評論
打印
And finally, there are no negative trials
最后，沒有負效試驗
I want to show you, as I did this morning, the instance of the key importance of a therapeutic blood level
和早上一樣，我要講治療血液水平的關鍵作用
Giving the agent isn't good enough, you have to give a right dose
劑量必須足夠正確
and you have to give a dose that produces a therapy above that level and we saw this slide earlier this morning
劑量要使得治療超過這個水平，這個幻燈早上就講過
unless you get it and achieve 25(OH)D level that is above 80 nmol
不達到高于80納摩的25(OH)D水平
you're not going to get a fracture benefit and the meta analyses show that very clearly
無法得到骨折方面的益處，綜合分析中很明確地證明了這一點
I mean here's where WHI was located right down here
這是WHI的值
I mean I was surprised that's no different from one point zero we should have be because there's nothing magic about it
我很驚訝這和一般的1.0沒什么區別，根本沒什么用
You have to give enough to change the blood level or you don't get anything
必須要達到足夠的血液水平才能有好處
Now I want to stress I can't go into detail. There isn't time
我就不細講了，時間有限
I want to stress there are no negative trials
我要強調沒有負效試驗
There are null trials but not negative trials
有無效試驗，但沒有負效試驗
Stop to think about it
想想
if this were a placebo effect and we just happen to have found positive trials by the time you've got 30+ trials you ought to have some negative ones too
如果只是安慰劑效應碰巧碰到正效果那30多個試驗的話，就肯定會有一些負效果
Some of them are going to work and given the skepticism out there
不可能全部是正效果，基于現在的懷疑論環境
it's highly unlikely that they wouldn't be published
有負效試驗人們不可能不發表
So the absence of negative trials is really assuring in its own right
這里沒有負效試驗就很好地證明了有效
There are some null trials which are often due to bad design basically or bad execution or both
有一些無效試驗，是因為設計糟糕或操作糟糕，或兩者都糟糕
