量化永生时间偏差的影响:经验证据
Min Seo Kim1,2,3, Dong Keon Yon4, Seung Won Lee5
1Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul 06351, Republic of Korea.
Journal of the Royal Society of Medicine
|August 22, 2025
概括
不朽时间偏差 (ITB) 在医学研究中很常见,可能会将治疗效果夸大近29%. 识别和排除ITB提高了证据的可靠性,并减少了统计异质性.
科学领域:
- 流行病学
- 生物统计学
- 医学研究方法
背景情况:
- 不朽时间偏差 (ITB) 是生存分析中的系统性错误,在暴露开始之前发生后续时间,导致人工有利的结果.
- 当参与者无法体验结果的时期被错误地包含在治疗组的随访中时,这种偏差可能会发生.
研究的目的:
- 系统地识别科学文献中受不朽时间偏差影响的研究.
- 评估不朽时间偏差对生存分析研究中的效果大小,统计意义和异质性的影响.
主要方法:
- 进行了一项超流行病学研究,搜索了PubMed,Embase和Cochrane图书馆的量化综合的系统审查.
- 对符合条件的系统审查进行了ITB存在的分析,并提取了影响大小和异质性的数据.
- 使用通用逆方差方法进行了再分析和小组分析,以比较ITB和无ITB的研究.
主要成果:
- 在25个主题和182个研究中,44. 0%的人受到ITB的影响.
- 与没有ITB的研究相比,使用ITB的研究显示效果大小平均增加了29% (ES比率:0. 71).
- 除了ITB研究,研究间的异质性 (I2) 降低了21. 4%,并且在23. 8%的主题中改变了统计意义.
结论:
- 不朽时间偏差在某些医学研究领域普遍存在,并且可以显著膨胀效应大小,导致夸大和误导性证据.
- 这些发现强调了在生存分析中仔细评估和处理ITB的重要性,以确保研究结论的有效性.
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