治疗层次的精度:从网络元分析中量化治疗层次的确定性的一种指标
Augustine Wigle1, Audrey Béliveau1, Georgia Salanti2
1Department of Statistics and Actuarial Science, University of Waterloo, Ontario, Canada.
网络元分析 (NMA) 处理层次缺乏确定性措施. 一个新的指标,治疗层次的精度 (POTH),量化了这种确定性,改善了临床医生对NMA的解释.
科学领域:
- 生物统计学 生物统计学
- 医疗保健服务研究 医疗服务研究
- 证据综合 证据综合
背景情况:
- 网络元分析 (NMA) 估计了多种干预措施的相对治疗效应.
- 治疗层次结构,通常是从积累性排名曲线 (SUCRA) 下的表面和P-score中得出的,是NMA的关键输出.
- 目前的排名指标缺乏一定程度的确定性,可能会误导临床决策.
研究的目的:
- 引入一种新型指标,即治疗层次的精度 (POTH),以量化NMA产生的治疗层次的确定性.
- 提供一个单一的,可解释的值,反映对估计治疗排名的信心.
主要方法:
- 通过整合Sucra值,平均等级和个别等级分布的差异来开发POTH.
- 适应的POTH用于评估特定治疗子集的确定性 (例如,排名最高的).
- 在一个NMA数据库中计算POTH,并在两个已公布的网络上演示其应用.
主要成果:
- POTH为从SUCRA或P-score获得的治疗层次结构提供了可量化的确定性.
- 该指标可用于评估网络内的任何治疗子集的确定性.
- 在众多NMA对POTH的实证分析证实了其实用性和可解释性.
结论:
- POTH解决了在NMA治疗层次结构中量化不确定性的关键需求.
- 这一指标提高了临床实践证据综合的可靠性和可解释性.
- POTH为研究人员和临床医生提供了一种有价值的工具,用于评估比较治疗有效性.
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