在估计对外部目标群体的影响时选择变量
Michael Webster-Clark1,2, Rachael K Ross2,3, Alexander P Keil4
1Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montreal, QC H3A 1G1, Canada.
American journal of epidemiology
|April 17, 2024
概括
在流行病学研究中包括非效果测量修饰剂 (非EMM) 可以降低估计精度. 然而,与选择相关的非EMM并不会因为省略必要效果测量调整器 (EMM) 而加剧偏差.
科学领域:
- 流行病学 流行病学
- 生物统计学 生物统计学
背景情况:
- 外部有效性对于将研究结果推广到目标人群至关重要.
- 在新种群中估计影响需要仔细考虑效果测量修饰剂 (EMM).
- 将非EMM纳入调整集对这些估计的影响尚不清楚.
研究的目的:
- 评估包括非EMM如何影响运输风险差异 (RDs) 的估计.
- 评估不同种群之间的共同变量的影响,与结果相关,或对估计精度和偏差修改 RDs.
主要方法:
- 使用模拟来建模包含具有不同特征的非EMM的模型.
- 基于试验和目标人群之间的差异,结果关联和RD修改,分析了共变量.
- 估计方法包括结果建模和逆赔率加权.
主要成果:
- 包括在人群之间分布差异的非EMM在内,降低了估计精度,无论结果关联如何.
- 与选择相关的非EMM并没有加剧因省略必要的EMM而引起的偏差.
- 调整所有与结果相关的变量可能会导致对外部人群的治疗效果估计不准确.
结论:
- 对于有效的外部有效性估计,需要仔细选择调整变量.
- 使用非EMM过度调整可能会损害传输效应估计的精度.
- 了解共变量作用是平衡流行病学研究有效性和精度的关键.
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