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临床证据评估的诱导推理的极限:一项模拟研究
Steffen Mickenautsch1,2, Veerasamy Yengopal1
1Faculty of Dentistry, University of the Western Cape, Cape Town, ZAF.
Cureus
|February 7, 2025
概括
一项研究发现,被评为低偏差风险的证据不太可能没有错误. 这表明,质量评估标准可能不能完全保证临床证据的准确性.
科学领域:
- 生物统计学 生物统计学
- 临床流行病学 临床流行病学
- 研究方法研究方法研究方法学
背景情况:
- 评估临床证据的质量对于可靠的治疗效果估计至关重要.
- 当前的评估标准可能不足以确保"低偏差风险"研究真正没有错误.
研究的目的:
- 为了确定一个由有限的标准来判断为"低偏差风险"/"高质量"的证据的概率,实际上没有错误.
- 量化模拟评估工具正确识别无错误证据的可能性.
主要方法:
- 45个模拟试验在65个领域中产生了0-5个错误.
- 用一个具有五个错误域的模拟评估工具来评估试验.
- 负概率比率 (-LR) 被计算并汇集在25个运行中,以评估无错证据的概率.
主要成果:
- 聚合的负概率比率 (-LR) 为0.84 (95% CI:0.80 - 0.88).
- 这表明没有错误的证据被评为"低偏差风险"/"高质量"的可能性仅为错误证据的1.2倍.
- 低LR表明当前评估方法的能力有限,以确认没有错误.
结论:
- 被评为"低偏差风险"/"高质量"的证据库真正无错误的概率很小.
- 从有限的评估标准中概括发现并不能保证对临床证据准确性的高度信心.
- 目前的研究质量评估方法可能需要改进,以更好地检测和考虑临床研究中的潜在错误.
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