logging in or signing up Клинические исследования Arkhipov Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 163 Category: Science & Tech.. License: All Rights Reserved Like it (0) Dislike it (0) Added: June 15, 2009 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... Premium member Presentation Transcript ??????????? ???????????? : ??????????? ???????????? 15 ???? 2009 ?. ???? ?????????????: : ???? ?????????????: ???????? ? ???? ?????????? 50-60 ???. ?? (23 ???. – FDA) ????????? ?? $ 0,5-2 ????. (??. 50% ???????? ?? R&D) ???? ???????? - ? ??????? 80 ???????????? ?????????????????? 14,9 ??? ? 5 000 ????????? 90% ??????????, ????????? ?? ????????? 20 ??? – ??????? 10-? ?????????? According to a recent report from the .Tufts Center for the Study of Drug Development, 2007 Stephen Andrade. ACT, April 2003 Schmidt A., 2005 ???? ???????????? ???????????? : ???? ???????????? ???????????? ???? I ???? II ???? III ???? IV ???????????? ? ???????? ???????????? ??????? ????????????? ????????????? ??????????????? ????????????? ???? ???????????? ??????????: : ???? ???????????? ??????????: ????????????? ???????? ????????????? ??????????????, ?????? ? ??????????? ????????????? ?????? ??????????? ??????????? ???????????? ??? ?????? ??????? ??????????? ????????. Evidence-Based Medicine Working Group. JAMA, 1994 ???? ????????????: : ???? ????????????: N Engl J Med 1999:341:709-17. RALES 1663 ??????? ??? , 2 ???? ?????????? ?????????? C????????????? ????????? ??????? ???? ?????????? ?????? ?? 27% ????? ????? ?????????????? ????????? ?? 17,7% ??????? ?? ?????????: : ??????? ?? ?????????: Slide 7: ??????? (USD 5,2 ????. 2007) TOP 2 USA – TOP 3 GLOBAL ????????? (USD 4,0 ????. 2007) TOP 2 USA – TOP 3 GLOBAL ??????? (USD 2,8 ????. 2007) www.astrazeneca.com ???? ????????: : ???? ????????: ???? ????????? ???????????? ???????? ???????? ?????? ????? ????, ??? ????? ? ????? ???????? ????? ??????????? ? 3-3,5 ???? ????, ?? ????????? ? ??????????????, ??????? ??????? – ??????????? ??????? ??? ????????????? ???????????! Woodstock P., BMJ 1999 ???? ??????: : ???? ??????: ???? ???????????: : ???? ???????????: http://www.ich.org International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use ??????????? ???????????? : ??????????? ???????????? Hulley & Cummings, 2001 ????????????????? ?????? ??????? ?????? ?????? ???? ???????????? ?????????? ???????????? ????????? ?????????? ???????????? ?????? ?????? ??? ??????? ???????????? ?????? ?????? ???????? ????? : ???????? ????? ??????????? ????????????: ???????????????? ?????????? ????, ??? ??????? ???????? ?? ???????. ??????????? ?????: ???????? ?????????? ?????????????, ????????? ? ???????? ??????????? ???????????? ???????????? ?????????? - ??????????? ??????????? ????????? ??????????, ??????????: ????? ????????? ?????????????????? ??????. ?????? ??????? ???????, ????????? ??????????? ?????? ? ?? : ?????? ??????? ???????, ????????? ??????????? ?????? ? ?? ???????????? ?????????? ?????????? ??????? ? ???????????? ????? ???????? ? ???????? ???????? ????? ??????-???????? : ??????-???????? ????????? ???????????? : ????????? ???????????? ??? : ??? ??????? ??????????????? : ??????? ??????????????? ????????? ? ???????? ?????? ??????????????? : ?????? ??????????????? ??????????? ???????????? : ??????????? ???????????? ????????? ? ? B ????? (????????????? / ?????????? / ?????????????? / ?????????? ????????????? ?????? ??????-???? ??????????) ???? ??????: P<0.0001 ???? ?2: P<0.0001 ???????? ????? ???????? ???????? ????????, ?? ????????? ??? ??????? Slide 20: ????????????? ???? (Relative Risk ??? Risk Ratio) ????????? ????? ? ???????? ?????? ? ????? ? ??????????? ??????? ? ?????? ? ????? ?????? 56% ?????? ?? ???????, ?? ????????? ? ??????? ???????? ?? ?????? ? Slide 21: 0,4 0,6 0,8 1,0 1,2 1,4 1,6 RR=1 ???????? ??????????? RR=0,559 95% CI [0.4056-0.7721] ???? ? ???????? ?????? ?????????? 56% ?? ????? ? ???????????: ??????? ?????????? ? ????????? ??????? ???? ?? 100-56=44% ???????? ??????????: 96% CI ?? ???????? 1 ?????? ? ???????????? ? 95% ???????? ????? ????? ?????????? ?????? 33% (100-77) ??? ?? ????? ???? ??????????? ????: 59% (100-41) Slide 22: ???????? ?????????????? ????? (Relative Risk Reduction) ???? ???????? ????? ? ????????????????? ??????, ?? ????????? ? ??????????? ??????? ?????????? ? ??????? ???? ?? 44% vs ??????? ? Slide 23: ???????? ??????????? ????? (Absolute Risk Reduction ??? Risk Difference) ???????? ? ??????? ????? ????? ???????? ??????? ???????????????? ??????? ? ?????? ? ?? 12,6% ????, ??? ? ?????? ? Slide 24: ????? ????? ?????????? ARR, ????? ? ??? ???? RR / ARR? Slide 25: NNT (Number Needed to Treat) ??????? ??????? ?????? ???????? ???????? A, ??? ?? ?? ????????? ? ?????????? ? ????????????? ???????? ?????? ???????????????? ??????? ???????? ??????? ??? ???????????? ??????, ??????? ?????? ?? ?????, ????????? ????????? ?????? ?? ????? ??????? ??????? ????? ????????????? ??? ?? ????????? Slide 26: ??????? ??? (???????? ????? – ???????????) Slide 27: Wiysonge CS et al. Beta-blockers for hypertension. Cochrane Database Syst Rev 2007;(1):CD002003. Number needed to harm ??? ??????? ???? ???????? ?? ????????? ? ??????? (NNT=200) ??? ?? ?????????? ?? ?????????? ? ????? ???????????? ???????? (NNT=0, ?? ??? ?????? ?? ???????) ??? ??????????? ???? ???????? ?? ????????? ? ???? (NNH=180) ??? ??????????? ???? ???????? ?? ????????? ? ??????????? (NNH=65) Slide 28: ????????? ?????? (Odds ratio) ????????? ?????? ?????? ? ???????? ?????? ? ????? ? ??????????? Slide 29: ????????? ?????? (Odds ratio) ????????? ?????? ?????? ? ???????? ?????? ? ????? ? ??????????? ??????????? ? ????????????? «??????-????????», ??? ??????????????? ??????? ???? ???????? ????? - ?????????? : ???? ???????? ????? - ?????????? ??????? ????????????? ????????? ????? ????????????, ?? ??? ?? ?????? ????????? ??????? ?????????? ??????! ?????????? : ?????????? Chi-square test: RR=24/24=1 (?=1,0) Log-rank (Mantel-Cox) Test: HR=0,87 [0,33-0,93], ?=0,01 Canadian ?ooperative Study Group : Canadian ?ooperative Study Group Gent. Circulation 1980 0 0.5 1 2 3 ??????? ????????? ?????? 0.7 (95% CI 0.5 to 1.0) ???????????? ???????? ??????? ??? ???? ????????/?????? ? 585 ???????, ????????? ??????????? ??????? ?????? 1: ?????????? ?? ?????? ???????? ? ?????????? ?? ????? : ?????? 1: ?????????? ?? ?????? ???????? ? ?????????? ?? ????? Gent. Circulation 1980 0 0.5 1 2 3 ??????? ????????? ?????? 0.7 (95% CI 0.5 to 1.0) ???????????? ???????? ??????? ??? ?? ??? ?????? 2: ?????????? ?? ?????? ???????? ? ?????????? ???? ?? ?????? : ?????? 2: ?????????? ?? ?????? ???????? ? ?????????? ???? ?? ?????? Gent. Circulation 1980 0 0.5 1 2 3 ??????? ????????? ?????? 0.7 (95% CI 0.5 to 1.0) ???????????? ???????? ??????? ??? ??? ??? ISIS-2 : ISIS-2 ISIS-2. Lancet 1988;ii: 349–60. ???????? ????? (?=0,05) : ???????? ????? (?=0,05) 95% 5% 5% 90% 5% 85% 1-? ????? 2-? ????? 3-? ????? 15% Slide 38: In clinical trials EVERYBODY LIES ????????? ?? ?????? ??? ?????????? ??? ??????? ???: : ????????? ?? ?????? ??? ?????????? ??? ??????? ???: ?????????? ?????????? ??????????? (? ???? ?????) ?????????? ?????????? ???????????? COMET : ???????????? COMET ?????? ?????? ????????? 2-? ??? ? ??????? ??? ?????????? ??? ??????? ???????????? – 33,9% ???????????? – 39,5% (?=0,0017) ?????????? «??? ?????? ?????? + ??? ??????????????» ? ??????????? ??????? ???????? ???????? ?????????? (p=0,122). Remme WJ et al. J Am Coll Cardiol 2007;49:963–71. Slide 41: KOL: ?????????? ?? ????????? ? ???????????? ?????????? ??????? ?????????? ??????? ??? ?? 14,2%! ????: ? ????? 14 ??????? ?? 100 ???? ?????? ?????????? ? ??????? ??????????! Slide 42: Remme WJ et al. J Am Coll Cardiol 2007;49:963–71. MERIT-HF Study Group. Lancet 1999;353:2001–7. ???. ????? ???????????: ?? ????? ???? ???????? ?? ????? ??????: ???? ????????? ?? ??? ? ???????? ? ?????? ??? ?????? ?? 5,6% ????, ? NNT=17. ?? ???? ?? ?????? 100 ???????, ??????? ???????? ? ??? ?? ??? ????????????? ????????? ???????? ?????? ???????? ? ???. Slide 43: Remme WJ et al. J Am Coll Cardiol 2007;49:963–71. MERIT-HF Study Group. Lancet 1999;353:2001–7. ???. ????? ???????????: ?? ????? ???? ???????? ?? ????? ??????: ???? ????????? ?? ??? ? ???????? ? ?????? ??? ?????? ?? 5,6% ????, ? NNT=17. ?? ???? ?? ?????? 100 ???????, ??????? ???????? ? ??? ?? ??? ????????????? ????????? ???????? ?????? ???????? ? ???. ?? ???? ??? ????????? ????? ???? ??????????? ???????! ?????? ?????? ?????????? ??? ?? ?????? ?? ?????? ???????? ????? (?????????? + ??????????????)? ?????? ? ???????????? ?????????? ??? ???????? ?????? ? ???????????? MERIT-HF ? ?????? ??? ????????? ?????????? ????????? ? 3 ???? ????, ??? ? ???????????? COMET ? ?????? ? ???????????? MERIT-HF ??????? ???? ????????? ? ????????? ?? «??????» ??? ?????????? 155 ??, ? ? ???????????? COMET ?????? 78 ??? ???????? ? ??????????????? : ???????? ? ??????????????? Andersson B., et al. J Card Fail 2001;7:311–317. ??????????? ??????? 50 ?? 3 ???? ? ????? 14 22 08 08 300 200 100 0 ??????????? ???????? CR/XL 100 ?? ??????????? ???????? CR/XL 200 ?? ??????????? ??????? 50 ?? ??????????? ??????? 50 ?? ????? ??????, ? ??????????? ???????? 200 ?? 1 ??? ? ????? ???????????? ????????? ? ?????? ????? (?????/?) ??????????? ???????? 100 ?? 1 ??? ? ????? MDS: ??????? ???? 100-150 ?? – ??? ??????? ?? ?????????? MERIT-HF: ??????? ???? 200 ?? – ???????? ?????????? ?? 34% ????? ??? ??????????? : ????? ??? ??????????? 5,6% COMET : COMET 5,6% 7,5 ???. COPERNICUS : COPERNICUS ?????????? ??????? 8 ???. ?????? ???????????? ???????????? : ?????? ???????????? ???????????? ? ????? ?????? ? ??? ??????? ??????: «???????? ?? ??? ????????? ????????? ??????? ????-??????? ??? ??? ????????? ???? ????????? ????-?????????? ? ?????????? ?????????????? ??????????, ??????? ?????????? ?????? ?????????» ?? ?????? ??????, ????? ??????? ?????, ?????????? ?? ???????????????: ????????? ???????? ???????????, ?? ???? ?? ???? ????????????? ???, ??? COMET ?????????????????: ????? ??????? ???? ??? ??????? ?????, ??? ??????. ??? ?? ????? ?????????. Eric Topol Ake Hjalmarson, PI of MERIT-HF Slide 49: In clinical trials EVERYBODY LIES, but do it CORRECTLY! You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
Клинические исследования Arkhipov Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 163 Category: Science & Tech.. License: All Rights Reserved Like it (0) Dislike it (0) Added: June 15, 2009 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... Premium member Presentation Transcript ??????????? ???????????? : ??????????? ???????????? 15 ???? 2009 ?. ???? ?????????????: : ???? ?????????????: ???????? ? ???? ?????????? 50-60 ???. ?? (23 ???. – FDA) ????????? ?? $ 0,5-2 ????. (??. 50% ???????? ?? R&D) ???? ???????? - ? ??????? 80 ???????????? ?????????????????? 14,9 ??? ? 5 000 ????????? 90% ??????????, ????????? ?? ????????? 20 ??? – ??????? 10-? ?????????? According to a recent report from the .Tufts Center for the Study of Drug Development, 2007 Stephen Andrade. ACT, April 2003 Schmidt A., 2005 ???? ???????????? ???????????? : ???? ???????????? ???????????? ???? I ???? II ???? III ???? IV ???????????? ? ???????? ???????????? ??????? ????????????? ????????????? ??????????????? ????????????? ???? ???????????? ??????????: : ???? ???????????? ??????????: ????????????? ???????? ????????????? ??????????????, ?????? ? ??????????? ????????????? ?????? ??????????? ??????????? ???????????? ??? ?????? ??????? ??????????? ????????. Evidence-Based Medicine Working Group. JAMA, 1994 ???? ????????????: : ???? ????????????: N Engl J Med 1999:341:709-17. RALES 1663 ??????? ??? , 2 ???? ?????????? ?????????? C????????????? ????????? ??????? ???? ?????????? ?????? ?? 27% ????? ????? ?????????????? ????????? ?? 17,7% ??????? ?? ?????????: : ??????? ?? ?????????: Slide 7: ??????? (USD 5,2 ????. 2007) TOP 2 USA – TOP 3 GLOBAL ????????? (USD 4,0 ????. 2007) TOP 2 USA – TOP 3 GLOBAL ??????? (USD 2,8 ????. 2007) www.astrazeneca.com ???? ????????: : ???? ????????: ???? ????????? ???????????? ???????? ???????? ?????? ????? ????, ??? ????? ? ????? ???????? ????? ??????????? ? 3-3,5 ???? ????, ?? ????????? ? ??????????????, ??????? ??????? – ??????????? ??????? ??? ????????????? ???????????! Woodstock P., BMJ 1999 ???? ??????: : ???? ??????: ???? ???????????: : ???? ???????????: http://www.ich.org International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use ??????????? ???????????? : ??????????? ???????????? Hulley & Cummings, 2001 ????????????????? ?????? ??????? ?????? ?????? ???? ???????????? ?????????? ???????????? ????????? ?????????? ???????????? ?????? ?????? ??? ??????? ???????????? ?????? ?????? ???????? ????? : ???????? ????? ??????????? ????????????: ???????????????? ?????????? ????, ??? ??????? ???????? ?? ???????. ??????????? ?????: ???????? ?????????? ?????????????, ????????? ? ???????? ??????????? ???????????? ???????????? ?????????? - ??????????? ??????????? ????????? ??????????, ??????????: ????? ????????? ?????????????????? ??????. ?????? ??????? ???????, ????????? ??????????? ?????? ? ?? : ?????? ??????? ???????, ????????? ??????????? ?????? ? ?? ???????????? ?????????? ?????????? ??????? ? ???????????? ????? ???????? ? ???????? ???????? ????? ??????-???????? : ??????-???????? ????????? ???????????? : ????????? ???????????? ??? : ??? ??????? ??????????????? : ??????? ??????????????? ????????? ? ???????? ?????? ??????????????? : ?????? ??????????????? ??????????? ???????????? : ??????????? ???????????? ????????? ? ? B ????? (????????????? / ?????????? / ?????????????? / ?????????? ????????????? ?????? ??????-???? ??????????) ???? ??????: P<0.0001 ???? ?2: P<0.0001 ???????? ????? ???????? ???????? ????????, ?? ????????? ??? ??????? Slide 20: ????????????? ???? (Relative Risk ??? Risk Ratio) ????????? ????? ? ???????? ?????? ? ????? ? ??????????? ??????? ? ?????? ? ????? ?????? 56% ?????? ?? ???????, ?? ????????? ? ??????? ???????? ?? ?????? ? Slide 21: 0,4 0,6 0,8 1,0 1,2 1,4 1,6 RR=1 ???????? ??????????? RR=0,559 95% CI [0.4056-0.7721] ???? ? ???????? ?????? ?????????? 56% ?? ????? ? ???????????: ??????? ?????????? ? ????????? ??????? ???? ?? 100-56=44% ???????? ??????????: 96% CI ?? ???????? 1 ?????? ? ???????????? ? 95% ???????? ????? ????? ?????????? ?????? 33% (100-77) ??? ?? ????? ???? ??????????? ????: 59% (100-41) Slide 22: ???????? ?????????????? ????? (Relative Risk Reduction) ???? ???????? ????? ? ????????????????? ??????, ?? ????????? ? ??????????? ??????? ?????????? ? ??????? ???? ?? 44% vs ??????? ? Slide 23: ???????? ??????????? ????? (Absolute Risk Reduction ??? Risk Difference) ???????? ? ??????? ????? ????? ???????? ??????? ???????????????? ??????? ? ?????? ? ?? 12,6% ????, ??? ? ?????? ? Slide 24: ????? ????? ?????????? ARR, ????? ? ??? ???? RR / ARR? Slide 25: NNT (Number Needed to Treat) ??????? ??????? ?????? ???????? ???????? A, ??? ?? ?? ????????? ? ?????????? ? ????????????? ???????? ?????? ???????????????? ??????? ???????? ??????? ??? ???????????? ??????, ??????? ?????? ?? ?????, ????????? ????????? ?????? ?? ????? ??????? ??????? ????? ????????????? ??? ?? ????????? Slide 26: ??????? ??? (???????? ????? – ???????????) Slide 27: Wiysonge CS et al. Beta-blockers for hypertension. Cochrane Database Syst Rev 2007;(1):CD002003. Number needed to harm ??? ??????? ???? ???????? ?? ????????? ? ??????? (NNT=200) ??? ?? ?????????? ?? ?????????? ? ????? ???????????? ???????? (NNT=0, ?? ??? ?????? ?? ???????) ??? ??????????? ???? ???????? ?? ????????? ? ???? (NNH=180) ??? ??????????? ???? ???????? ?? ????????? ? ??????????? (NNH=65) Slide 28: ????????? ?????? (Odds ratio) ????????? ?????? ?????? ? ???????? ?????? ? ????? ? ??????????? Slide 29: ????????? ?????? (Odds ratio) ????????? ?????? ?????? ? ???????? ?????? ? ????? ? ??????????? ??????????? ? ????????????? «??????-????????», ??? ??????????????? ??????? ???? ???????? ????? - ?????????? : ???? ???????? ????? - ?????????? ??????? ????????????? ????????? ????? ????????????, ?? ??? ?? ?????? ????????? ??????? ?????????? ??????! ?????????? : ?????????? Chi-square test: RR=24/24=1 (?=1,0) Log-rank (Mantel-Cox) Test: HR=0,87 [0,33-0,93], ?=0,01 Canadian ?ooperative Study Group : Canadian ?ooperative Study Group Gent. Circulation 1980 0 0.5 1 2 3 ??????? ????????? ?????? 0.7 (95% CI 0.5 to 1.0) ???????????? ???????? ??????? ??? ???? ????????/?????? ? 585 ???????, ????????? ??????????? ??????? ?????? 1: ?????????? ?? ?????? ???????? ? ?????????? ?? ????? : ?????? 1: ?????????? ?? ?????? ???????? ? ?????????? ?? ????? Gent. Circulation 1980 0 0.5 1 2 3 ??????? ????????? ?????? 0.7 (95% CI 0.5 to 1.0) ???????????? ???????? ??????? ??? ?? ??? ?????? 2: ?????????? ?? ?????? ???????? ? ?????????? ???? ?? ?????? : ?????? 2: ?????????? ?? ?????? ???????? ? ?????????? ???? ?? ?????? Gent. Circulation 1980 0 0.5 1 2 3 ??????? ????????? ?????? 0.7 (95% CI 0.5 to 1.0) ???????????? ???????? ??????? ??? ??? ??? ISIS-2 : ISIS-2 ISIS-2. Lancet 1988;ii: 349–60. ???????? ????? (?=0,05) : ???????? ????? (?=0,05) 95% 5% 5% 90% 5% 85% 1-? ????? 2-? ????? 3-? ????? 15% Slide 38: In clinical trials EVERYBODY LIES ????????? ?? ?????? ??? ?????????? ??? ??????? ???: : ????????? ?? ?????? ??? ?????????? ??? ??????? ???: ?????????? ?????????? ??????????? (? ???? ?????) ?????????? ?????????? ???????????? COMET : ???????????? COMET ?????? ?????? ????????? 2-? ??? ? ??????? ??? ?????????? ??? ??????? ???????????? – 33,9% ???????????? – 39,5% (?=0,0017) ?????????? «??? ?????? ?????? + ??? ??????????????» ? ??????????? ??????? ???????? ???????? ?????????? (p=0,122). Remme WJ et al. J Am Coll Cardiol 2007;49:963–71. Slide 41: KOL: ?????????? ?? ????????? ? ???????????? ?????????? ??????? ?????????? ??????? ??? ?? 14,2%! ????: ? ????? 14 ??????? ?? 100 ???? ?????? ?????????? ? ??????? ??????????! Slide 42: Remme WJ et al. J Am Coll Cardiol 2007;49:963–71. MERIT-HF Study Group. Lancet 1999;353:2001–7. ???. ????? ???????????: ?? ????? ???? ???????? ?? ????? ??????: ???? ????????? ?? ??? ? ???????? ? ?????? ??? ?????? ?? 5,6% ????, ? NNT=17. ?? ???? ?? ?????? 100 ???????, ??????? ???????? ? ??? ?? ??? ????????????? ????????? ???????? ?????? ???????? ? ???. Slide 43: Remme WJ et al. J Am Coll Cardiol 2007;49:963–71. MERIT-HF Study Group. Lancet 1999;353:2001–7. ???. ????? ???????????: ?? ????? ???? ???????? ?? ????? ??????: ???? ????????? ?? ??? ? ???????? ? ?????? ??? ?????? ?? 5,6% ????, ? NNT=17. ?? ???? ?? ?????? 100 ???????, ??????? ???????? ? ??? ?? ??? ????????????? ????????? ???????? ?????? ???????? ? ???. ?? ???? ??? ????????? ????? ???? ??????????? ???????! ?????? ?????? ?????????? ??? ?? ?????? ?? ?????? ???????? ????? (?????????? + ??????????????)? ?????? ? ???????????? ?????????? ??? ???????? ?????? ? ???????????? MERIT-HF ? ?????? ??? ????????? ?????????? ????????? ? 3 ???? ????, ??? ? ???????????? COMET ? ?????? ? ???????????? MERIT-HF ??????? ???? ????????? ? ????????? ?? «??????» ??? ?????????? 155 ??, ? ? ???????????? COMET ?????? 78 ??? ???????? ? ??????????????? : ???????? ? ??????????????? Andersson B., et al. J Card Fail 2001;7:311–317. ??????????? ??????? 50 ?? 3 ???? ? ????? 14 22 08 08 300 200 100 0 ??????????? ???????? CR/XL 100 ?? ??????????? ???????? CR/XL 200 ?? ??????????? ??????? 50 ?? ??????????? ??????? 50 ?? ????? ??????, ? ??????????? ???????? 200 ?? 1 ??? ? ????? ???????????? ????????? ? ?????? ????? (?????/?) ??????????? ???????? 100 ?? 1 ??? ? ????? MDS: ??????? ???? 100-150 ?? – ??? ??????? ?? ?????????? MERIT-HF: ??????? ???? 200 ?? – ???????? ?????????? ?? 34% ????? ??? ??????????? : ????? ??? ??????????? 5,6% COMET : COMET 5,6% 7,5 ???. COPERNICUS : COPERNICUS ?????????? ??????? 8 ???. ?????? ???????????? ???????????? : ?????? ???????????? ???????????? ? ????? ?????? ? ??? ??????? ??????: «???????? ?? ??? ????????? ????????? ??????? ????-??????? ??? ??? ????????? ???? ????????? ????-?????????? ? ?????????? ?????????????? ??????????, ??????? ?????????? ?????? ?????????» ?? ?????? ??????, ????? ??????? ?????, ?????????? ?? ???????????????: ????????? ???????? ???????????, ?? ???? ?? ???? ????????????? ???, ??? COMET ?????????????????: ????? ??????? ???? ??? ??????? ?????, ??? ??????. ??? ?? ????? ?????????. Eric Topol Ake Hjalmarson, PI of MERIT-HF Slide 49: In clinical trials EVERYBODY LIES, but do it CORRECTLY!