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And finally, there are no negative trials
最后，没有负效试验
I want to show you, as I did this morning, the instance of the key importance of a therapeutic blood level
和早上一样，我要讲治疗血液水平的关键作用
Giving the agent isn't good enough, you have to give a right dose
剂量必须足够正确
and you have to give a dose that produces a therapy above that level and we saw this slide earlier this morning
剂量要使得治疗超过这个水平，这个幻灯早上就讲过
unless you get it and achieve 25(OH)D level that is above 80 nmol
不达到高于80纳摩的25(OH)D水平
you're not going to get a fracture benefit and the meta analyses show that very clearly
无法得到骨折方面的益处，综合分析中很明确地证明了这一点
I mean here's where WHI was located right down here
这是WHI的值
I mean I was surprised that's no different from one point zero we should have be because there's nothing magic about it
我很惊讶这和一般的1.0没什么区别，根本没什么用
You have to give enough to change the blood level or you don't get anything
必须要达到足够的血液水平才能有好处
Now I want to stress I can't go into detail. There isn't time
我就不细讲了，时间有限
I want to stress there are no negative trials
我要强调没有负效试验
There are null trials but not negative trials
有无效试验，但没有负效试验
Stop to think about it
想想
if this were a placebo effect and we just happen to have found positive trials by the time you've got 30+ trials you ought to have some negative ones too
如果只是安慰剂效应碰巧碰到正效果那30多个试验的话，就肯定会有一些负效果
Some of them are going to work and given the skepticism out there
不可能全部是正效果，基于现在的怀疑论环境
it's highly unlikely that they wouldn't be published
有负效试验人们不可能不发表
So the absence of negative trials is really assuring in its own right
这里没有负效试验就很好地证明了有效
There are some null trials which are often due to bad design basically or bad execution or both
有一些无效试验，是因为设计糟糕或操作糟糕，或两者都糟糕
