Time-dependent bias was common in survival analyses published in leading clinical journals
Time-dependent bias was common in survival analyses published in leading clinical journals
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DOI：
10.1016/j.jclinepi.2003.12.008
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发表时间：
2004-07-01
影响因子：
7.2
通讯作者：
Wells, GA
中科院分区：
文献类型：
--
作者：
van Walraven, C;Davis, D;Wells, GA
目的：在生存分析中，无法在基线时记录“基线不可测量”的时间依赖性因素，并在患者观察开始后改变值。如果未适当分析这些变量，则可能会出现时间依赖性偏差。本研究旨在确定高被引医学期刊中这种时间依赖性偏差的普遍程度。 研究设计和设置：我们检索了 Medline 数据库，以识别 1998 年至 2002 年间《American Journal of Medicine》、《Annals of Internal Medicine》、《Archives of Internal Medicine》、《British Medical Journal》、《Chest》、《Circulation》、《Journal of the American Medical Association》、《Lancet》和《New England Journal of Medicine》中使用生存分析的所有观察性研究。“基线不可测量”的研究如果不使用时间依赖性协变量分析，时间依赖性因素容易受到时间依赖性偏差的影响。结果：在 682 项合格研究中，127 项（18.6%，95% CI 15.8-21.8%）包含“基线不可测量”时间依赖性因素，52 项（占所有生存分析的 7.6% [5.8-9.9%]/40.9%） [32.3-50.0%]的研究具有时间依赖性因素）容易受到时间依赖性偏差的影响。在 35 项研究中（5.1% [3.7-7.1%]/27.6% [20.5-35.9%]），偏倚影响了研究摘要中突出显示的变量，并且偏倚的纠正可能会定性地改变一半以上研究的研究结论。结论：在医学期刊中，时间依赖性偏倚相当常见，并且经常影响关键因素和研究结论。 (C) 2004 Elsevier Inc. 保留所有权利。
Objective: In survival analysis, "baseline immeasurable" time-dependent factors cannot be recorded at baseline, and change value after patient observation starts. Time-dependent bias can occur if such variables are not analyzed appropriately. This study sought to determine the prevalence of such time-dependent bias in highly-cited medical journals.Study Design and Setting: We searched Medline databases to identify all observational studies that used a survival analysis in American Journal of Medicine, Annals of Internal Medicine, Archives of Internal Medicine, British Medical Journal, Chest, Circulation, Journal of the American Medical Association, Lancet, and New England Journal of Medicine between 1998 and 2002. Studies with "baseline immeasurable" time-dependent factors were susceptible to time-dependent bias if a time-dependent covariate analysis was not used.Results: Of 682 eligible studies, 127 (18.6%, 95% CI 15.8-21.8%) contained a "baseline immeasurable" time-dependent factor and 52 (7.6% [5.8-9.9%] of all survival analyses/40.9% [32.3-50.0%] of studies with a time-dependent factor) were susceptible to time-dependent bias. In 35 studies (5.1% [3.7-7.1%]/27.6% [20.5-35.9%]), the bias affected a variable highlighted in the study abstract and correction of the bias could have qualitatively changed the study's conclusion in over half of studies.Conclusion: In medical journals, time-dependent bias is concerningly common and frequently affects key factors and the study's conclusion. (C) 2004 Elsevier Inc. All rights reserved.