评估在没有活跃的比较器的情况下计算人时的潜在方法
Katherine Giorgio1, Pamela L Lutsey1, Wendy Wang1
1University of Minnesota School of Public Health.
American journal of epidemiology
|December 3, 2025
概括
在药理流行病学中,为未接受治疗的患者找到替代指数日期至关重要. 为了确定这些日期,拒绝采样方法在本研究中显示出潜在偏差最小.
科学领域:
- 药学流行病学 药学流行病学
- 医疗保健服务研究 医疗服务研究
- 生物统计学 生物统计学
背景情况:
- 在药理流行病学中模拟目标试验框架是很困难的,没有活跃的比较器.
- 确定不偏见的估计需要适当的方法来处理未经治疗的患者群体.
研究的目的:
- 评估六种选择替代指数日期的方法,用于未接受治疗的患者.
- 评估观察性研究中不同索引日期选择方法引入的潜在偏差.
主要方法:
- 一个数字实验,使用来自MarketScan数据库 (2013-2019) 的73,070名II型糖尿病患者进行了数值实验.
- 接受二线硫尿素治疗的患者被视为"未经治疗"的手臂.
- 测试了六种替代指数日期方法:拒绝抽样,中位数和预测模型.
主要成果:
- 拒绝采样方法产生了0.61和0.63的危险比率 (HRs),最接近0.69.63的参考HR.
- 中位数 (1.10,1.15),预测模型 (0.96) 和匹配算法 (1.07) 的方法显示出更高的潜在偏差.
- 只有排斥抽样方法在估计治疗效果时显示了低潜在偏差.
结论:
- 拒绝采样是选择替代指数日期在药理学流行病学中的一个有前途的方法,当没有活跃的比较器时.
- 对于缺乏活跃对比组的观察性研究,仔细考虑研究设计是必不可少的.
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