相对风险和几率比率的置信区间可以预测在元分析中不能满足最佳信息大小的情况
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Updated: Jun 4, 2025

An R-Based Landscape Validation of a Competing Risk Model
Published on: September 16, 2022
M Hassan Murad1, George A Tomlinson2, Romina Brignardello-Petersen3
1Evidence-based Practice Center, Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA.
信任区间比率在元分析中有效排除了最佳信息大小 (OIS),但不能证实它. 这有助于因不准确性而降低证据确定性,特别是当可信的效应大小超过30%的相对风险降低时.
科学领域:
- 生物统计学 生物统计学
- 证据综合 证据综合
- 临床试验方法论 临床试验方法论
背景情况:
- 最佳信息大小 (OIS) 对于确定元分析功率至关重要.
- 在证据分类中的不准确性判断通常依赖于与OIS相对的样本大小.
- 信心区间 (CI) 的宽度是OIS评估的潜在替代品.
研究的目的:
- 实证评估CI宽度的相对风险 (RR) 和赔率比 (OR) 是否可以取代OIS计算的不准确性判断.
- 评估CI比率的实用性,以确定OIS是否满足.
主要方法:
- 来自系统评价的科克兰数据库的元分析的一个方便样本的分析.
- 基于15%-50%的相对风险降低 (RRRs) 的OIS计算.
- 对RR (RR CI比率) 和OR (OR CI比率) 的上下95%CI边界的比率的评估.
- 对CI比率预测OIS状态的正预测值 (PPV) 和负预测值 (NPV) 的计算.
主要成果:
- 分析包括了39,569个元分析 (266,877项研究).
- 在各种RRR中观察到高的NPV和低的PPV,表明CI比率更好地排除OIS,而不是排除它.
- 之前提出的RR CI比率 (>2.5) 和OR CI比率 (>3) 的切割值显示了高的NPV (>90%),除了高的RRR (30%-50%) 或基线风险/研究数量的增加.
结论:
- 可以使用RR和OR的CI比率来"排除"OIS的满足,支持由于不精确的证据确定性的降级.
- 投资组合方法对于"裁决"OIS已经满足是不可靠的.
- 当可信效应大小大于30%的RRR时,CI方法的帮助较少.
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