处理作为基线共变体的实验室测试结果中缺少的数据:使用数据库系统对日本MID-NET®做出贡献的多医院队列研究的结果
Maki Komamine1,2, Yoshiaki Fujimura3, Masatomo Omiya4
1Department of Biostatistics, Kyoto University School of Public Health, Yoshida-konoecho, Sakyo-ku, Kyoto, 606-8501, Japan. komamine-maki@pmda.go.jp.
BMC medical informatics and decision making
|October 31, 2023
概括
单回归归算 (SRI) 和多重归算 (MI) 在混调整中为调整的危险比率 (aHR) 提供了可比的结果. 医院的变化没有显著影响这些发现,但倾向性得分匹配需要仔细应用.
科学领域:
- 健康研究方法的方法论.
- 医疗保健中的统计分析.
- 观察性研究的设计.
背景情况:
- 缺少实验室测试结果在观察性研究的混调整方面带来了挑战.
- 评估不同缺失数据方法的性能对于可靠的分析至关重要.
- MID-NET®协作医院为此评估提供了一个强大的数据集.
研究的目的:
- 为了比较各种缺失数据处理方法对实验室测试结果的有效性.
- 评估医院特定与整体方法对缺失数据的影响.
- 为了指导在现实数据中适当使用混调整技术.
主要方法:
- 应用了五种方法来找出缺失的实验室测试结果,包括单回归归算 (SRI),多重归算 (MI) 和反向概率权重 (IPW).
- 使用的倾向性得分 (PS) 权重,PS匹配,并对混进行回归调整.
- 在各种方法和场景中比较调整后的危险比率 (aHR) 和95%置信区间 (CI).
主要成果:
- 在这两种情景中,SRI和MI对aHRs产生了类似的点估计.
- 处理缺失数据的医院特定和整体方法在结果中显示出极小的差异.
- 倾向性得分匹配显著影响了aHRs,而PS权重显示SRI和MI之间的差异较小.
结论:
- SRI和MI是处理缺少实验室测试结果的可靠方法,提供一致的aHR估计.
- 考虑到缺少数据的医院变化,并没有实质性地改变研究结果.
- 倾向性得分匹配需要仔细考虑,因为它可能对结果产生影响.
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