评估在案例交叉设计中使用减轻非暂时药物偏差的方法:系统性审查
Hsiao-Ching Huang1, Wen-Chin Li1, Mina Tadrous2
1Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois Chicago, Chicago, Illinois, USA.
Pharmacoepidemiology and drug safety
|June 7, 2023
概括
案例交叉设计通常用于药物研究,但可以偏向于非暂时性暴露. 许多研究未能使用推方法来解决这些偏见,特别是对于慢性药物.
科学领域:
- 药学流行病学 药学流行病学
- 生物统计学 生物统计学
- 健康研究方法 健康研究方法
背景情况:
- 案例交叉设计是一种自我控制的统计方法,用于比较最近的风险与早期的风险.
- 它最适合短暂的暴露,因为非短暂的 (慢性) 暴露可以引入偏差.
- 对于类似的研究问题,也存在像病例时间控制和病例时间控制这样的变体.
研究的目的:
- 系统地审查案例交叉,案例时间控制和案例时间控制研究.
- 为了比较这些研究中的设计和分析选择,特别是按药物类型.
- 评估对非暂时性曝光的偏差缓解方法的应用.
主要方法:
- 在MEDLINE和EMBASE系统搜索2015年1月至2021年12月期间发表的研究.
- 包括以病例交叉,病例时间控制或病例时间控制设计的药物暴露为重点的研究.
- 不包括评论,方法研究,评论,非药物曝光和没有全文的文章.
主要成果:
- 包括114个项目;案例交叉是占主导地位的设计 (88%).
- 53%的研究集中在短暂的药物上,35%的研究集中在非短暂的药物上,12%的研究集中在两者上.
- 41%使用非短暂药物病例交叉研究的研究没有应用推的偏差缓解方法.
结论:
- 病例交叉设计经常应用于药物流行病学中的非暂时药物暴露.
- 研究人员必须在使用病例交叉用于慢性药物暴露时,仔细选择适当的设计和分析.
- 坚持推的偏差校正方法对于研究有效性至关重要.
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