Vibration of effects in epidemiologic studies of alcohol consumption and breast cancer risk
Vibration of effects in epidemiologic studies of alcohol consumption and breast cancer risk
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DOI：
10.1093/ije/dyz271
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发表时间：
2020-04-01
影响因子：
7.7
通讯作者：
Wallach, Joshua D.
中科院分区：
文献类型：
--
作者：
Chu, Lingzhi;Ioannidis, John P. A.;Wallach, Joshua D.
背景：不同的分析方法可以影响观察性研究中估计的关联。我们评估了在评估酒精对乳腺癌影响的观察性研究中报告的效应估计值的变异性。方法：我们提取了最大的有害，最大的保护和最小的（最接近空值1.0）最近的酒精-乳腺癌荟萃分析中包含的研究中的相对风险估计，并记录了它们如何基于五个模型规范特征，包括暴露定义，暴露对比水平、研究人群、调整协变量和/或模型方法。对于每项研究，我们近似振动的影响除以最小的影响估计[即比值比（ROR）]。结果：在97个合格的研究，85（87.6%）报告了有害和保护的相对影响估计酒精乳腺癌的关系，范围从1.1到17.9和0.0到1.0，分别。比较最大和最小估计值的ROR范围为1.0 - 106.2，中位数为3.0 [四分位距（IQR）2.0-5.2]。三分之一（35，36.1%）的ROR是基于极端效应估计，至少有三种不同的模型规格特征;绝大多数（87，89.7%）具有不同的暴露定义或对比度水平。类似的振动效果时，观察到只有极端的估计与研究人群和/或调整协变量的基础上的差异compared.Conclusions：大多数观察性研究评估酒精对乳腺癌的影响报告的相对效果估计相同的协会，偏离>2倍。因此，观察性研究应该估计效应的波动，以提供有关结果稳定性的见解。
Background: Different analytical approaches can influence the associations estimated in observational studies. We assessed the variability of effect estimates reported within and across observational studies evaluating the impact of alcohol on breast cancer.Methods: We abstracted largest harmful, largest protective and smallest (closest to the null value of 1.0) relative risk estimates in studies included in a recent alcohol-breast cancer meta-analysis, and recorded how they differed based on five model specification characteristics, including exposure definition, exposure contrast levels, study populations, adjustment covariates and/or model approaches. For each study, we approximated vibration of effects by dividing the largest by the smallest effect estimate [i.e. ratio of odds ratio (ROR)].Results: Among 97 eligible studies, 85 (87.6%) reported both harmful and protective relative effect estimates for an alcohol-breast cancer relationship, which ranged from 1.1 to 17.9 and 0.0 to 1.0, respectively. The RORs comparing the largest and smallest estimates in value ranged from 1.0 to 106.2, with a median of 3.0 [interquartile range (IQR) 2.0-5.2]. One-third (35, 36.1%) of the RORs were based on extreme effect estimates with at least three different model specification characteristics; the vast majority (87, 89.7%) had different exposure definitions or contrast levels. Similar vibrations of effect were observed when only extreme estimates with differences based on study populations and/or adjustment covariates were compared.Conclusions: Most observational studies evaluating the impact of alcohol on breast cancer report relative effect estimates for the same associations that diverge by >2-fold. Therefore, observational studies should estimate the vibration of effects to provide insight regarding the stability of findings.