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• W2092333828 abstract "Clinicians routinely apply randomized trial evidence to their patients who meet study selection criteria. However, little is known about how clinicians interpret conflicting subgroup data. We mailed a self-administered survey to all practicing cardiologists (n = 309) and 695 randomly chosen other specialists in Ontario, Canada. The survey presented 6 hypothetical trials where a subgroup result deviated from the overall result. We also elicited responses to some general statements about clinical evidence and subgroups. Completed surveys were received from 435 physicians (44%). Faced with overall benefit but no apparent treatment effect in a subgroup, almost 44% would exclude subgroup-type patients, notwithstanding the hazard of β error. Given overall harm but significant benefit for a subgroup, responses were split approximately 60:40 between continuing conventional therapy for all and treating subgroup-type patients with the new drug. For an overall null result with a positive treatment-subgroup interaction term, 25% of respondents would continue conventional therapy, whereas 69% would adopt the new drug for subgroup-type patients. Physicians with an academic appointment, devoting more time to research, or with formal training in research methodology were more likely to ignore subgroups unless a treatment-subgroup interaction term was significant (P values ranging from .018 to <.0001). Asked if in general they paid special attention to individual subgroup results, respondents were again divided with 37.5% agreeing, 39.5% disagreeing, and the rest undecided. Clinicians disagree sharply in interpretation of clinical trials when the overall and subgroup results diverge. Clearer guidelines are needed for undertaking, reporting, and interpreting subgroup analyses." @default.
• W2092333828 created "2016-06-24" @default.
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• W2092333828 date "2006-03-01" @default.
• W2092333828 modified "2023-09-26" @default.
• W2092333828 title "Interpretation of subgroup results in clinical trial publications: Insights from a survey of medical specialists in Ontario, Canada" @default.
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• W2092333828 doi "https://doi.org/10.1016/j.ahj.2005.05.002" @default.
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