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对手术中个人内观测中使用的统计方法的批判性评估

Rawan ElAbd¹, Natasha Barone², Yasmina Richa³

¹Division of Plastic & Reconstructive Surgery, McGill University Health Centre, Montreal, QC, Canada.

Hand (New York, N.Y.)

|July 31, 2025

概括

许多手术研究在没有适当的统计方法的情况下多次使用单个患者的数据,可能会导致结果偏差. 很少有研究能够解释这些非独立的观察结果,这增加了偏见治疗效应发现的风险.

科学领域:

整形外科手术整形外科手术
生物统计学生物统计学
医学研究方法学医学研究方法学

背景情况:

手术研究经常利用单个患者内多个解剖部位 (手,手指,关节) 的数据.
这种做法,如果不从统计上解决,可以在治疗效果评估中引入偏见.

研究的目的:

批判性地评估手术文献中使用的统计方法,以处理个人内观测.
确定近期手术出版物中非独立观察的普遍性和适当的统计调整的使用.

主要方法:

研究人员对2020年至2022年间发表在五家知名期刊上的手术文章进行了系统审查.
包括至少有五名参与者接受手术干预的研究.
计算了具有非独立观察结果的患者比例和非独立观察结果的总比例. 评估了患者内部关系的统计调整方法.

主要成果:

在465项已识别的研究中,124项 (27%) 涉及单个个体的多个手,手指或关节.
只有14.5%的研究使用了对这些患者内部关系的方法调整.
缺乏适当统计调整的高百分比 (88.7%) 的研究报告了重大发现,表明存在潜在的偏差.

结论:

很大一部分手术研究涉及个体患者的非独立观察.
设计用于解释这些依赖观测的统计方法的利用不足显著.
在没有适当调整的研究中,显著发现的高率表明,手术文献中报告的治疗效果存在相当大的偏差风险.

关键词:

这就是DASH的意义.在K线电线上.手术手术手术手术手术手术手术手术手术共同的共同的共同的共同的在法兰克斯 (phalanx) 中.统计统计统计统计统计大指指的使用方法

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