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JAMA推荐：临床研究如何减少偏倚——倾向评分法

2017-04-16 张艳娜/张岩波 BioMed数据坊

倾向评分法偏倚
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近期，发表于JAMA上的两项研究，都是通过对观察性资料进行分析，评价治疗措施对患者结局的影响。在Rozé等[1]的研究中，通过对847名接受过动脉导管未闭筛查和666例未接受过动脉导管未闭筛查的婴儿死亡率进行比较（一个比较庞大的观察性数据集进行分析），估计接受过早期超声心动图检查动脉导管未闭和早产儿死亡率之间的关系。但两组婴儿在某些特征上是不相似的，接受过筛查的婴儿较未接受过筛查的婴儿年龄较小

近期，发表于JAMA上的两项研究，都是通过对观察性资料进行分析，评价治疗措施对患者结局的影响。在Rozé等[1]的研究中，通过对847名接受过动脉导管未闭筛查和666例未接受过动脉导管未闭筛查的婴儿死亡率进行比较（一个比较庞大的观察性数据集进行分析），估计接受过早期超声心动图检查动脉导管未闭和早产儿死亡率之间的关系。但两组婴儿在某些特征上是不相似的，接受过筛查的婴儿较未接受过筛查的婴儿年龄较小，女孩偏多，并且几乎都没有接受过皮质类固醇。为调整这些差异，作者使用倾向评分匹配法从原始队列中创建了605对匹配的婴儿对。在Huybrechts等[2]的研究中，通过分析Medicaid Analytic extract的数据集，估计妊娠期孕妇抗抑郁药的使用与新生儿持续性肺动脉高压之间的关系。该项研究总共包含了3 789 330名妇女，其中128 950人使用过抗抑郁药。但使用抗抑郁药的妇女与不使用抗抑郁药的妇女在年龄，种族/民族，慢性疾病，肥胖，吸烟和保健方面都存在差异，作者也使用倾向评分分层方法对这部分差异进行了调整。 为什么使用倾向评分法？治疗方法的选择往往会受众多需要考虑的因素影

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  1. 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    2017-05-07 jin321

    学习

    0

  2. 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    2017-04-23 ffaadd

    不错，值得学习。。。

    0

  3. 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    2017-04-18 hanchunhee

    最近正在用倾向评分法分析数据。这篇文章很有用。

    0

  4. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/16/16d7c85592250ddc55f326a48ffe2353.jpg, createdBy=26ab2050208, createdName=1591eba326m, createdTime=Sun Apr 16 22:10:43 CST 2017, time=2017-04-16, status=1, ipAttribution=)]
    2017-04-17 cqykthl

    临床研究型，统计学知识

    0

  5. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/16/16d7c85592250ddc55f326a48ffe2353.jpg, createdBy=26ab2050208, createdName=1591eba326m, createdTime=Sun Apr 16 22:10:43 CST 2017, time=2017-04-16, status=1, ipAttribution=)]
    2017-04-17 医艺依意

    太强大了，赞赞赞赞赞赞赞赞赞赞赞赞，赞不绝口

    0

  6. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/16/16d7c85592250ddc55f326a48ffe2353.jpg, createdBy=26ab2050208, createdName=1591eba326m, createdTime=Sun Apr 16 22:10:43 CST 2017, time=2017-04-16, status=1, ipAttribution=)]
    2017-04-17 tofsw

    学习了谢谢分享

    0

  7. 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createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K6hq2LmWPOViahibFAUK6qIgYDYRCuDHfj1nJkb5WHIZEj8BwULbciboiblfEG1rA78tX3E0Hp7iaCAg3/0, createdBy=f37b2049644, createdName=virya, createdTime=Mon Apr 17 04:59:55 CST 2017, time=2017-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188036, encodeId=4226188036a9, content=学习了，不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/icyLhIGqru6gIknBJqfuPhQkEvDREF6S2vZq3ZIpUYjdqicKVoAWaJSGoe8xNvS6o6QpmOlh2AQ7xuUpj8NiaDjJJgjbc7Xj3T6/0, createdBy=1c242047915, createdName=daiyaozu, createdTime=Sun Apr 16 23:54:00 CST 2017, time=2017-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188020, encodeId=8bc618802067, content=真不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/16/16d7c85592250ddc55f326a48ffe2353.jpg, createdBy=26ab2050208, createdName=1591eba326m, createdTime=Sun Apr 16 22:10:43 CST 2017, time=2017-04-16, status=1, ipAttribution=)]
    2017-04-17 刘煜

    学习了谢谢分享

    0

  8. 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createdBy=74221626377, createdName=tofsw, createdTime=Mon Apr 17 07:41:47 CST 2017, time=2017-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188072, encodeId=c14e1880e2a7, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Mon Apr 17 06:11:11 CST 2017, time=2017-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188061, encodeId=ac3a188061cf, content=如何更接近真理真相，是努力的方向, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K6hq2LmWPOViahibFAUK6qIgYDYRCuDHfj1nJkb5WHIZEj8BwULbciboiblfEG1rA78tX3E0Hp7iaCAg3/0, createdBy=f37b2049644, createdName=virya, createdTime=Mon Apr 17 04:59:55 CST 2017, time=2017-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188036, encodeId=4226188036a9, content=学习了，不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/icyLhIGqru6gIknBJqfuPhQkEvDREF6S2vZq3ZIpUYjdqicKVoAWaJSGoe8xNvS6o6QpmOlh2AQ7xuUpj8NiaDjJJgjbc7Xj3T6/0, createdBy=1c242047915, createdName=daiyaozu, createdTime=Sun Apr 16 23:54:00 CST 2017, time=2017-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188020, encodeId=8bc618802067, content=真不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/16/16d7c85592250ddc55f326a48ffe2353.jpg, createdBy=26ab2050208, createdName=1591eba326m, createdTime=Sun Apr 16 22:10:43 CST 2017, time=2017-04-16, status=1, ipAttribution=)]
    2017-04-17 virya

    如何更接近真理真相，是努力的方向

    0

  9. 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createdBy=74221626377, createdName=tofsw, createdTime=Mon Apr 17 07:41:47 CST 2017, time=2017-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188072, encodeId=c14e1880e2a7, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Mon Apr 17 06:11:11 CST 2017, time=2017-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188061, encodeId=ac3a188061cf, content=如何更接近真理真相，是努力的方向, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K6hq2LmWPOViahibFAUK6qIgYDYRCuDHfj1nJkb5WHIZEj8BwULbciboiblfEG1rA78tX3E0Hp7iaCAg3/0, createdBy=f37b2049644, createdName=virya, createdTime=Mon Apr 17 04:59:55 CST 2017, time=2017-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188036, encodeId=4226188036a9, content=学习了，不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/icyLhIGqru6gIknBJqfuPhQkEvDREF6S2vZq3ZIpUYjdqicKVoAWaJSGoe8xNvS6o6QpmOlh2AQ7xuUpj8NiaDjJJgjbc7Xj3T6/0, createdBy=1c242047915, createdName=daiyaozu, createdTime=Sun Apr 16 23:54:00 CST 2017, time=2017-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188020, encodeId=8bc618802067, content=真不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/16/16d7c85592250ddc55f326a48ffe2353.jpg, createdBy=26ab2050208, createdName=1591eba326m, createdTime=Sun Apr 16 22:10:43 CST 2017, time=2017-04-16, status=1, ipAttribution=)]
    2017-04-16 daiyaozu

    学习了，不错

    0

  10. 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createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K6hq2LmWPOViahibFAUK6qIgYDYRCuDHfj1nJkb5WHIZEj8BwULbciboiblfEG1rA78tX3E0Hp7iaCAg3/0, createdBy=f37b2049644, createdName=virya, createdTime=Mon Apr 17 04:59:55 CST 2017, time=2017-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188036, encodeId=4226188036a9, content=学习了，不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/icyLhIGqru6gIknBJqfuPhQkEvDREF6S2vZq3ZIpUYjdqicKVoAWaJSGoe8xNvS6o6QpmOlh2AQ7xuUpj8NiaDjJJgjbc7Xj3T6/0, createdBy=1c242047915, createdName=daiyaozu, createdTime=Sun Apr 16 23:54:00 CST 2017, time=2017-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188020, encodeId=8bc618802067, content=真不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/16/16d7c85592250ddc55f326a48ffe2353.jpg, createdBy=26ab2050208, createdName=1591eba326m, createdTime=Sun Apr 16 22:10:43 CST 2017, time=2017-04-16, status=1, ipAttribution=)]
    2017-04-16 1591eba326m

    真不错

    0

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