医学调查数据中的面试者偏见:血压测量的例子
Pascal Geldsetzer1,2,3, Andrew Young Chang2,4,5, Erik Meijer6
1Division of Primary Care and Population Health, Department of Medicine, Stanford University, 3180 Porter Drive, Palo Alto, CA 94304, USA.
PNAS nexus
|March 25, 2024
概括
在全球健康调查中,访谈者对血压测量的影响在统计学上是显著的,但很小,对国家高血压患病率估计的影响很小. 然而,极端的采访者可能会导致局部测量的显著变化.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 生物统计学 生物统计学
背景情况:
- 卫生机构将调查数据用于全球健康指标,如高血压.
- 调查中的物理测量,特别是在低收入和中等收入国家,由于"采访者效应",可能会有测量错误.
- 在全球卫生背景下,对物理测量的面试者诱导的偏见未被充分研究.
研究的目的:
- 评估采访者效应对血压测量变异的贡献.
- 检查全球南方国家代表性健康调查中的面试者偏见.
- 量化访谈者对高血压患病率估计的影响.
主要方法:
- 分析了来自三个大型健康调查 (2008-2019) 的169,681个观察结果.
- 使用线性混合模型,采访者效应作为随机效应.
- 采用引导式方法来比较观察和调整的血压测量.
主要成果:
- 面试者效应在统计学上是显著的,但对整个队列的总血压变异贡献的比例很小 (<%).
- 在国家范围内,高血压患病率估计没有受到实质性的影响.
- 个人采访者表现出极端的偏见,高达12%的测量差异,影响了分区级估计.
结论:
- 采访者影响对全国高血压患病率的影响很小,但在地方层面可能很重要.
- 虽然通常很小,但极端的采访者偏见需要注意准确的分区健康指标估计.
- 调查结果凸显了全球健康调查中面试官管理的物理测量质量控制的需要.
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