Survival analysis in observational studies.
Survival analysis in observational studies.
复制标题
观察性研究中的生存分析。
DOI：
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发表时间：
1997
影响因子：
2
通讯作者：
D. Spiegelhalter
中科院分区：
文献类型：
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作者：
K. Bull;D. Spiegelhalter
多中心数据库正在为医学理解做出越来越大的贡献。虽然随机实验研究的统计处理在医学文献中有很好的记录，但观察性研究的分析需要解决与进入研究的时间相关的其他重要问题，以及在此之后才引入的潜在解释变量的影响。一系列的分析是在一个小的数据集上进行的。单一和多个解释变量对固定时间间隔后的结果和特定事件发生前的生存时间的影响进行了检验。然后分析只在随访期间起作用的因素对存活率的影响。讨论了每项分析的目的、所用数据的选择、方法的要点、对结果的解释以及局限性和基本假设。强调指出，与随机研究不同，观察性研究中选择干预措施的依据和时机没有明确规定，因此，将生存影响归因于干预措施必须是试探性的。提供了术语词汇表。
Multi-centre databases are making an increasing contribution to medical understanding. While the statistical handling of randomized experimental studies is well documented in the medical literature, the analysis of observational studies requires the addressing of additional important issues relating to the timing of entry to the study and the effect of potential explanatory variables not introduced until after that time. A series of analyses is illustrated on a small data set. The influence of single and multiple explanatory variables on the outcome after a fixed time interval and on survival time until a specific event are examined. The analysis of the effect on survival of factors that only come into play during follow-up is then considered. The aim of each analysis, the choice of data used, the essentials of the methodology, the interpretation of the results and the limitations and underlying assumptions are discussed. It is emphasized that, in contrast to randomized studies, the basis for selection and timing of interventions in observational studies is not precisely specified so that attribution of a survival effect to an intervention must be tentative. A glossary of terms is provided.