结肠椎病随机试验中统计显著结果的脆弱性:系统性审查
Tyler McKechnie1, Shuling Yang2, Kathy Wu2
1Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
Diseases of the colon and rectum
|October 27, 2023
概括
大多数随机试验对分歧性疾病干预缺乏稳定性. 大多数研究中的单一结果变化使得统计学上显著的发现变得不显著,这表明手术和医疗治疗的证据很脆弱.
科学领域:
- 胃肠病学和肝病学
- 临床试验方法论 临床试验方法论
- 生物统计学 生物统计学
背景情况:
- p值是一种被批评的,过于简单的治疗效应显著性的衡量标准.
- 脆弱性指数提供了一个替代方案,通过量化改变一个显著的p值变为非显著 (p > 0.05) 所需的最小"无事件".
结论:
- 对于分歧性疾病干预的RCT表明缺乏稳定性.
- 结果事件的最小变化 (通常只有一个) 足以否定大多数纳入研究的统计学意义.
- 限制包括小样本大小,异质性和排除连续结果.
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