The impact of early transfer bias in a growth study among neonatal intensive care units.
The impact of early transfer bias in a growth study among neonatal intensive care units.
复制标题
新生儿重症监护病房生长研究中早期转移偏差的影响。
DOI：
10.1016/s0895-4356(03)00168-9
复制
发表时间：
2003
影响因子：
7.2
通讯作者：
Dwyer,JohannaT
中科院分区：
文献类型：
--
作者：
Olsen,IreneE;Richardson,DouglasK;Schmid,ChristopherH;Ausman,LynneM;Dwyer,JohannaT
背景和结论：婴儿在医院或出院回家之间的转移可能会使新生儿重症监护病房（NICU）之间的表现比较产生偏差。本研究试图显示在一个大型队列研究的背景下转移偏倚的潜在大小，并描述了减少这种类型的偏倚的策略。我们限制出生时妊娠<30周的婴儿的资格，并以匹配的替代品代替早期转移限制策略是成功的，将总体早期转移率从16.4%降至3.6%，将单个新生儿重症监护病房的转移率从0.6-32.7%降至0- 11.0%。替换匹配的替代品有一个小得多的影响，因为早期转移的数量少，我们无法匹配的所有因素区分早期transfers.CONCLUSIONSampling策略，以尽量减少婴儿失去后续行动是更成功的替代策略，在限制转移偏见在新生儿重症监护室的增长研究。虽然完全消除偏倚可能是不可能的，但有效的研究需要努力最大限度地减少、量化和测试转移偏倚的影响。
BACKGROUND AND OBJECTIVETransfer of infants between hospitals or their discharge home may bias comparisons of the performance across neonatal intensive care units (NICUs). This study attempts to show the potential size of transfer bias in the context of a large cohort study and describe strategies for minimizing this type of bias.METHODSTo limit transfer bias in a neonatal growth study of extremely premature infants in six tertiary NICUs, we restricted eligibility to infants <30 weeks gestation at birth and substituted matched replacements for early transfers (infants transferred or discharged prior to day of life 16).RESULTSThe restriction strategy was successful, reducing the overall early transfer rate from 16.4 to 3.6% and the range of transfer rates among individual NICUs from 0.6–32.7% to 0–11.0%. Replacement by matched substitutes had a much smaller effect because of the small number of early transfers and our inability to match on all factors distinguishing early transfers.CONCLUSIONSampling strategies to minimize infants lost to follow-up were more successful than replacement strategies in limiting transfer bias in a NICU growth study. Although complete elimination of bias is likely impossible, valid studies require efforts to minimize, quantify, and test the effect of transfer bias.