在医学研究中实施试验模拟方法:一个范围审查
Giulio Scola1, Anca Chis Ster2, Daniel Bean2,3
1Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. giulio.1.scola@kcl.ac.uk.
BMC medical research methodology
|August 16, 2023
概括
目标试验框架指导观察性研究,以防止偏见. 这次审查发现38项研究模拟试验,主要是心脏病学,使用各种方法来解决混,不朽时间和选择偏差.
科学领域:
- 流行病学 流行病学
- 生物统计学 生物统计学
- 健康研究方法 卫生研究方法
背景情况:
- 随机对照试验 (RCT) 是理想的,但通常是不切实际的.
- 观察性研究提供了一个替代方案,但面临着统计偏见的挑战.
- 目标试验框架提供了一种结构化的方法,以减轻观察性研究中的偏见.
研究的目的:
- 在所有医学领域进行明确试验模拟研究的范围审查.
- 识别和分析在试验模拟中使用的方法.
- 了解如何在模拟试验的观察性研究中解决不同的偏见.
主要方法:
- 在Embase,Medline和Web of Science中搜索到2021年2月25日的试验模拟研究.
- 提取了有关主题领域的数据,观察数据类型和使用的统计方法.
- 专注于解决混偏差,不朽时间偏差和选择偏差的方法.
主要成果:
- 从617个初步结果中确定了38项符合条件的研究.
- 研究主要集中在心脏病学,传染病和瘤学.
- 通常使用的数据来源包括电子健康记录和队列数据.
- 混的方法包括对混因子的条件化;对于选择偏差,使用了审查权重的反向概率.
- 不朽时间偏差的方法涉及在基线分配治疗或使用序列/克隆仿真.
结论:
- 在观察性研究中,各种统计方法有效地解决了混,不朽时间和选择偏差.
- 目标试验框架为设计和分析观察性研究提供了一种有价值的结构化方法.
- 模拟目标试验是一个强大的策略,以加强从观察数据的因果推断.
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