Characteristics of randomized controlled trials (RCT) published in Latin America and the Caribbean’s (LAC) in 2010

Article type
Authors
Reveiz L1, Glujovsky D2, P I3, Asenjo-Lobos C4, Cortes M5, Canon M6, Bardach A2, Comandé D2, C A7
1Policy and Research, Health Systems Based on Primary Health Care. Pan American Health Organization, WDC, USA
2Argentine Cochrane Centre IECS, Institute for Clinical Effectiveness and Health Policy Buenos Aires, Argentina
3Instituto de Investigaciones, Fundación Universitaria Sanitas, Bogot’{a} D.C., Colombia
4Centro Rehabilitación Oral Avanzada e Implantología (CRAI) Universidad de Concepción (Centro Adherido Chileno de la Red Cochrane Iberoamericana) - Chile
5Chilean branch of the Iberoamerican Cochrane Network, Universidad Católica de la Santísima Concepción, Chile
6Facultad de Medicina, Fundación Universitaria Sanitas, Bogotá D.C., Colombia
7Grupo Oncología Clínica y Traslacional, Instituto de Oncología, Fundación Santa Fe de Bogot’, Bogot’ D.C., Colombia
Abstract
Introduction: Few studies have evaluated the characteristics of RCTs conducted in LAC countries.Methods: A review of RCTs published in 2010 in which the author’s affiliation was from LAC was performed in PUBMED-LILACS; the RCT was included if it explicitly used the word 'random’ or variations thereof. Two reviewers independently extracted key data and assessed the risk of bias (RoB).

Results: We identified 1695 references including 526 RCTs (N = 73.513) recruiting 139.8 (SD = 284.53) participants on average. English was the dominant publication language (93%); with Spanish (3.4%) and Portuguese (2.9%) following. We found RCTs with affiliations representing 19 LAC countries; 70% were from Brazil. Maternal health represented 6.7% and neglected diseases-HIV-tuberculosis-malaria 3.8%. We assessed the following characteristics in a sample of 326/526 RCTs. Settings/Authorship: 7.7% were multinational and 12.0% multicenter. 10.6% included a co-author from a different country (the USA being the most frequent). Participant’s sex: 75.3% of RCTs recruited men and women; 19.6% exclusively women. Overall, 57.4% of participants were women. Gender analysis was performed in 6.8% of studies. 19% were < 18 years.
Type of intervention: Drugs (47.3%) and procedures (24.5%) were the most frequent.
Follow-up: Short term (<1month) (38%) and 1-6 months 39% were the most frequent.
Risk of bias: Scores were low (25.2%), unclear (60.1%), and high (14.7%). Ethic/Conflict of interest: 95.1% reported approval by ethics review committee and 93.1% presented an informed consent process. Conflicts of interest were declared by at least one author in 11.5% of RCTs; 42.5% failed to provide a declaration.
Funding: Public 33.9% private (i.e. pharmaceutical) 14.4% not reported 36.6% others (i.e. mixed-NGO) 15.1%. More frequent funders were FAPESP, CAPES and CNPq from Brazil.

Conclusion: There is plenty of room for improvement in South-South collaboration and RCTs addressing regional priorities. Methods and result reporting of RCTs should be improved to meet international standards.