Continuous quality improvement in statistical code: avoiding errors and improving transparency.
Continuous quality improvement in statistical code: avoiding errors and improving transparency.
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DOI：
10.1136/bmjqs-2020-012387
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发表时间：
2021-03
影响因子：
5.4
通讯作者：
Nallamothu BK
中科院分区：
文献类型：
--
作者：
Valley TS;Kamdar N;Wiitala WL;Ryan AM;Seelye SM;Waljee AK;Nallamothu BK
统计方法的清晰沟通可以确保医疗保健研究得到充分理解，减少重大错误，促进科学进步。然而，与日益复杂的数据和分析相比，已发表的方法部分有时不足以描述必要的细节。因此，确保医疗保健研究中统计方法的质量、透明度和可重复性至关重要。这些问题不仅仅是理论上的，而且对质量和安全领域的研究有直接的影响。例如，美国医疗保险和医疗补助服务中心（CMS）于2012年制定了减少医院再入院计划，并对再入院率高的医院实施了经济处罚。随后的研究试图确定该方案在多大程度上成功地减少了再入院，而没有引起诸如死亡率增加等意外后果。明确定义该计划的成功或失败至关重要，但在2018年，两篇使用相同CMS数据集的著名文章给出了相反的结果。这些冲突无疑是由于分析选择的差异，但鉴于读者无法获得统计代码，调和具体的差异是具有挑战性的。在最近的另一个例子中，一篇重要的文章因发现一个统计编码错误而被撤回，该错误颠倒了实验组和对照组的分类。5本临床试验检查了慢性阻塞性肺疾病住院患者的支持方案，最初报告住院风险较低
Clear communication of statistical approaches can ensure healthcare research is well understood, reduce major errors and promote the advancement of science. Yet in contrast to the increasing complexity of data and analyses, published methods sections are at times insufficient for describing necessary details. Therefore, ensuring the quality, transparency and reproducibility of statistical approaches in healthcare research is essential. 1 2Such concerns are not just theoretical and have direct implications for research in the quality and safety field. For example, the Hospital Readmissions Reduction Program was instituted in 2012 by the US Centers for Medicare & Medicaid Services (CMS) and imposed financial penalties on hospitals with high readmission rates. Subsequent studies sought to determine the extent to which this programme was successful in reducing readmissions without promoting unintended consequences, such as increased mortality. Clearly defining the success or failure of this programme is essential, but in 2018 two prominent articles using the same CMS data set presented opposing results. 3 4 These conflicts are undoubtedly due to differences in analytical choices, but specific differences are challenging to reconcile given statistical code was unavailable to readers. In another recent example, a major article was retracted due to the discovery of a statistical coding error that reversed the categorisation of treatment and control groups. 5 This clinical trial examined a support programme for hospitalised patients with chronic obstructive pulmonary disease, originally reporting a lower risk of hospitalisation
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影响因子：
13.8
作者：
Khera, Rohan;Dharmarajan, Kumar;Krumholz, Harlan M.
通讯作者：
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影响因子：
15.8
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影响因子：
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通讯作者：
Marang-van de Mheen PJ
影响因子：
5.4
作者：
Taylor MJ;McNicholas C;Nicolay C;Darzi A;Bell D;Reed JE
通讯作者：
Reed JE