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药监中的比较:一个准量化偏差分析
Christopher A Gravel1,2,3,4, William Bai1, Antonios Douros5,6,7
1School of Epidemiology and Public Health, University of Ottawa, Ottawa, OΝ, Canada.
选择正确的比较器对于减少药物监督不成比例性分析中的偏差至关重要. 该研究发现,虽然日历时间限制会影响结果,但没有任何一个比较器能够持续减少药物事件组合的偏差.
科学领域:
- 药监和药物安全 药监和药物安全
- 生物统计学和流行病学方法
- 监管科学 监管科学
背景情况:
- 不成比例性分析是药物监测的关键,用于检测不良药物事件.
- 对比组的选择显著影响了这些分析的可靠性.
- 为了减少偏差,最佳的比较器选择仍然是一个开放的问题.
研究的目的:
- 评估不同的比较器策略如何影响不成比例性分析中的偏见.
- 评估受限制与不受限制的比较对信号检测的影响.
- 调查基于时间的限制对偏差方向性的影响.
主要方法:
- 使用美国食品和药物管理局的不良事件报告系统 (FAERS).
- 检查了两种药物事件组合:里瓦罗克萨班/肝毒性和卡纳格利弗洛辛/急性损伤.
- 在定义的时间段中使用无限制和受限制的比较器对比三个不成比例估计 (ROR,PRR,IC).
主要成果:
- 对于任何药物事件对,在所有比较者中都没有观察到一致的偏差方向性.
- 基于时间的限制,特别是围绕外部事件,显著改变了结果.
- 受到限制的对比器显示出不同的性能,有时会恶化,有时会改善信号检测.
结论:
- 没有一个单一的比较器能够在不成比例性分析中持续减少偏差.
- 外部事件和相关的时间限制对分析结果产生重大影响.
- 需要进一步的研究,以建立强大的药物监测对比方法.
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