Comment publication of positive results, the effcacy of most Jiyao Wang traditional therapies is uncertain. Department of Internal Medicine, Zhongshan He Several factors might contribute to this situation. University, Shanghai200032, China Most active clinical researchers and physicians have wang jiyao@zs-hospitalshcn little formal training in research methods. "Even the the chinese Medical Association; vice chair of the Society of Evidence-Based do not know or ignore reporting criteria, such as of Education's virtual research centre of evidence-based medicine; anda try editors and peer reviewers of Chinese medical journals Medicine, Chinese Medical Doctor Association a board member of the Mini he Board of Trustees, INCLEN. I thank Xue-juan Jin for collecting CONSORT STROBE. STARD and PRISMA 13 Preclinical information to make the figure. trial registration has not been essential for publication, 1ChinadinicalEpidemiologyNetwork.httpc//www.chinaclen.org.cn ccessed Dec 13, 2009) eventhoughregistrationresultsintrialsthataremore2chineseCochraneCentrehttp:/www.hxyx.com/cochrane_new(accessed rigoroUs, effciently conducted, and ethically sound Oct 12, 2009)(in Chinese) 3ChineseMedicalDoctorAssociationhttp://www.cmdagov.cn(accessed To counter these problems, I have several suggestion Oct 12, 2009)(in Chinese). Clinical researchers in China should be formally trained andaccreditedinclinicaltrialmethodologyReporting5clinicaLtrialsgov.http://www.clinicaltrials.gow(accesSedJune15,2009). guidelines have been translated into Chinese and pub- Straus SE, Richardson WS, Glasziou P, Haynes RB Evidence-based medicine. lished partly in Chinese, 5 and are now available online. 77 Wang )Y Follow international reporina(Commentary ) e the quality of searchers need to improve study design by adopting the advice in relevant reporting guidelines to reduce 8 WuT, LiY, Bian Z, Liu G, Moher D Randomized trials published in some how many are randomized? Trials 2009: 10: bias. National level platforms need to be established for 9 He, jinz, Yu D Statistical reporting in Chinese biomedical joumal consultation and administration of multicentre clinical trials. journal editors must require documentation of f 10 Lexchin Bero JA, Djubegovic B, Clark. Pharmaceutical industry ethics approval and clinical trial registration before BM20x261670 Journals in China that are 372:1938-40. members of the ICMJE should obey international criteria 12 Schulz KF, Grimes DA. The Lancet handbook of essential concepts in dinical for publication. Finally, the Chinese Government should 13 EQUATOR Network Enhancin increaseitssupportofclinicalresearchintheformofresearchhttp://www.equator-networkorg(accessedDec13,2009) clinical research grants for physicians, the creation of YiJie He Xue Bao 2007: 5: 234-42(in Chinese) national repositories of clinical cases and samples of 15 Gluud C, eds Evidence based medicine and clinical practice, endix 3 and 5. Beijing, China: Science Publishe serum and tissues, and financial support for universities in remote areas to buy literature databases There is a long way to go before the words of a Lancet Dec13,2009) Editorial-"China has the opportunity to lead the world The Lancet. Reforming research in China. Lancet 2007: 369: 880. not only in research quantity, but also in quality"are fulfilled Fomenting a prevention revolution for Hiv 2010 heralds the year set by the UN to achieve universal stay, and residence in some 57 countries. M About access to HIV prevention, treatment, care, and support 10 million people are currently denied access Despite major achievements and heroic efforts over saving treatment the past decades by people living with HIv to assert Despite or perhaps because of, its success, the AIDS their rights for treatment equity, to end stigma and response has itself come under attack. Coalitions of discrimination, and to ensure more inclusive approaches social conservatives have orchestrated a global campaign to governing the response, much remains to be against condom promotion and supported legislation done. 80 countries still criminalise homosexuality? criminalising same-sex relations. Such actions increase People living with Hiv face restrictions on entry, stigma and isolate people most at risk of Hiv at a 第11页 www.thelancet.comVol375February13,2010Comment www.thelancet.com Vol 375 February 13, 2010 533 Fomenting a prevention revolution for HIV 2010 heralds the year set by the UN to achieve universal access to HIV prevention, treatment, care, and support.1 Despite major achievements and heroic eff orts over the past decades by people living with HIV to assert their rights for treatment equity, to end stigma and discrimination, and to ensure more inclusive approaches to governing the response, much remains to be done. 80 countries still criminalise homosexuality.2 People living with HIV face restrictions on entry, stay, and residence in some 57 countries.3,4 About 10 million people are currently denied access to life￾saving treatment. Despite, or perhaps because of, its success, the AIDS response has itself come under attack.5,6 Coalitions of social conservatives have orchestrated a global campaign against condom promotion and supported legislation criminalising same-sex relations.7 Such actions increase stigma and isolate people most at risk of HIV at a publication of positive results, the effi cacy of most traditional therapies is uncertain.11 Several factors might contribute to this situation. Most active clinical researchers and physicians have little formal training in research methods.12 Even the editors and peer reviewers of Chinese medical journals do not know or ignore reporting criteria, such as CONSORT, STROBE, STARD, and PRISMA.13 Preclinical trial registration has not been essential for publication, even though registration results in trials that are more rigorous, effi ciently conducted, and ethically sound.14 To counter these problems, I have several suggestions. Clinical researchers in China should be formally trained and accredited in clinical trial methodology. Reporting guidelines have been translated into Chinese and pub￾lished partly in Chinese,15 and are now available online.1,7 Researchers need to improve study design by adopting the advice in relevant reporting guidelines to reduce bias. National level platforms need to be established for consultation and administration of multicentre clinical trials. Journal editors must require documentation of ethics approval and clinical trial registration before manuscript acceptance. Journals in China that are members of the ICMJE16 should obey international criteria for publication. Finally, the Chinese Government should increase its support of clinical research, in the form of clinical research grants for physicians, the creation of national repositories of clinical cases and samples of serum and tissues, and fi nancial support for universities in remote areas to buy literature databases. There is a long way to go before the words of a Lancet Editorial—“China has the opportunity to lead the world not only in research quantity, but also in quality”17—are fulfi lled. Jiyao Wang Department of Internal Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China wang.jiyao@zs-hospital.sh.cn I am: president of ChinaCLEN; chair of the Clinical Epidemiology Committee of the Chinese Medical Association; vice chair of the Society of Evidence-Based Medicine, Chinese Medical Doctor Association; a board member of the Ministry of Education’s virtual research centre of evidence-based medicine; and a member of the Board of Trustees, INCLEN. I thank Xue-juan Jin for collecting information to make the fi gure. 1 China Clinical Epidemiology Network. http://www.chinaclen.org.cn (accessed Dec 13, 2009). 2 Chinese Cochrane Centre. http://www.hxyx.com/cochrane_new (accessed Oct 12, 2009) (in Chinese). 3 Chinese Medical Doctor Association. http://www.cmda.gov.cn (accessed Oct 12, 2009) (in Chinese). 4 The Chinese Clinical Trial Register. http://www.chictr.org (accessed Dec 14, 2009). 5 ClinicalTrials.gov. http://www.clinicalTrials.gov (accessed June 15, 2009). 6 Straus SE, Richardson WS, Glasziou P, Haynes RB. Evidence-based medicine: therapy, 3rd edn. London, UK: Elsevier, 2005. 7 Wang JY. Follow international reporting guidelines to raise the quality of articles about clinical research in China (Commentary). Chung Hua Hsiao Hua Tsa Chih 2010; 30: 1 (in Chinese). 8 Wu T, Li Y, Bian Z, Liu G, Moher D. Randomized trials published in some Chinese journals: how many are randomized? Trials 2009; 10: 46. 9 He J, Jin Z, Yu D. Statistical reporting in Chinese biomedical journals. Lancet 2009; 373: 2091–93. 10 Lexchin J, Bero LA, Djulbegovic B, Clark O. Pharmaceutical industry sponsorship and research outcome and quality: systematic review. BMJ 2003; 326: 1167–70. 11 Tang J-L, Liu B-Y, Ma K-W. Traditional Chinese medicine. Lancet 2008; 372: 1938–40. 12 Schulz KF, Grimes DA. The Lancet handbook of essential concepts in clinical research. Philadelphia, PA, USA: Elsevier, 2006. 13 EQUATOR Network. Enhancing the quality and transparency of health research. http://www.equator-network.org (accessed Dec 13, 2009). 14 Yu H, Liu JP. A review of international clinical trial registration. Zhong Xi Yi Jie He Xue Bao 2007; 5: 234–42 (in Chinese). 15 Wang J, Gluud C, eds. Evidence based medicine and clinical practice, 2nd edn. Appendix 3 and 5. Beijing, China: Science Publisher, 2006: 383–87. 16 International Committee of Medical Journal Editors. Uniform requirements for manuscripts submitted to biomedical journals. http://www.icmje.org (accessed Dec 13, 2009). 17 The Lancet. Reforming research in China. Lancet 2007; 369: 880. 第 11 页