多站点试验中的因果效应和不合规性的变化:二元结果的双变层次概括随机系数模型
Xinxin Sun1,2, Yongyun Shin1, Jennifer Elston Lafata3
1Virginia Commonwealth University, Richmond, Virginia, USA.
Statistics in medicine
|October 16, 2024
概括
这项研究评估了一个在线工具,以增加结直肠癌查 (CRCS). 这些发现提供了对病因影响和医生在患者查行为上的变异的见解.
科学领域:
- 生物统计学 生物统计学
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
背景情况:
- 结肠直肠癌查 (CRCS) 率可以通过有针对性的干预措施来提高.
- 在线工具在增加患者参与预防性健康措施方面表现有前途.
- 了解干预措施的因果关系及其在医疗保健提供者之间存在的差异至关重要.
研究的目的:
- 估计电子辅助工具对CRCS的平均因果效应,并对CRCS编译平均因果效应.
- 为了分析这些因果效应在170名医生中的变化.
- 开发一个统计方法来估计医生特定查的概率与部分观察到的合规性.
主要方法:
- 随机试验将电子辅助工具与CRCS的对照组进行比较.
- 最大概率估计,结合随机效应来建模医生特定的概率.
- 适应高斯-赫米特方程用于概率边缘化.
- 分享随机效应的因子分析结构,以减少维度.
主要成果:
- 该研究开发了一种新的统计方法,以估计在部分遵守和医生级别变化的情况下的因果关系.
- 该方法成功地解决了联合估计医生特定查概率的挑战.
- 模拟研究为准确和精确的估计提供了最佳样本大小的建议.
结论:
- 开发的统计框架为分析部分合规性和层次数据结构的干预提供了强大的方法.
- 这些发现有助于了解在线工具在促进结直肠癌查方面的有效性.
- 该研究提供了关于研究设计的指导,包括样本大小建议,用于类似的未来干预.
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