引用数が多い個々の記事と,その後のメタ解析で報告されたバイオマーカーに関連した効果の大きさの比較
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
JAMA
|June 3, 2011
まとめ
よく引用されているバイオマーカー研究は,後のメタ解析と比較して,しばしば効果の大きさを過大評価しています. これは,疾患リスクと予後バイオマーカーの早期発見における潜在的インフレを示唆しています.
科学分野:
- バイオメディカル研究
- 翻訳医学は翻訳医学である.
- バイオマーカーの発見
背景:
- 高度引用された研究は,疾患のリスク,予後,または治療への反応のためのバイオマーカーを提案することが多い.
- しかし,これらのバイオマーカーのうち,臨床実務に最終的な影響を与えるものはほとんどありません.
研究 の 目的:
- よく引用されているバイオマーカー研究で報告された効果サイズが正確であるか過大評価されているかどうかを調査する.
- 高インパクトバイオマーカー研究からの効果サイズを,その後のメタ解析と比較する.
主な方法:
- Web of ScienceとMEDLINEで,報告された相対リスクと >400件の引用を伴うバイオマーカー研究を検索しました.
- 引用数が高い24の生物医学誌に掲載された研究も含まれています.
- よく引用されている研究から効果の大きさを抽出し,同じ関連性のメタ解析と比較した.
主要な成果:
- 35の多く引用された関連性を評価し,86%が最大の研究よりも大きな効果の推定を示しました.
- その後のメタアナリシスでは,これらの関連性の83%において,より小さな効果の推定値が報告されました.
- 最大の研究では,臨床的に有意な効果サイズを持つ統計的に有意な関連はほとんどありませんでした.
結論:
- よく引用されているバイオマーカーの研究では,膨らんだ効果の推定値が報告される傾向があります.
- この過大評価は,提案されたバイオマーカーのほとんどが臨床実践に転用する理由を説明するかもしれない.
- 早期のバイオマーカー発見のさらなる検討は正当である.
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