Relation between burden of disease and randomised evidence in sub-Saharan Africa: survey of research
Abstract Objective: To evaluate whether the amount of randomised clinical research on various medical conditions is related to the burden of disease and health needs of the local populations in sub-Saharan Africa. Design: Construction and analysis of comprehensive database of randomised controlled t...
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| Veröffentlicht in: | BMJ Jg. 324; H. 7339; S. 702 - 705 |
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| Hauptverfasser: | , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
England
British Medical Journal Publishing Group
23.03.2002
British Medical Association BMJ Publishing Group Ltd BMJ Publishing Group LTD BMJ |
| Schlagworte: | |
| ISSN: | 0959-8138, 1756-1833, 1468-5833, 1756-1833 |
| Online-Zugang: | Volltext |
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| Zusammenfassung: | Abstract Objective: To evaluate whether the amount of randomised clinical research on various medical conditions is related to the burden of disease and health needs of the local populations in sub-Saharan Africa. Design: Construction and analysis of comprehensive database of randomised controlled trials in sub-Saharan Africa based on Medline, the Cochrane Controlled Trials Register, and several African databases. Setting: Sub-Saharan Africa. Main outcome measures: Number of trials and randomised subjects for each category of disease in the global burden of disease taxonomy; ratios of disability adjusted life years (DALYs) per amount of randomised evidence. Results: 1179 eligible randomised controlled trials were identified. The number of trials published each year increased over time. Almost half of the trials (n=565) had been done in South Africa. There was relatively good correlation between the estimated burden of disease at year 2000 and the number of trials performed (r=0.53, P=0.024) and the number of participants randomised (r=0.68, P=0.002). However,some conditions—for example, injuries (over 20 000 DALYs per patient ever randomised)—were more neglected than others. Conclusion: Despite recent improvements, few clinical trials are done in sub-Saharan Africa. Clinical research in this part of the world should focus more evenly on the major contributors to burden of disease. What is already known on this topic Sub-Saharan Africa has a large burden of disease Little clinical research is conducted for problems affecting sub-Saharan Africa What this study adds Only 1179 randomised controlled trials conducted in sub-Saharan Africa in the past 50 years were identified Correlation between the amount of randomised evidence and the estimated burden of disease was fairly good However, some disease categories were more neglected than others, with the worst being injuries |
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| Bibliographie: | ark:/67375/NVC-8Q2X15VG-M Correspondence to: J P A Ioannidis href:bmj-324-702.pdf ArticleID:bmj.324.7339.702 istex:1FC8D5D10825A861C7D4EEE73476BAC08F03B9B3 PMID:11909786 local:bmj;324/7339/702 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Review-3 content type line 23 Correspondence to: J P A Ioannidis jioannid@cc.uoi.gr Contributors: The original idea for correlating DALYs and randomised trials belongs to JPAI, who is also the guarantor of the paper. JPAI and PI wrote the first draft of the study protocol, which was edited by GHS and JV. The idea for creating a comprehensive registry of controlled trials for Africa first originated from GHS, EP, and JV under the leadership of JV. PI and EP took the lead in creating the randomised trials' database with help from the other authors. JPAI and PI did the statistical analysis and wrote the first draft of the manuscript. The manuscript was edited for important scientific content by the other authors. |
| ISSN: | 0959-8138 1756-1833 1468-5833 1756-1833 |
| DOI: | 10.1136/bmj.324.7339.702 |