评估基于风险预测的使用差异差异的干预措施的临床实施情况
Maricela Cruz1,2, Susan M Shortreed1,2, Gregory E Simon1
1Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA.
Health services research
|July 21, 2025
概括
传统的差异差异 (DID) 模型适合在绝对差异尺度上评估风险分层干预. 风险评分调整模型适用于所有对待的 (ATT) 估计值的平均治疗效应.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 生物统计学 生物统计学
- 流行病学 流行病学
背景情况:
- 评估风险分层干预措施需要强大的统计方法.
- 差异差异 (DID) 是一种常见的准实验方法.
- 针对特定风险群体的干预措施的评估对标准的DID模型提出了独特的挑战.
研究的目的:
- 为了比较替代差异差异 (DID) 方法的性能.
- 评估风险分层干预对二元结果的有效性.
- 确定最适合用于分析针对风险人群的干预措施的DID模型.
主要方法:
- 进行了模拟,以比较三个DID模型:传统的,风险得分调整和风险得分调整与相互作用.
- 循环预测估计器用于对待 (ATT) 估计值的共同平均治疗效果.
- 将DID估计与来自凯泽永久华盛顿 (KPWA) 的现实干预的随机评估数据进行了比较.
主要成果:
- 传统的DID和风险评分调整模型在模拟中显示出更低的偏差,更小的标准错误和更好的覆盖概率.
- 传统的DID模型和风险评分调整模型 (与各种链接) 提供了最接近ATT在绝对差异尺度上的随机评估结果的估计.
- 风险评分调整模型与日志或logit链接适用于所有考虑的ATT估计值.
结论:
- 传统的DID模型适合在风险分层干预的绝对差异尺度上估计对待的平均治疗效应 (ATT).
- 风险评分调整模型,特别是具有日志或logit链接,在评估此类干预时适用于所有ATT估计值.
- 这些发现为为复杂干预评估选择合适的DID方法提供了指导.
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