在集群随机对照试验中,缺失的数据是如何处理的? 在NIHR期刊图书馆发表的试验综述1997-2024年
Siqi Wu1, Richard M Jacques1, Stephen J Walters1
1School of Medicine and Population Health, University of Sheffield, Sheffield, UK.
Clinical trials (London, England)
|October 4, 2025
概括
许多集群随机对照试验没有正确处理缺失的数据,可能会导致结果偏见. 改进的报告和先进的方法,如多重归因,对于集群试验设计中的可靠证据至关重要.
科学领域:
- 临床试验 临床试验
- 公共卫生研究 公共卫生研究
- 生物统计学 生物统计学
背景情况:
- 集群随机对照试验 (CRCT) 对于评估干预措施至关重要.
- 在CRCT中缺少数据可能会损害研究的有效性和功率.
- 适当处理缺失的数据对于准确的试验结果至关重要.
研究的目的:
- 在公开资助的CRCT报告中审查和总结缺失的初级结果数据处理.
- 确定在CRCT中管理缺失数据的趋势和常见实践.
- 评估CRCT中缺少数据报告的透明度和方法严格性.
主要方法:
- 来自英国国家卫生和护理研究所研究期刊图书馆 (1997-2024) 的CRCT系统综述.
- 数据提取侧重于试验设计,缺失数据机制和归算方法.
- 对缺少数据处理的初级和敏感性分析的分析.
主要成果:
- 45%的CRCT报告说没有针对缺失数据采取任何行动.
- 75%的人在初级分析中没有归算缺失的值.
- 2017年后,多重归算的使用增加了,但报告透明度仍然是一个问题.
结论:
- 不一致的报告和简单的方法 (例如,完整的案例分析) 降低了CRCT的可信度.
- 建议严格遵守CONSORT指南和敏感性分析.
- 需要对先进的归算技术进行增强的培训,以产生可靠的证据.
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