对观察性研究的系统审查经常基于对偏见结果的元分析得出结论:标准必须得到改进
Mical Paul1, Judith Olchowski2, Leonard Leibovici3
1Infectious Diseases Division, Rambam Health Care Campus, Haifa, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
对观察性研究的系统性审查通常使用未经调整的数据,忽略了关键偏见. 这种做法导致误导性结论,需要改进分析和报告观察研究结果的标准.
科学领域:
- 医学研究方法学 医学研究方法学
- 证据综合 证据综合
- 观察研究分析 观察研究分析
背景情况:
- 对观察性研究的系统审查很普遍,但缺乏标准化的方法.
- 现有的审查经常依赖于原始,未经调整的数据,可能导致偏见的结论.
研究的目的:
- 评估包含观察性研究的系统性审查的方法和报告.
- 为进行和报告此类审查提出最低标准.
主要方法:
- 在2024年在顶级医学期刊上发表的观察性研究的系统审查.
- 提取了关于审查方法的数据,重点是使用调整和未调整的估计.
- 分析了研究设计的呈现方式和在审查中进行的统计调整.
主要成果:
- 80.9%的纳入评论 (51/63) 使用观察性研究的未经调整的结果进行元分析.
- 只有34.9% (22/63) 解决了调整后的关联估计.
- 大约三分之一的评论未能在摘要或方法中提出包含的研究设计.
- 评论往往得出了强有力的结论,而这些结论并没有得到观察数据的细微差别的支持.
结论:
- 在观察性研究的系统审查中,通常使用原始数据忽略了显著的偏差 (例如,根据指示的偏差,不朽的时间偏差).
- 当前的做法可能会产生误导性的结果,夸大治疗效果.
- 加强标准对于准确的综合和报告观测研究至关重要.
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