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Strengthening transparency in randomised trials related to multimorbidity: key points and recommendations to guide reporting
  1. Zijun Wang1,2,
  2. Jako S Burgers3,
  3. Ruitai Shao4,
  4. Zhaoxiang Bian5,
  5. Chen Wang4,
  6. Yaolong Chen1,
  7. Janne Estill1,2
  1. 1Research Unit of Evidence-Based Evaluation and Guidelines (2021RU017), Chinese Academy of Medical Sciences, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
  2. 2Institute of Global Health, University of Geneva, Geneve, GE, Switzerland
  3. 3Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Limburg, Netherlands
  4. 4School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, Beijing, China
  5. 5China EQUATOR Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong
  1. Correspondence to Professor Yaolong Chen, Lanzhou University, Lanzhou, Gansu, China; chevidence{at}

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Multimorbidity, defined by the WHO as the coexistence of two or more chronic conditions,1 is a growing challenge for public health globally. Lower quality of life, psychological distress, long hospital stays, postoperative complications, high costs of care and elevated mortality are becoming an enormous burden for patients and their families as the prevalence of multimorbidity increases along with the ageing population.2 To deliver adequate and cost-effective care for patients with multimorbidity, healthcare needs to transition from traditional single-disease management to a patient-centred approach to managing complex health needs.3

A randomised controlled trial (RCT) is considered the gold standard in the evaluation of health interventions. High-quality evidence from RCTs is crucial for the management of comorbidities and health in general in populations with multimorbidity.4 However, the evidence remains sparse. Clinical trials commonly exclude patients with multimorbidity to reduce bias, and the applicability of the findings for patients with different comorbidities is not addressed.5 Conversely, since multimorbidity is common in elderly people, it can be expected that most participants in trials among elderly populations have several underlying comorbidities. However, the comorbidities and their interactions are not necessarily fully considered in the analyses and it may be questionable whether and how the results apply to patients with …

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  • Contributors ZW and YC conceived the idea of the opinion. JSB, RS, ZB and CW contributed to the suggestions in their opinion. ZW and JE wrote the first draft of the manuscript. All authors read and approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.