中药上市后临床再评价试验样本含量估算方法探讨

样本含量的大小是决定临床试验结果的重要因素之一,样本含量估算方法的选择与不同的临床试验设计类型有关.在中药上市后临床安全性再评价试验中,通常采取队列研究、病例一对照研究、巢式病例-对照研究或医院集中监测等设计方法,所需要的样本含量通常较大.在评价上市中药在广泛人群中应用的治疗效果时,实用性随机对照试验比解释性随机对照试验更符合试验目的.在中药新的功能主治验证性研究中,开展解释性随机对照试验仍然是必须的.根据具体的试验目的、设计类型和评价指标来选择样本含量估算方法,并确定相应的估算参数.必须在综合考虑检验效能、研究成本和实际可操作性的基础上,根据具体的临床再评价试验设计类型来估算并确定试验所需的样本含量.

Discussion on methods of sample size estimation in conducting clinical reevaluation of postmarketing Chinese medicine

Sample size is one of important factors determining the results of a clinical trial, and the choice of sample size estimation methods is related to the specific design of clinical trials. On clinical safety reevaluation of postmarketing Chinese medicine,we often design cohort study, case-control study,nested case-control study or hospital centralized monitoring,which need large sample sizes. In evaluating the effectiveness of postmarketing Chinese medicine widely applied in the large population, pragmatic randomized controlled trial(PRCT)is more suitable than explanatory randomized controlled trial(ERCT). ERCT is necessary to conduct confirmatory study for new indications of postmarketing Chinese medicine. According to the specific purpose, design type and evaluation index, we choose the suitable sample size estimation method, and determine the corresponding parameters. We must estimate and determine the suitable sample size according to the specific clinical evaluation design, with comprehensive consideration of the test power, research cost and practical operability.