评估医生的处方偏好作为一个工具变量在中等和小样本大小的比较有效性研究中的表现:一个模拟研究
Lisong Zhang1, Jim Lewsey2, David A McAllister2
1Department of Population Health Sciences, University of Leicester, Leicester, LE1 7RH, UK.
Journal of comparative effectiveness research
|April 3, 2024
概括
医生 医生 医生
科学领域:
- 流行病学 流行病学
- 生物统计学 生物统计学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 比较有效性研究 (CER) 经常面临混的挑战.
- 仪表变量 (IV) 方法为未测量的混提供了潜在的解决方案.
- 医生的处方偏好 (PPP) 被探索为一个潜在的仪器变量.
研究的目的:
- 评估医生的处方偏好 (PPP) 作为一个仪器变量 (IV) 的有效性.
- 评估PPP在模拟研究中适度和小样本大小的实用性.
- 为了比较IV和非IV方法来估计治疗的有效性.
主要方法:
- 一个模拟研究,模仿比较有效性研究场景.
- 两阶段最小平方 (2SLS) 的IV分析和普通最小平方 (OLS) 的非IV分析的比较.
- 评估PPP作为工具变量的不同代理.
主要成果:
- 使用PPP作为IV的2SLS方法表明约有20%的偏差.
- 没有静脉调整的OLS方法显示偏差明显更高,接近60%.
- 样本大小没有影响PPP IV方法的偏差水平.
结论:
- 与OLS相比,PPP IV方法提供了较少偏差的治疗有效性估计,无论样本大小如何.
- 对于较小的样本大小,建议从广泛的处方史中构建PPP.
- 这增强了统计能力,并提高了治疗效果估计的可靠性.
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