base Sequence ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Endpoint Determination ; Female ; Genetic Variation ; Humans ; Male ; Risk Factors ; Treatment Outcome ; Vitamin K Epoxide Reductases ; genetics ; Warfarin ; therapeutic use
7.Guideline Recommendation for Endpoints Used in Clinical Trials for Functional Dyspepsia.
Han Hee LEE ; Hye Kyung JUNG ; Myung Gyu CHOI
The Korean Journal of Gastroenterology 2018;72(4):170-178
Functional dyspepsia is a disease, in which there is no organic lesion but chronic and repetitive postprandial fullness, early satiation, epigastric pain, and epigastric burning. Functional dyspepsia is not life-threatening but its symptoms are relapsing and remitting and persist over a lifetime, limiting the social life and reducing the quality of life. Therefore, the treatment for acute relapsing period may help improve the short-term symptoms. Continuous medication may be needed to improve the long-term symptoms. Research designs to demonstrate the short-term efficacy of therapeutic agents may differ from clinical trials to demonstrate long-term efficacy. There are many difficulties in clinical trial design, implementation, and screening because there are no international standards of clinical trials for functional dyspepsia. The purpose of this guideline recommendation is to develop a standard for clinical trials, such as clinical trial subjects and evaluation methods, in the development of therapeutic agents for functional dyspepsia. The ultimate aim is to enhance the safety and efficacy of therapeutic agents for functional dyspepsia and promote the development of new therapeutic agents.
Burns
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Dyspepsia*
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Endpoint Determination
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Gastrointestinal Diseases
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Mass Screening
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Quality of Life
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Research Design
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Satiation
8.Evaluation of the potential inhibitory activity of a combination of L. acidophilus, L. rhamnosus and L. sporogenes on Helicobacter pylori: A randomized double-blind placebo-controlled clinical trial.
Chien-Ying LEE ; Hung-Che SHIH ; Min-Chien YU ; Ming-Yung LEE ; Ya-Lan CHANG ; Ya-Yun LAI ; Yi-Ching LEE ; Yu-Hsiang KUAN ; Chun-Che LIN
Chinese journal of integrative medicine 2017;23(3):176-182
OBJECTIVESTo investigate whether three strains of probiotics, L. acidophilus, L. rhamnosus, and L. sporogenes, had signifificant inhibitive effects on Helicobacter pylori (H. pylori).
METHODSThis is a 4-week, randomly assigned, parallel-group, doubled-blind, and placebo-controlled study. Fifty patients with a positive H. pylori infection urea breath test (△UBT) result > 10% and without ulcer symptoms were randomized into a treatment group and a placebo group by a computer generated allocation sheet with 1:1. These subjects took one capsule of probiotics or placebo twice daily. The primary measurement was the change in △UBT values.
RESULTSThe △UBT values during the 4-week treatment period and the 2-week follow-up period were not signifificantly different between the treatment group and the placebo group, indicating that the inhibitive effects on H. pylori were comparable between both groups. The monocyte count (%) was 5.77±1.11 in the treatment group versus 5.09±1.12 in the placebo group (P=0.044), and the basophile count was 0.55±0.32 in the treatment group versus 0.36±0.23 in the placebo group (P=0.024) at week 2 of the treatment period, both of which reached statistical signifificance. The monocyte count was 5.75±1.26 in the treatment group and 4.72±0.99 in the placebo group at the end of the follow-up period (P=0.003).
CONCLUSIONThere was no signifificant inhibitive effects of the three probiotic strains (L. acidophilus, L. rhamnosus, and L. sporogenes) on H. pylori. Probiotics can not play the same role as antibiotics in the eradication of H. pylori, the role of probiotics is likely to be important as adjuvant to the triple or quadruple therapy for H. pylori, especially in resistance cases.
Adult ; Aged ; Breath Tests ; Demography ; Double-Blind Method ; Endpoint Determination ; Female ; Helicobacter pylori ; drug effects ; Humans ; Lactobacillus ; metabolism ; Male ; Middle Aged ; Probiotics ; administration & dosage ; adverse effects ; pharmacology ; Urea ; analysis ; Young Adult
9.Activating blood circulation to remove stasis treatment of hypertensive intracerebral hemorrhage: A multi-center prospective randomized open-label blinded-endpoint trial.
Jing-Ya LI ; Li-Xin YUAN ; Gen-Ming ZHANG ; Li ZHOU ; Ying GAO ; Qing-Bin LI ; Che CHEN
Chinese journal of integrative medicine 2016;22(5):328-334
OBJECTIVETo investigate the efficacy and safety of the Chinese herbal therapeutic regimen of activating blood circulation (TRABC) in treatment of hypertensive intracerebral hemorrhage (HICH).
METHODSThis was a multi-center prospective randomized open-label blinded-endpoint (PROBE) trial with HICH admitted to 12 hospitals. Totally 240 participants were randomized to the treatment group treated with TRABC in addition to conventional Western treatment or the control group with conventional Western treatment equally for 3 months. Primary outcome was degree of disability as measured by modified Rankin Scale (mRS). Secondary outcomes were the absorption of hematoma and edema, National Institutes of Health Stroke Scale (NIHSS) scores and patient-reported outcome measures for stroke and Barthel activities of daily living index. Adverse events and mortality were also recorded.
RESULTSAfter 3 months of treatment, the rate of mRS 0-1 and mRS 0-2 in the treatment group was 72.5% and 80.4%, respectively, and in the control group 48.1% and 63.9%, respectively, with a significant difference between groups (P<0.01). Hematoma volume decreased significantly at day 7 of treatment in the treatment group than the control group (P=0.038). Average Barthel scores in the treatment group after treatment was 89.11±19.93, and in the control group 82.18±24.02 (P=0.003). NIHSS scores of the two groups after treatment decreased significantly compared with before treatment (P=0.001). Patient-reported outcomes in the treatment group were lower than the control group at day 21 and 3 months of treatment (P<0.05). There were 4 deaths, 2 in each group, and 11 adverse events, 6 in the treatment group and 5 in the control group.
CONCLUSIONThe integrative therapy combined TRABC with conventional Western treatment for HICH could promote hematoma absorption thus minimize neurologic impairment, without increasing intracerebral hematoma expansion and re-bleeding.
Blood Circulation ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Endpoint Determination ; Female ; Hematoma ; blood ; complications ; drug therapy ; Humans ; Intracranial Hemorrhage, Hypertensive ; blood ; drug therapy ; Male ; Middle Aged ; Prospective Studies ; Stroke ; blood ; drug therapy ; Treatment Outcome
10.Change of Regulatory Requirement on Cohort Grouping and Endpoint Seting for Intervertebral Fusion Device Clinical Trial.
Chinese Journal of Medical Instrumentation 2015;39(4):279-281
Combining technical requirement from main international administration and status quo of China administration, current regulatory requirement on clinical trail of conventional intervertebral fusion devices has been simplified. Cervical, thoracic and lumbar cases can be grouped into the same cohort, and primary endpoints are mainly based on imageology rather than clinical score. This is an attempt to rationally lessen industrial burdensome.
China
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Clinical Trials as Topic
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standards
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Cohort Studies
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Endpoint Determination
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Humans
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Research Design
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standards
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Spinal Fusion
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instrumentation

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