在当代比较有效性研究中区分临床和统计意义
Ajami Gikandi1, Julie Hallet2, Bas Groot Koerkamp3
1Harvard Medical School, Boston, MA.
Annals of surgery
|February 23, 2024
概括
大多数比较疗效研究 (CER) 研究没有报告临床意义. 这种监督可能会导致仅基于统计学意义的不适当的医疗保健建议.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床流行病学 临床流行病学
背景情况:
- 对比疗效研究 (CER) 在现实环境中评估治疗方法.
- 统计学意义并不总是等同于临床意义,可能导致错误的临床决策和增加医疗保健成本.
研究的目的:
- 评估在当前的CER中报告临床意义的频率.
- 确定如何在CER出版物中定义和使用临床意义.
主要方法:
- 系统审查2022年发表在五个主要的外科和医学期刊上的CER研究.
- 两个独立的研究人员评估了"方法"部分,以明确定义临床显著差异.
主要成果:
- 在307项审查的研究中,只有8.5%的研究发现了临床上显著的差异.
- 在推临床改变的研究中,大多数 (71.4%) 缺乏明确的临床意义.
- 临床意义,当定义时,主要使用的验证标准.
结论:
- 当代的CER经常忽略了临床意义的报告.
- 临床决策的建议往往仅基于统计学意义,突出显示了报告实践中的差距.
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