MULTIPLE SIGNIFICANCE TESTS - THE BONFERRONI METHOD .10.
MULTIPLE SIGNIFICANCE TESTS - THE BONFERRONI METHOD .10.
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DOI：
10.1136/bmj.310.6973.170
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发表时间：
1995-01-21
影响因子：
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通讯作者：
ALTMAN, DG
中科院分区：
文献类型：
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作者：
BLAND, JM;ALTMAN, DG
许多已发表的论文包括大量的显著性检验。这些可能很难解释，因为如果我们继续测试足够长的时间，我们将不可避免地发现一些“重要”的东西。我们必须注意，在一大堆不重要的结果中，不要过分重视一个单独的重要结果。Lee等人模拟了一项冠状动脉疾病治疗的临床试验，将过去病例中的1073例患者随机分配到两个“治疗”组。[1]然后，他们分析了结果，就好像这是两种治疗方法的真正试验一样。分析的很详细，也很透彻。正如我们所预期的那样，它未能显示分配到两种治疗的患者之间的生存率有任何显着差异。然后根据影响预后的两个变量对患者进行细分，即病变冠状动脉血管的数量和左心室收缩模式是正常还是异常。两个“治疗”组之间的生存率有显着差异，发现在那些患者的三个病变血管（最大）和心室收缩异常。由于这是预后最差的患者子集，因此很容易解释这一发现，即上级“治疗”在病情最严重的患者中具有最大的优势！这种比较亚组的方法显然有缺陷。
Many published papers include large numbers of significance tests. These may be difficult to interpret because if we go on testing long enough we will inevitably find something which is “significant.” We must beware of attaching too much importance to a lone significant result among a mass of non-significant ones. It may be the one in 20 which we expect by chance alone.Lee et al simulated a clinical trial of the treatment of coronary artery disease by allocating 1073 patient records from past cases into two “treatment” groups at random. 1 They then analysed the outcome as if it were a genuine trial of two treatments. The analysis was quite detailed and thorough. As we would expect, it failed to show any significant difference in survival between those patients allocated to the two treatments. Patients were then subdivided by two variables which affect prognosis, the number of diseased coronary vessels and whether the left ventricular contraction pattern was normal or abnormal. A significant difference in survival between the two “treatment” groups was found in those patients with three diseased vessels (the maximum) and abnormal ventricular contraction. As this would be the subset of patients with the worst prognosis, the finding would be easy to account for by saying that the superior “treatment” had its greatest advantage in the most severely ill patients! This approach to the comparison of subgroups is clearly flawed.