与高度引用的个人文章和随后的元分析中报告的生物标志物相关的效应大小的比较
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
概括
高度引用的生物标志物研究经常高估了效果大小,与以后的元分析相比. 这表明疾病风险和预后生物标志物早期发现的潜在通货膨胀.
科学领域:
- 生物医学研究的研究.
- 翻译医学是一种翻译医学.
- 发现生物标志物的发现.
背景情况:
- 高度引用的研究经常提出疾病风险,预后或治疗反应的生物标志物.
- 然而,这些生物标志物的很少一部分最终会影响临床实践.
研究的目的:
- 调查大量引用的生物标志物研究中报告的效应大小是否准确或高估.
- 将高影响生物标志物研究的效应大小与随后的元分析进行比较.
主要方法:
- 搜索了Web of Science和MEDLINE的生物标志物研究报告的相对风险和>400个引用.
- 包括发表在24个高度引用的生物医学期刊上的研究.
- 从大量引用的研究中提取了效果大小,并将其与相同关联的元分析进行了比较.
主要成果:
- 评估了35个高度引用的关联; 86%的效果估计比最大的研究更大.
- 随后的元分析报告显示,这些关联中83%的效果估计较小.
- 在最大的研究中,很少有关联在统计学上仍然显著,具有临床意义的效果大小.
结论:
- 高度引用的生物标志物研究往往会报告膨胀的效果估计.
- 这种高估可能解释了为什么很少有拟议的生物标志物转化为临床实践.
- 进一步审查早期生物标志物发现是有必要的.
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