Cited by 202Meta-analysis and systematic reviewsStatistical Methods in Clinical TrialsPharmaceutical industry and healthcare

Discrepancies in sample size calculations and data analyses reported in randomised trials: comparison of publications with protocols

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Chan, A.-W., Hrobjartsson, A., Jorgensen, K. J, Gotzsche, P. C, Altman, D. G·2008·BMJ

Abstract

OBJECTIVE: To evaluate how often sample size calculations and methods of statistical analysis are pre-specified or changed in randomised trials. DESIGN: Retrospective cohort study. Data source Protocols and journal publications of published randomised parallel group trials initially approved in 1994-5 by the scientific-ethics committees for Copenhagen and Frederiksberg, Denmark (n=70). MAIN OUTCOME MEASURE: Proportion of protocols and publications that did not provide key information about sample size calculations and statistical methods; proportion of trials with discrepancies between information presented in the protocol and the publication. RESULTS: Only 11/62 trials described existing sample size calculations fully and consistently in both the protocol and the publication. The method of handling protocol deviations was described in 37 protocols and 43 publications. The method of handling missing data was described in 16 protocols and 49 publications. 39/49 protocols and 42/43 publications reported the statistical test used to analyse primary outcome measures. Unacknowledged discrepancies between protocols and publications were found for sample size calculations (18/34 trials), methods of handling protocol deviations (19/43) and missing data (39/49), primary outcome analyses (25/42), subgroup analyses (25/25), and adjusted analyses (23/28). Interim analyses were described in 13 protocols but mentioned in only five corresponding publications. CONCLUSION: When reported in publications, sample size calculations and statistical methods were often explicitly discrepant with the protocol or not pre-specified. Such amendments were rarely acknowledged in the trial publication. The reliability of trial reports cannot be assessed without having access to the full protocols.

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  • The interpretation of trial results in published reports is not always consistent with the prespecified conceptual framework.

    “In addition, the interpretation of trial results in published reports is not always consistent with the prespecified conceptual framework,198 199 200 especially among reports claiming post hoc equivalence based on a failure to show superiority, rather than on a specific test of equivalence.198”
  • Among randomised trial protocols that describe a sample size calculation, studies often do not state all components necessary to understand and reproduce the sample size (including the derivation of the target difference and the source of estimated values).

    “Among randomised trial protocols that describe a sample size calculation, studies often do not state all components necessary to understand and reproduce the sample size (including the derivation of the target difference and the source of estimated values).200 297”
  • These substantive modifications are rarely acknowledged in the final trial reports.

    “These substantive modifications are rarely acknowledged in the final trial reports.200 249 250 480”

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Research works printed but not linked: 4

  1. [6]Murray GD. Research governance must focus on research training. BMJ 2001; 322: 1461-2.
  2. [30]PLoS Med. Guidelines for authors. http://journals.plos.org/plosmedicine/guidelines.php#supporting.
  3. [31]Altman DG, Moher D, Schulz KF. Peer review of statistics in medical research: reporting power calculations is important. BMJ 2002; 325: 491. 12211233
  4. [46]Chan AW, Tetzlaff J, Altman DG, Gøtzsche PC, Hróbjartsson A, Krleža-Jeric K, et al. The SPIRIT initiative: defining standard protocol items for randomised trials. German J Evid Quality Health Care (suppl) 2008; 102: S27.

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Authors
Chan, A.-W., Hrobjartsson, A., Jorgensen, K. J., Gotzsche, P. C., & Altman, D. G.
Affiliations
  • Mayo Clinic (US)
  • Cochrane (DK)
  • University of Oxford (GB)
Corresponding author
Chan, A.-W.
Venue
BMJ
Publisher
BMJ
Published
2008-12-04
Volume
337
Issue
dec04 1
Pages
a2299-a2299
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
OpenAlex
W2074736802
Cited by
202
References
59
Citations by year
2026: 4 · 2025: 4 · 2024: 9 · 2023: 9 · 2022: 10 · 2021: 15 · 2020: 16 · 2019: 6 · 2018: 15 · 2017: 11 · 2016: 10 · 2015: 9 · 2014: 14 · 2013: 9 · 2012: 16
FWCI
17.02
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion)
  • University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion, cc-by)
Topics
  • Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
  • Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmaceutical industry and healthcare
Keywords
sample size determination, statistical methods reporting, randomized controlled trials, missing data handling, protocol deviations, subgroup analysis, interim analysis
MeSH terms
Data Collection, Data Interpretation, Statistical, Publishing, Retrospective Studies, Cohort Studies, Randomized Controlled Trials as Topic, Sample Size

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