在ICI肺炎风险预测研究中常见的方法陷
Yichen K Chen1, Sarah Welsh2, Ardon M Pillay3
1Department of Applied Mathematics and Theoretical Physics, University of Cambridge, Cambridge, United Kingdom.
Frontiers in immunology
|October 11, 2023
概括
由于研究设计有缺陷,免疫检查点抑制剂 (ICI) 肺炎缺乏可靠的风险预测模型. 未来的研究必须优先考虑高质量的方法来改善患者风险分层和对这种常见不良事件的监测.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 肺部病理学 肺部病理学
背景情况:
- 肺炎是一种与免疫检查点抑制剂 (ICI) 相关的频繁且可能致命的不良事件.
- 目前ICI诱导肺炎的风险预测模型尚未在临床上部署,这阻碍了患者风险分层和监测.
- 现有的文献缺乏最佳的研究设计和方法,从而无法有效评估风险.
研究的目的:
- 系统地审查和分析用于确定风险因素和开发ICI诱导肺炎预测模型的研究中的方法方法.
- 确定常见的方法陷,并评估它们对现有研究中偏见风险的贡献.
- 突出需要高质量的研究来开发可临床部署的风险预测模型.
主要方法:
- 在PubMed,medRxiv和bioRxiv上进行了系统的文献搜索,以研究ICI诱导的肺炎风险因素和预测模型.
- 符合条件的研究使用QUIPS和PROBAST工具分析了常见的方法陷,以评估偏差风险.
- 方法论实践,诊断方法,统计分析和缺少数据的处理得到了批判性审查.
主要成果:
- 在51个符合条件的手稿中,只有2个显示出整体偏差风险较低,表明广泛的方法限制.
- 常见的偏见诱导实践包括不清楚的诊断标准,缺乏多次测试校正,不适当的特征选择,变量离散以及对缺失数据的处理不善.
- 风险模型可能过度乐观,因为缺乏持久集,这表明预测不可靠.
结论:
- 目前关于ICI诱导肺炎的研究特点是存在高偏差风险,限制了可靠预测模型的开发.
- 迫切需要进行方法严格的研究,重点关注准确的风险因素识别和强大的模型开发.
- 讨论了建议和替代方法,以指导未来的研究,以创造临床上有用的ICI肺炎风险预测工具.
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