通过应用诊断测试评估方法,在随机并发受控试验中可视化和诊断溢出影响
James C Hurley1,2,3
1Melbourne Medical School, University of Melbourne, Ballarat, Australia. jamesh@gh.org.au.
BMC medical research methodology
|August 16, 2024
概括
随机试验中的溢出效应可以使结果无效. 基于手臂的数据分析的新方法揭示了预防肺炎的抗微生物干预措施的有害溢出效应,与标准基于对比度的分析相反.
科学领域:
- 流行病学 流行病学
- 生物统计学 生物统计学
- 预防传染病 预防传染病
背景情况:
- 稳定单元治疗变量假设 (SUTVA) 对于随机对照试验中的因果推断至关重要,但溢出效应可能会违反它.
- 溢出,特别是在感染预防方面,可以影响群体免疫力,并且通常嵌入整体影响大小估计中.
- 群体效应表现为对照组内感染发病率扩散的增加.
研究的目的:
- 探索在随机对照试验中可视化和诊断溢出效应的方法.
- 调查抗微生物与非抗微生物干预措施的溢出效应,以预防ICU患者肺炎.
主要方法:
- 利用了来自190个随机并发受控试验 (RCCT) 的数据,跨越13个Cochrane评论.
- 采用基于手臂的分析技术,包括对比发病率,对照组和干预组之间的分散性进行比较,并使用汇总接收器操作员特征图 (SROC).
- 这些方法用于诊断感染预防RCCT中的溢出.
主要成果:
- 基于手臂的技术发现了扩散的增加,表明溢出,而基于对比度的技术没有显示.
- 对ICU患者的肺炎预防干预措施的分析显示,对并发对照组患者的有害溢出效应.
- 该研究发现,对照组感染发病率的分散率增加.
结论:
- 基于手臂和基于对比的技术从抗菌干预的聚合RCCT中得出矛盾的推断.
- 当使用基于手臂的方法时,基础对照组风险和影响大小之间的关系是反转的.
- 有害的溢出效应需要在某些RCCT环境中重新评估标准分析方法.
关键词:
基于武器的武器.卡特彼勒的地块是什么意思基于对比的对比基于对比.诊断测试评价诊断测试的评估.异质性 异质性 异质性预防感染 预防感染重症监护室的重症监护室是重症监护室的重症监护室.随机同步对照试验随机同步对照试验在SROC中,图片是SROC图片.溢出影响 溢出影响更多相关视频
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