Hopefully, the initiation Epacadostat cost of the World Health Organization International Clinical Trials Registry Platform will facilitate such
assessments for future trials.41, 42 Another limitation in this review was insufficient reporting. Investigators of future trials are therefore well advised to adhere to the Consolidated Standards for Reporting of Trials in order to improve the quality of trial reports.43 These potential limitations and concerns may lower our confidence in the estimates of intervention effect. However, in our meta-analysis for SVR there is no apparent heterogeneity (I2 = 0%), and the direction of the treatment effect is the same across all included trials. Further research is unlikely to change our confidence in the estimate of the effect. It is a common misconception that large RCTs are generally more reliable than meta-analyses. The reason this misconception has prevailed is due to a number of highly
cited papers that compared high-quality large trials with collections of low-quality small trials (an unfair comparison). In empirical studies where high-quality large trials are compared with a collection of high-quality small trials, the results from the two are typically nondiscrepant. In the case of the IDEAL trial,3 the results still show an effect—albeit small—in favor of peginterferon alpha-2a. There are many examples of large trials that underestimate the treatment effect simply by chance. Current evidence suggests that peginterferon alpha-2a is significantly superior to beta-catenin mutation peginterferon alfa-2b regarding benefits (SVR, which is clearance of the virus from the blood). However, there is insufficient evidence to detect any differences regarding harms (mortality and adverse events). Future trials must further the correlation between achieving SVR and clinically relevant outcomes such as risk of cirrhosis, hepatocellular carcinoma, and mortality. Glycogen branching enzyme We thank the patients and investigators who participated
in the included trials, with special thanks to the investigators who responded to our inquiries. We also thank our colleagues Dimitrinka Nikolova and Sarah Louise Klingenberg. “
“Dorrell C, Erker L, Schug J, Kopp JL, Canaday PS, Fox AJ, et al. Prospective isolation of a bipotential clonogenic liver progenitor cell in adult mice. Genes Dev 2011;25:1193-1203. (Reprinted with permission.) The molecular identification of adult hepatic stem/progenitor cells has been hampered by the lack of truly specific markers. To isolate putative adult liver progenitor cells, we used cell surface-marking antibodies, including MIC1-1C3, to isolate subpopulations of liver cells from normal adult mice or those undergoing an oval cell response and tested their capacity to form bilineage colonies in vitro.