国内入院患者サンプルを用いた研究における方法論的基準の遵守
Rohan Khera1, Suveen Angraal2, Tyler Couch1
1Division of Cardiology, University of Texas Southwestern Medical Center, Dallas.
JAMA
|November 29, 2017
まとめ
国立入院患者サンプル (NIS) データベースを使用したほとんどの研究は,必要な研究慣行に従わなかった. これは公衆衛生研究におけるデータ分析と解釈戦略の改善の必要性を強調しています.
科学分野:
- 医療サービス研究
- 公共衛生データ分析
- バイオ統計学
背景:
- 国家入院患者サンプル (NIS) のような公的に利用可能なデータセットは,貴重な研究機会を提供します.
- しかし,それらのユニークな構造は,正確な解釈のための特定の分析的アプローチを必要とします.
- 推奨される研究慣行に従うことは,そのようなデータから得られた発見の妥当性にとって極めて重要です.
研究 の 目的:
- 国立入院患者サンプル (NIS) データベースを利用した研究における基本的研究慣行の遵守を評価する.
- NISの研究で推奨される方法論からの一般的な偏差を特定する.
- 大規模な公衆衛生データセットを用いた研究の質を向上させるための戦略を策定する.
主な方法:
- 2015年1月から2016年12月までの間,NISを使用した120の出版物を体系的に検討した観察研究が行われました.
- 研究は,AHRQ (医療研究と品質庁) が推奨する7つの主要な研究慣行への遵守を評価した.
- 実践はデータ解釈,研究設計,データ分析,調査設計とデータ構造の変更の会計を含む.
主要な成果:
- 検討された研究の有意な多数 (85%) は,少なくとも1つの必要な手順を遵守しなかった.
- 62%の研究は2つ以上の重要な研究方法から逸脱した.
- 一般的な問題は,入院をユニークな患者として誤って解釈すること,州レベルの不適切な分析,NISの複雑な調査設計とデータ構造の変更を考慮しないことです.
結論:
- NISデータベースを使用した最近の出版物の大半は,必要とされる研究慣行に従わなかった.
- NISで実施される研究の質と厳格性を向上させるための戦略を策定し,実施する必要がある.
- 発見は,他の大規模で公的に利用可能な健康データセットの利用に類似した問題を示唆し,さらなる調査を正当化しています.
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