模拟随机对照试验——一种新的用于疗效比较研究的统计分析方法

2014-08-18 陈少科 赵倩 等 中国循证儿科杂志

本研究旨在通过探索处理混杂因素的手段,创造一种新的用于观察性数据疗效比较研究的统计分析方法.方法 本方法基于以下原理:针对诊断为同种疾病接受不同治疗的一组患者,采用反复多次模拟随机化分组并根据RCT的统计分析策略进行疗效比较,以拒绝H0的试验 频率和不拒绝H0的试验频率之比(odds值)及其95%CI作为判断不同治疗方法间疗效差异的依据.采用计算机模拟的方法获得统计量odds值的分布. 对包

本研究旨在通过探索处理混杂因素的手段,创造一种新的用于观察性数据疗效比较研究的统计分析方法.方法 本方法基于以下原理:针对诊断为同种疾病接受不同治疗的一组患者,采用反复多次模拟随机化分组并根据RCT的统计分析策略进行疗效比较,以拒绝H0的试验 频率和不拒绝H0的试验频率之比(odds值)及其95%CI作为判断不同治疗方法间疗效差异的依据.采用计算机模拟的方法获得统计量odds值的分布. 对包含结局变量和混杂因素变量的模拟数据库进行随机化分组,对根据符合方案集分析(PP)策略保留下来的样本进行结局变量比较.重复100次随机化分组, 并对每次随机化分组后结局变量进行比较,同时也对混杂因素变量的组间均衡性进行分析.计算100次结局变量比较分析结果中拒绝H0与不拒绝H0的比值,即 odds值,重复100次odds值的计算过程得到odds值的点估计值及其95%CI.根据样本量(n1=n2 =50,100,500和1 000)、组间差异的把握度和效应量产生多个模拟数据库,观察分析得到的odds值及其95%CI的一致性和稳定性.同时验证混杂因素在根据PP策略保留 下来的样本的组间均衡性.结果 ①对不同样本量下疗效有差异数据库分析得到的odds值均>1,odds值及其95% CI均随把握度的增加呈上升趋势;②对不同样本量下疗效无差异数据库分析得到的odds值均<1,odds值及其95%CI均随把握度的增加呈下降趋势, 二者变化均呈现良好的线性关系;③同时验证样本量相等和不相等的情况下,混杂因素组间均衡的概率均>95%.结论 将本文发明的方法命名为模拟随机对照试验方法,简称sRCT.运用sRCT对模拟数据库分析得到结果的一致性和稳定性高,实现了在均衡混杂因素的基础上, 创建了一种用于观察性数据疗效比较研究的新方法.



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    2015-02-23 amyloid
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    2014-08-24 rosa00tong

    统计学,为什么越来越不懂你

    0

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