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Openai/692db3d0-8048-8004-a5d5-765a3231a3c9
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===== A7 — 推薦 RCT 規劃(具體設計建議) ===== * 目的:比較 Urocross 作為手術通道 vs 標準 UAS 在 RIRS(逆行性腎鏡碎石術)中的臨床效果。 * 主要終點(Primary endpoint):術後 4 週之 stone-free rate(CT / US 依中心標準)。 * 次要終點:手術時間、器械交換次數、腎內壓測量(若可行)、輸尿管損傷率、併發症、成本分析。 * 試驗型式:多中心、隨機、平行兩臂(1:1)。 * 樣本數估算(示例):假設對照組 stone-free rate = 75%,欲檢測絕對差 10%(到 85%),α=0.05,power=80% → 約 250 人 / 組(共 500 人)。若接受較小樣本做示範,可先做 2–3 個中心、共 100–150 病例的前瞻性隊列研究作為先期證據。(樣本數估算步驟我以標準雙比例樣本數公式計算)。 - 計算備註:若要更保守地偵測 5% 差異,樣本數會大幅增加(需調整)。(已做數學計算)。 * 建議資源:中心報酬、影像讀片盲化、獨立安全監督委員會(DSMB)。(計畫經費估算可在需要時展開)。(試驗細節與 IRB / 報批流程需本地調整) : 樣本數計算來源/說明:我以常見的雙比例檢定樣本數公式計算(參考統計標準方法),得到每組約 250 人(共 500 人)以檢測 10% 絕對差。若你要我,我可以把完整計算步驟、Excel 模版或 R / SAS 程式碼直接放進附件。
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