MULTIPLE-OUTCOMES METAANALYSIS OF TREATMENTS FOR PERIODONTAL-DISEASE
MULTIPLE-OUTCOMES METAANALYSIS OF TREATMENTS FOR PERIODONTAL-DISEASE
复制标题
DOI：
10.1177/00220345950740040201
复制
发表时间：
1995-04-01
影响因子：
7.6
通讯作者：
PIHLSTROM, BL
中科院分区：
文献类型：
--
作者：
BERKEY, CS;ANTCZAKBOUCKOMS, A;PIHLSTROM, BL
牙周治疗的结果因疾病严重程度、结果测量和数据分析方法而异。几项临床试验和随后的荟萃分析表明，对于严重疾病的牙齿，手术比非手术治疗更能降低探诊深度（PD）并增加附着水平（AL）。对于其他疾病水平，治疗的选择取决于结局指标。临床上。试验使用两个或多个结局指标（如PD和AL），研究人员通常分别分析每个结局。当结果之间的相关性被纳入时，荟萃分析可以使用广义最小二乘（GLS）回归来联合分析多个结果。我们应用GLS多结局模型对5项比较手术和非手术牙周治疗的试验进行荟萃分析，每项试验评估治疗后一年的PD和AL结局。临床结论与之前报道的相似，但我们对手术和非手术治疗相对获益的估计应该更准确，因为GLS方法考虑了AL和PD之间的相关性。当两种结果之间的相关性上升时，正如疾病严重程度增加一样，GLS估计值偏离了PD和AL单独分析得出的估计值。
The results of periodontal therapy vary by disease severity, outcome measure, and method of data analysis. Several clinical trials and a subsequent meta-analysis have demonstrated that, for teeth with severe disease, surgery decreases probing depth (PD) and increases attachment level (AL) more than non-surgical treatment. For other disease levels, the choice of therapy depends on the outcome measure. When clinical. trials use two or more outcome measures (such as PD and AL), investigators ordinarily analyze each outcome separately. When the correlations are incorporated among the outcomes, a metaanalysis can use generalized-least-squares (GLS) regression to analyze multiple outcomes jointly. We applied the GLS multiple-outcomes model in a meta-analysis of 5 trials comparing surgical and non-surgical periodontal treatments, each assessing the outcomes PD and AL one year after treatment. The clinical conclusions are similar to those reported earlier, but our estimates of the relative benefits of surgical and non-surgical treatment should be more accurate, because the GLS method takes into account correlation between AL and PD. When correlations between the two outcomes rise, as they do with increasing severity of disease, the GLS estimates depart from those derived from separate analyses of PD and AL.