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Updated: May 24, 2025

An R-Based Landscape Validation of a Competing Risk Model
Published on: September 16, 2022
当目标值为零,点估值接近零时,评级确定性
Linan Zeng1,2,3,4, Monica Hultcrantz5,6, David Tovey7
1Pharmacy Department/Evidence-based Pharmacy Centre/Children's Medicine Key Laboratory of Sichuan Province, West China Second University Hospital, Sichuan University; Sichuan University and Key Laboratory of Birth Defects and Related Disease of Women and Children, Ministry of Education, West China Second University Hospital, Chengdu, People's Republic of China.
这项研究修订了当结果接近零时证据的确定性如何被评价. 它建议专注于一系列最小重要的差异,以避免误导性精度评估.
科学领域:
- 医学研究方法论医学研究方法论.
- 基于证据的医学是基于证据的医学.
背景情况:
- 当前评估证据确定性的方法面临挑战,当点估计接近零效应时.
- 接近于零的狭窄置信区间 (CI) 可以导致不准确的不适当的降级.
研究的目的:
- 为了应对评级证据确定性的挑战,当点估计接近于零效应时.
- 提出对证据的评级确定性的修订方法.
主要方法:
- 将确定性评级的目标从非零效应修改为"影响很小或没有影响"范围.
- 估计利害最小重要差异 (MID) 的范围.
- 根据点估计和CI是否属于"影响很小或没有影响"范围,调整确定性评级.
主要成果:
- 建议的方法只允许在CI包含重要影响时,根据不准确性进行适当的下调评级.
- 对证据确定性的信心可以在点估计表明效应低于最小可信的MID时进行修订.
- 这种方法可以防止因不准确性而降级,当一个狭窄的CI跨过零时.
结论:
- 修订后的方法提供了更准确的证据确定性评估,特别是当影响很小时.
- 这种方法增强了推,评估,开发和评估 (GRADE) 系统的有用性.
- 通过考虑最小重要的差异,为确定性评级进行最佳目标选择是容易的.
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