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Comparación de los tamaños de efecto asociados con los biomarcadores informados en artículos individuales muy citados

John P A Ioannidis¹, Orestis A Panagiotou

¹Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California 94305, USA. jioannid@stanford.edu

|June 3, 2011

Resumen

Los estudios de biomarcadores altamente citados frecuentemente sobreestiman el tamaño del efecto en comparación con metaanálisis posteriores. Esto sugiere una posible inflación en los hallazgos tempranos de los biomarcadores de riesgo de enfermedad y pronóstico.

Área de la Ciencia:

Investigación biomédica en la investigación biomédica.
La medicina traslacional es una medicina traslacional.
El descubrimiento de biomarcadores.

Sus antecedentes:

Los estudios altamente citados a menudo proponen biomarcadores para el riesgo de enfermedad, el pronóstico o la respuesta al tratamiento.
Sin embargo, pocos de estos biomarcadores finalmente tienen un impacto en la práctica clínica.

Objetivo del estudio:

Investigar si los tamaños de efecto reportados en estudios de biomarcadores muy citados son exactos o sobreestimados.
Para comparar el tamaño de los efectos de la investigación de biomarcadores de alto impacto con metaanálisis posteriores.

Principales métodos:

Buscado en la Web of Science y MEDLINE para estudios de biomarcadores con riesgo relativo reportado y >400 citas.
Se incluyeron estudios publicados en 24 revistas biomédicas altamente citadas.
Extrajo tamaños de efecto de estudios muy citados y los comparó con metaanálisis de las mismas asociaciones.

Principales resultados:

Se evaluaron 35 asociaciones muy citadas; el 86% mostró estimaciones de efectos más grandes que el estudio más grande.
Los metanálisis posteriores informaron estimaciones de efectos más pequeñas para el 83% de estas asociaciones.
Pocas asociaciones se mantuvieron estadísticamente significativas con un tamaño de efecto clínicamente significativo en los estudios más grandes.

Conclusiones:

Los estudios de biomarcadores muy citados tienden a informar estimaciones de efectos inflados.
Esta sobreestimación puede explicar por qué pocos biomarcadores propuestos se traducen en la práctica clínica.
Se justifica un mayor escrutinio de los hallazgos tempranos de biomarcadores.

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