가정의학회지에 실린 중재 관련 비무작위연구논문의 질 평가
Quality Assessment of Non-Randomized Studiesin the Korean Journal of Family Medicine
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연구배경: 1980년 가정의학회지가 발간된 이후로 다양한 연 구설계방법의 연구논문이 게재되면서 비무작위연구논문의 양적 및 질적 성장을 가져왔다. 국내 연구에서 무작위대조시 험에 관한 질 평가는 일부 있었지만 아직까지 비무작위연구 논문에 관한 질 평가가 이루어진 적은 없었다. 방법: 1980년부터 2006년까지 발행된 가정의학회지의 원저 1,343편을 대상으로 중재 관련 비무작위연구논문을 분류한 후, Methodological Index for Non-Randomized Studies (MINORS) 를 이용해 질 평가를 시행하였다. 또한 원저에서 비무작위연 구가 차지하는 비중을 분석하고 연도별 연구방법에 따른 분 류 및 항목별 점수와 평균 점수를 분석하였으며, 연구설계별 총점 및 평균점수를 측정하였다. 결과: 포함된 중재 관련 비무작위연구논문은 총 34편이었다. 연도별로 1980년부터 1990년까지는 1편으로 원저의 0.65%에 불과하였지만, 1991년부터 2000년까지는 12편(1.54%), 2001 년부터 2006년까지 21편(5.11%)으로 양적증가를 보였다. 연 구설계방법의 종류에 따른 평균점수는 전후연구 8.5점, 단락 시계열 연구(Interrupted Time Series, ITS) 9.7점, 비교 전후 연구 (Controlled Before and A er studies, CBA) 13.5점, 준무작위 시 험(Quasi-Randomized Trial, QRT) 12.6점, 비무작위 시험(Non Randomized Trial, NRT) 13점으로 낮게 측정되었다. 가장 흔한 연구설계방법은 전후 연구로 55.9%를 차지했고 QRT, NRT/ QET는 각각 14.7%, 2.9%로 많지 않았다. 결론: 가정의학회지에 게재된 비무작위연구논문의 비중은 지 속적으로 상승하고 있지만 방법론적 질은 그다지 높지 않다. 또한 대조군이 없는 전후 연구가 대부분을 차지한다.
Abstract
Background: Since the Korean Journal of Family Medicine (KJFM) started publishing in 1980, randomized controlled trials (RCTs) and non-randomized controlled studies (NRSs) consistently have increased in quality and quantity. Although there have been several studies on the quality assessment of RCTs in Korea, there has been no study on quality assessment of NRSs. Thus, this study evaluated NRS in the KJFM to assess the quantity and quality. Methods: Upon extracting NRSs for assessing the intervention effects from all the articles published in the KJFM from 1980 to 2006, assessments were made on methodological index for non-randomized studies (MINORS). Also, the analysis were made upon the proportion of NRSs within original articles according to two categories (comparative study, noncomparative study). The mean scores by research methods and years, and total scores and mean scores of yearly research methods were analyzed. Results: A total of 34 trials on NRSs were selected. In 1980s, 0.65% of the total selected original articles, in 1990s, 1.54%, and in 2000s 5.11% were NRSs. According to the research designs, the mean scores of MINORS were before and after study 8.5, interrupted Time Series 9.7 (out of 16), controlled before and after 13.5, quasi randomized trial 12.6, and non randomized trial 13 (out of 24). Before and after design was the most frequently used (55.9%). Conclusion: Although NRSs consistently increased in quantity, the assessed mean scores were low and most articles used before and after design. Thus, there should be studied using appropriate research methods in the future.
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