避免死亡:一种不偏见的替代方法,用于测量癌症查计划的绩效
1Direction de santé publique, Gaspé, Quebec, Canada.
Journal of medical screening
|November 22, 2023
概括
一种分析癌症查试验的新方法,计算每次避免死亡的查,提供了查有效性的未经稀释的衡量标准. 这种方法避免了晚发现癌症的偏见,为计划规划提供了更清晰的画面.
科学领域:
- 在瘤学瘤学.
- 生物统计学 生物统计学
- 公共卫生 公共卫生
背景情况:
- 传统的癌症查试验分析通常使用癌症死亡率的比率,这可以被晚发现的癌症稀释.
- 这种稀释是因为随访期超出了积极查的范围,包括只有在查后才能检测到的癌症.
研究的目的:
- 引入和验证一种用于评估癌症查试验的新型指标:每避免死亡 (DA) 的查.
- 为了证明这个指标如何避免传统基于比率的分析所固有的偏差.
主要方法:
- 审查了癌症查试验的传统分析,鉴定了由于延长后续的比例估计中的偏差.
- 建议计算查和对照组之间癌症死亡的差异,通过查邀请进行正常化,以避免偏见.
- 重新分析了肺癌 (LC) 断层扫描查试验的数据,使用每个DA指标的拟议查.
主要成果:
- 分析了9项肺癌查试验 (2000 - 2013) 涉及94441名高风险患者.
- 较旧的试验 (CT vs. X-ray) 显示,每次避免死亡 (DA) 的邀请数为1068次.
- 最近的试验 (查与不查) 显示每DA有577份邀请,这表明效率有所提高.
结论:
- 查每次避免死亡 (DA) 提供了一个未经稀释和强大的查有效性的衡量标准.
- 该指标独立于随意的后续持续时间,因此对于计划规划和知情同意讨论非常有价值.
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