围产科研中的选择偏差:反向概率权重,仪器变量和兄弟对比设计的比较
Basma N Dib1, Ellen C Caniglia2, Sean Brummel3
1Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Paediatric and perinatal epidemiology
|April 25, 2025
概括
围产期研究中的选择偏差可能会扭曲治疗效果估计. 虽然反向概率权重 (IPW),仪器变量 (IV) 和兄弟对比设计显示出类似的偏差,但IV分析更受强烈的治疗-审查关联的影响.
科学领域:
- 流行病学 流行病学
- 生物统计学 生物统计学
- 产周研究 产周研究
背景情况:
- 长度围产期研究面临的选择偏差来自诸如活产限制或不完整的随访等因素.
- 这种偏见往往与治疗和结果相关,可能会扭曲因果关系的估计.
- 不同因果推理方法之间的比较偏差大小仍然不清楚.
研究的目的:
- 在三种常见的分析方法中评估和比较由于审查导致的偏见方向和大小.
- 评估的方法包括反向概率权重 (IPW),仪器变量 (IV) 和兄弟对比设计.
- 该研究模拟了数据,以了解各种审查场景下的偏见.
主要方法:
- 对于没有真实因果效应的场景和两个审查机制 (追踪损失,竞争事件) 的数据模拟.
- 场景对审查概率及其与治疗/结果的关联强度有所不同.
- 每个场景生成500个数据集 (N=10,000),以计算风险差异估计中的平均偏差.
主要成果:
- 审查比例没有影响平均偏差;与治疗/结果相关性增加扩大偏差.
- 偏差通常在IPW,IV和兄弟对比设计中类似地远离零.
- 与IPW和兄弟对比相比,IV分析显示偏差明显高 (高达2个百分点),与强烈的治疗-审查关联相比,IPW和兄弟对比.
结论:
- 这三种方法都表现出类似的偏差方向和大小,通常远离零.
- 在围产期研究中,从不同的方法进行三角估计是具有挑战性的,因为选择过程.
- 在存在选择偏差的情况下,依赖多种分析方法可能会导致无效的解释.
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