A focused review of statistical practices for relating radiation dose-volume exposure and toxicity.
A focused review of statistical practices for relating radiation dose-volume exposure and toxicity.
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DOI：
10.1186/s13014-023-02220-9
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发表时间：
2023-03-24
影响因子：
3.6
通讯作者：
Mayo, Charles S.
中科院分区：
文献类型：
--
作者：
McDonald, Andrew M.;Schneider, Craig S.;Stahl, John M.;Oster, Robert A.;Popple, Richard A.;Mayo, Charles S.
将剂量-体积直方图(DVH)信息与患者预后联系起来对于放射肿瘤学的预后研究至关重要，但这在统计学上具有挑战性。我们对DVH毒性研究进行了重点审查，以确定当前的统计方法，并确定更新报告建议的必要性。我们进行了一次重点MEDLINE搜索，以确定发表在5种放射肿瘤学专业杂志上的研究，这些研究将剂量学与2015年至2021年接受放射治疗的人类的毒性结果联系起来。从每份手稿中提取的要素包括研究结果、考虑的危险器官、分析的DVH参数、分析方法的总结、多变量统计的使用、拟合度报告、模型报告的完整性、多重共线性的评估、多重比较的调整以及变量的二分法。还对每项研究进行了评估，以确定是否有足够的报告，以便复制结果。MEDLINE检索返回了2300项供审查的研究，其中325项符合分析的纳入标准。在154项(47.4%)研究中，DVH变量使用切点进行了二分法。Logistic回归(55.4%的研究)是将DVH与毒性结局联系起来的最常见的统计方法，其次是COX回归(20.6%)和线性回归(12.0%)。在226项(69.5%)研究中进行了多变量统计检验，其中47.8%的研究涉及多重共线性的可能性，32.6%的研究报告了模型的拟合优度。对统计意义的阈值进行了调整，以考虑196项研究中的41项(17.1%)的多次比较，这些研究包括多项统计比较。28项研究(8.6%)被归类为重复研究结果所需的缺失细节。目前DVH结果中统计报告的做法表明，研究可能容易受到内部和外部有效性的威胁。在此提供报告建议，以防范此类威胁，并促进放射肿瘤学结果研究人员之间的凝聚力。网上版载有补充材料，可在10.1186/s13014-023-02220-9查阅。
Relating dose-volume histogram (DVH) information to patient outcomes is critical for outcomes research in radiation oncology, but this is statistically challenging. We performed this focused review of DVH toxicity studies to characterize current statistical approaches and determine the need for updated reporting recommendations. We performed a focused MEDLINE search to identify studies published in 5 radiation oncology specialty journals that associated dosimetry with toxicity outcomes in humans receiving radiotherapy between 2015 and 2021. Elements abstracted from each manuscript included the study outcome, organs-at-risk (OARs) considered, DVH parameters analyzed, summary of the analytic approach, use of multivariable statistics, goodness-of-fit reporting, completeness of model reporting, assessment of multicollinearity, adjustment for multiple comparisons, and methods for dichotomizing variables. Each study was also assessed for sufficient reporting to allow for replication of results. The MEDLINE search returned 2,300 studies for review and 325 met the inclusion criteria for the analysis. DVH variables were dichotomized using cut points in 154 (47.4%) studies. Logistic regression (55.4% of studies) was the most common statistical method used to relate DVH to toxicity outcomes, followed by Cox regression (20.6%) and linear regression (12.0%). Multivariable statistical tests were performed in 226 (69.5%) studies; of these, the possibility of multicollinearity was addressed in 47.8% and model goodness-of-fit were reported in 32.6%. The threshold for statistical significance was adjusted to account for multiple comparisons in 41 of 196 (17.1%) studies that included multiple statistical comparisons. Twenty-eight (8.6%) studies were classified as missing details necessary to reproduce the study results. Current practices of statistical reporting in DVH outcomes suggest that studies may be vulnerable to threats against internal and external validity. Recommendations for reporting are provided herein to guard against such threats and to promote cohesiveness among radiation oncology outcomes researchers. The online version contains supplementary material available at 10.1186/s13014-023-02220-9.
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影响因子：
5.7
作者：
Van den Bosch, Lisa;Schuit, Ewoud;van der Schaaf, Arjen
通讯作者：
van der Schaaf, Arjen
DOI：
10.1016/j.ijrobp.2009.08.074
发表时间：
2010-03-01
影响因子：
7
作者：
Jackson, Andrew;Marks, Lawrence B.;Bentzen, Soren M.;Eisbruch, Avraham;Yorke, Ellen D.;Ten Haken, Randal K.;Constine, Louis S.;Deasy, Joseph O.
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Deasy, Joseph O.
影响因子：
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作者：
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通讯作者：
Altman, D. G.
影响因子：
39.2
作者：
Collins, Gary S.;Reitsma, Johannes B.;Moons, Karel G. M.
通讯作者：
Moons, Karel G. M.
影响因子：
3.5
作者：
Jackson, Andrew;Yorke, Ellen D.;Rosenzweig, Kenneth E.
通讯作者：
Rosenzweig, Kenneth E.