Inadequate planning and reporting of adjudication committees in clinical trials: recommendation proposal.
OBJECTIVE
Adjudication committees (ACs) are recommended in randomized controlled trials (RCTs) to standardize the assessment of events. We aimed to assess the reporting and functioning of ACs (synonyms: clinical event committees, endpoint committees) in clinical trials.


METHODS
We searched five high-impact-factor medical journals for reports of RCTs with clinical event endpoints published between January 1, 2004 and December 31, 2005.


RESULTS
ACs were reported in 33.4% of the 314 reports of RCTs. ACs were reported in 29.6% of trials with low risk of misclassification (i.e., "hard" main outcome), in 47.5% of trials with medium risk of misclassification (i.e., subjective main outcome and intervention delivered in a blinded fashion) and in 31% of trials with high risk of misclassification (i.e., subjective main outcome without intervention delivered in a blinded fashion). Selected cases to be adjudicated consisted largely of events identified by site investigators (93.3%). Data provided to the AC were reported for 47.4% of ACs.


CONCLUSIONS
Reporting of ACs is not fitted to the risk of biased misclassification. Important aspects of the functioning of ACs are insufficiently reported or raise methodological issues. We propose some recommendations for planning and reporting ACs in clinical trials.
Dechartres
Agnes
A
INSERM U738, Paris, France. adechartres@gmail.com
Boutron
Isabelle
I
Roy
Carine
C
Ravaud
Philippe
P
D026661:Clinical Trials Data Monitoring Committees / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D055811:Journal Impact Factor; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000592:standards; D016032:Randomized Controlled Trials as Topic / Q000592:standards*; D012107:Research Design