偏见分析以调查差异参与的影响:应用于出生缺陷病例控制研究
Julie M Petersen1, Jacob C Kahrs2, Nedghie Adrien1,3
1Division for Surveillance, Research, and Promotion of Perinatal Health, Massachusetts Department of Public Health, Boston, Massachusetts, USA.
Paediatric and perinatal epidemiology
|December 16, 2023
概括
参与研究的差异可能解释了对叶酸,丹和母亲吸烟的意外发现,以预防出生缺陷. 需要进一步的研究来理解这些偏见.
科学领域:
- 生殖流行病学 生殖流行病学
- 出生缺陷病因学 产生的缺陷病因学
- 生物统计学 生物统计学
背景情况:
- 国家出生缺陷预防研究 (NBDPS) 确定了与先前研究不一致的关联.
- 具体发现包括叶酸和脊柱裂的无关联,使用丹塞增加了口腔裂的几率,减少了母亲吸烟的低血压几率.
研究的目的:
- 调查研究对象之间的差异性参与是否可以解释NBDPS中观察到的影响估计.
- 量化产生研究结果所需的选择偏差的程度.
主要方法:
- 进行了与参与相关因素的文献审查和定量偏差分析.
- 使用内部和外部数据估计了病例控制参与率和暴露率.
- 确定性偏差分析量化了必要的参与差异,以使观察到的结果与假设的真实关联相协调.
主要成果:
- 在NBDPS参与者中,叶酸使用过多,而丹塞使用和吸烟不足.
- 为了达到叶酸和脊柱裂的零发现,暴露病例需要比对照组参与率高≥1.2倍.
- 为了解释与零真实OR相关的奥丹塞特龙-裂 palatal 关联,暴露的病例需要1.6倍的参与.
- 为了解释保护性低血压症与吸烟的关联,暴露病例需要≥1.2倍低的参与率.
结论:
- 不同的参与是对某些NBDPS发现的合理解释,尽管不是唯一的解释.
- 建议进行进一步的研究,以探索其他潜在的系统性错误,例如暴露错误分类.
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