BACKGROUND Palliative care trials have higher rates of attrition. The MORECare guidance recommends applying classifications of attrition to report attrition to help interpret trial results. The guidance separates attrition into three categories: attrition due to death, illness or at random. The aim of our study is to apply the MORECare classifications on reported attrition rates in trials. METHODS A systematic review was conducted and attrition classifications retrospectively applied. Four databases, EMBASE; Medline, CINHAL and PsychINFO, were searched for randomised controlled trials of palliative care populations from 01.01.2010 to 08.10.2016. This systematic review is part of a larger review looking at recruitment to randomised controlled trials in palliative care, from January 1990 to early October 2016. We ran random-effect models with and without moderators and descriptive statistics to calculate rates of missing data. RESULTS One hundred nineteen trials showed a total attrition of 29% (95% CI 28 to 30%). We applied the MORECare classifications of attrition to the 91 papers that contained sufficient information. The main reason for attrition was attrition due to death with a weighted mean of 31.6% (SD 27.4) of attrition cases. Attrition due to illness was cited as the reason for 17.6% (SD 24.5) of participants. In 50.8% (SD 26.5) of cases, the attrition was at random. We did not observe significant differences in missing data between total attrition in non-cancer patients (26%; 95% CI 18-34%) and cancer patients (24%; 95% CI 20-29%). There was significantly more missing data in outpatients (29%; 95% CI 22-36%) than inpatients (16%; 95% CI 10-23%). We noted increased attrition in trials with longer durations. CONCLUSION Reporting the cause of attrition is useful in helping to understand trial results. Prospective reporting using the MORECare classifications should improve our understanding of future trials.

中文翻译：

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MORECare关于姑息治疗研究人群流失报告的指南是否合适？随机对照试验的系统评价和荟萃分析。

背景技术姑息治疗试验具有更高的损耗率。MORECare指南建议应用损耗分类来报告损耗，以帮助解释试验结果。该指南将损耗分为三类：因死亡，疾病或随机损耗。我们的研究目的是将MORECare分类应用于试验中报告的损耗率。方法进行了系统评价，并追溯应用了损耗分类。四个数据库，EMBASE；从Medline，CINHAL和PsychINFO中检索了2010年1月1日至2016年10月8日的姑息治疗人群的随机对照试验。这项系统评价是大型综述的一部分，该综述着眼于招募1990年1月至2016年10月上旬的姑息治疗随机对照试验。我们运行带有或不带有主持人和描述性统计信息的随机效应模型，以计算丢失数据的比率。结果119个试验显示总磨损率为29％（95％CI为28％至30％）。我们将MORECare损耗分类法应用于包含足够信息的91篇论文中。磨损的主要原因是由于死亡导致的磨损，其平均损失率为31.6％（SD 27.4）。疾病引起的人员流失被认为是17.6％（SD 24.5）参与者的原因。在50.8％（SD 26.5）的情况下，损耗是随机的。我们未观察到非癌症患者（26％； 95％CI 18-34％）和癌症患者（24％； 95％CI 20-29％）的总耗损之间的缺失数据没有显着差异。门诊患者的遗漏数据（29％； 95％CI 22-36％）明显多于住院患者（16％； 95％CI 22-36％）。95％CI 10-23％）。我们注意到，持续时间较长的试验中，损耗有所增加。结论报告磨损的原因有助于理解试验结果。使用MORECare分类进行的前瞻性报告应增进我们对未来试验的了解。