WHO SAYS YES - IDENTIFYING SELECTION BIASES IN A PSYCHOSOCIAL INTERVENTION STUDY OF MULTIPLE-SCLEROSIS
WHO SAYS YES - IDENTIFYING SELECTION BIASES IN A PSYCHOSOCIAL INTERVENTION STUDY OF MULTIPLE-SCLEROSIS
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DOI：
10.1016/0277-9536(94)e0092-7
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发表时间：
1995-02-01
影响因子：
5.4
通讯作者：
FOX, BH
中科院分区：
文献类型：
--
作者：
SCHWARTZ, CE;FOX, BH
这项工作的目的是检验患者的社会人口学和医学特征是否与参加两项心理社会干预的随机对照试验有关。在从多发性硬化症患者登记中排除基本不合格后，325名患者收到了一封邀请参加随机试验的信。在受邀者中，29%的人表示有兴趣参与，19%的人安排了面试，13%的人实际上是随机抽样的CHI2，通过Logistic回归分析确定哪些因素与连续参与或不参与研究有关。不同的转介和参与率可以部分追溯到医生的因素。就患者因素而言，家庭收入中位数较高、居住距离医院适中、无法工作的人更有可能参与招募的后续阶段。对患者因素的多变量分析显示，在调整了病程、残疾状况和其他社会人口学预测因素的影响后，收入较高和工作残疾是参与的最强预测因素。这些发现的影响从选择符合条件的患者的潜在偏见来源以及研究人员在突出或淡化这种选择偏见方面可能发挥的作用进行了讨论。建议将产生偏差的障碍降至最低。
The purpose of this work is to examine whether patients' sociodemographic and medical characteristics are associated with participation in a randomized controlled trial of two psychosocial interventions.After elimination of basic ineligibles from a registry of multiple sclerosis patients, 325 patients were sent a letter inviting participation in the randomized trial. Among those invited, 29% expressed an interest in participating, 19% scheduled an intake interview and 13% were actually randomized chi2 and logistic regression analyses were used to determine what factors were associated with successive stages of participation or non-participation in the study.Differential referral and participation rates could be traced in part to physician factors. With respect to patient factors, people were more likely to participate in the successive stages of recruitment if they had a higher median family income, lived a moderate distance from the hospital, and were disabled from working. Multivariate analyses of patient factors revealed that having a higher income and being disabled from work were the strongest predictors of participation, after adjusting for the effects of course of disease, disability status, and other sociodemographic predictors.Implications of these findings are discussed in terms of potential sources of bias in the selection of eligible patients, as well as the role the investigator may play in highlighting or underplaying this selection bias. Suggestions are made to minimize the bias-generating barriers.