仪器变量方法使实用癌症查试验中的意图与查效应相协调
Joshua D Angrist1, Peter Hull2
1Department of Economics and National Bureau of Economic Research, Massachusetts Institute of Technology, Cambridge, MA 02142.
概括
仪器变量 (IV) 方法始终估计癌症查效果,克服了差异依从的实用试验中的挑战. 这种方法揭示了查的真正影响,无论患者是否遵守.
科学领域:
- 临床试验 临床试验
- 流行病学 流行病学
- 生物统计学 生物统计学
背景情况:
- 实用癌症查试验反映了现实世界的临床决策.
- 意图选 (ITS) 分析受到差异依从性的限制,阻碍了试验间的对比.
研究的目的:
- 评估仪器变量 (IV) 方法,以解决癌症查试验中的不遵守问题.
- 为了比较IV估计与ITS估计在多个站点和试验.
主要方法:
- 使用仪器变量 (IV) 方法,对来自五项结直肠癌查随机试验的17个地点的数据进行分析.
- 采用图形分析和统计测试来评估依守对ITS估计的影响.
主要成果:
- 仪器变量 (IV) 提供了对不同试验场所的每个方案查效应的一致估计.
- 不同的坚持显著影响了意向选 (ITS) 估计,解释了观察到的变化.
- 查填写者与整个试验人群的人口结构相似.
结论:
- 仪表变量 (IV) 方法提供了一个可靠的解决方案,用于估计癌症查有效性,如果存在不遵守.
- IV估计表明临床相关性和一致性,支持它们在实用性试验分析中的使用.
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