Statistical Consideration for Bilateral Cases in Orthopaedic Research
Statistical Consideration for Bilateral Cases in Orthopaedic Research
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DOI：
10.2106/jbjs.i.00724
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发表时间：
2010-07-21
影响因子：
5.3
通讯作者：
Lee, Kyoung Min
中科院分区：
文献类型：
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作者：
Park, Moon Seok;Kim, Sung Ju;Lee, Kyoung Min
背景资料：统计独立性意味着一个观察结果不受另一个观察结果的影响;然而，如果一个受试者的左侧和右侧测量被认为是独立的，则违反了统计独立性原则，因为它们通常是相关的，并且可以相互影响。本研究的目的是分析违反统计的独立性，在最近的骨科研究论文，并证明统计分析的效果，认为数据的依赖性内subject.Methods：首先，所有的原始文章，已发表在骨与关节外科杂志（美国卷）超过两年的时间进行了评估。分析旨在识别包含双边病例和可能违反统计独立性的文章。其次，进行了不考虑统计独立性的实证逻辑回归，并与考虑受试者内数据依赖性的统计分析进行了比较。600例患者的1200个髋关节的X线片被用来检查比值比的差异（95%可信区间）的危险因素。结果：486篇原创文章被审查，151篇（包括涉及臀部的四十一条，涉及膝盖的三十四条，涉及脚或脚踝的二十一条，涉及肩膀的十九条，10例涉及手或手腕，9例涉及手肘，17例涉及其他结构）被认为包括双侧病例。在审查的486篇文章中，发现120篇（25%）（包括36篇涉及髋关节的文章，26篇涉及膝关节的文章，15篇涉及足或踝关节的文章，14篇涉及肩关节的文章，7篇涉及手肘关节的文章，6篇涉及手或腕关节的文章，16篇涉及其他结构的文章）可能违反了统计独立性。实证统计分析表明，逻辑回归是不稳健的违反统计独立性。的风险因素的比值比的95%置信区间表现出较窄的范围（1.13至2.68倍）时，数据的依赖性在一个主题是不considered.Conclusions：研究人员需要考虑统计独立性进行统计分析时，特别是在涉及双边的情况下的研究。如果不考虑受试者内的数据依赖性，则涉及双侧病例的研究可能会导致结果偏倚，具体取决于这些研究的背景。
Background: Statistical independence means that one observation is not affected by another; however, the principle of statistical independence is violated if left and right-side measures within a subject are considered to be independent, because they are usually correlated and can affect each other. The purpose of the present study was to analyze the violation of statistical independence in recent orthopaedic research papers and to demonstrate the effect of statistical analysis that considered the data dependency within a subject.Methods: First, all original articles that had been published in The Journal of Bone and Joint Surgery (American Volume) over a two-year period were evaluated. The analysis was designed to identify articles that included bilateral cases and possible violations of statistical independence. Second, a demonstrative logistic regression without consideration of statistical independence was performed and was compared with a statistical analysis that considered data dependency within a subject. Radiographs of 1200 hips in 600 patients were used to examine the differences in terms of odds ratios (with 95% confidence intervals) of the risk factors for hip osteoarthritis.Results: Four hundred and eighty-six original articles were reviewed, and 151 articles (including forty-one articles involving the hip, thirty-four involving the knee, twenty-one involving the foot or ankle, nineteen involving the shoulder, ten involving the hand or wrist, nine involving the elbow, and seventeen involving other structures) were considered to include bilateral cases. Of the 486 articles that were reviewed, 120 articles (25%) (including thirty-six articles involving the hip, twenty-six involving the knee, fifteen involving the foot or ankle, fourteen involving the shoulder, seven involving the elbow, six involving the hand or wrist, and sixteen involving other structures) were found to have possibly violated statistical independence. Demonstrative statistical analysis showed that logistic regression was not robust to the violation of statistical independence. The 95% confidence intervals of the odds ratios for the risk factors showed narrower ranges (1.13 to 2.68 times) when data dependency within a subject was not considered.Conclusions: Researchers need to consider statistical independence when performing statistical analysis, particularly in studies involving bilateral cases. If data dependency within a subject is not considered, studies involving bilateral cases can bias results, depending on the context of those studies.