Methodological challenges in the evaluation of prognostic factors in breast cancer
Methodological challenges in the evaluation of prognostic factors in breast cancer
复制标题
DOI：
10.1023/a:1006193704132
复制
发表时间：
1998-01-01
影响因子：
3.8
通讯作者：
Lyman, GH
中科院分区：
文献类型：
--
作者：
Altman, DG;Lyman, GH
许多研究都是为了寻找有助于解释乳腺癌患者预后中无法解释的巨大差异的因素。与治疗试验相比，良好的研究设计和分析原则在预后因素研究中不太受重视。肿瘤学文献中充斥着质量参差不齐的研究结果，而且这些研究结果往往相互矛盾。因此，尽管进行了大量研究，但大多数预后因素的重要性仍然存在不确定性。最近提出的乳腺癌预后因素很少被广泛接受。本文回顾了此类研究背后的重要方法论问题。这些问题通过已发表的研究和最近在癌症期刊上发表的论文的评论中的例子来说明。提出了进行和评估预后因素研究的指南，这应该提高这一重要领域的研究质量。
Many studies are carried out in an effort to find factors that help explain the large unexplained variation in prognosis of breast cancer patients. The principles of good study design and analysis are less well appreciated for prognostic factor studies than for therapeutic trials. The oncology literature is full of results from studies of varying quality, often with conflicting findings. As a consequence, despite the large number of studies, there is still uncertainty about the importance of most prognostic factors. Few recently proposed prognostic factors for breast cancer have become widely accepted. This paper reviews the important methodological issues underlying such research. These issues are illustrated with examples from published studies and recent reviews of papers published in cancer journals. Guidelines are proposed for conducting and evaluating prognostic factor studies which should improve the quality of research in this important area.