Exploring treatment by covariate interactions using subgroup analysis and meta-regression in cochrane reviews: a review of recent practice.
Exploring treatment by covariate interactions using subgroup analysis and meta-regression in cochrane reviews: a review of recent practice.
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DOI：
10.1371/journal.pone.0128804
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Welton N
中科院分区：
文献类型：
--
作者：
Donegan S;Williams L;Dias S;Tudur-Smith C;Welton N
通过协变量相互作用的治疗可以在使用相互作用分析的综述中进行探索（例如，亚组分析）。这种分析可以提供有关协变量如何改变治疗效果的信息，并且是个性化药物的重要方法。关于如何应用这种分析的指导是存在的，但对作者是否遵循指导知之甚少。使用已发表的建议，我们制定了标准，以评估如何以及相互作用分析的设计，应用，解释和报告。检索了科克伦系统评价数据库（2013年8月8日）。我们将该标准应用于最近发表的综述，并为每个科克伦综述组提供一个可访问的协议。我们排除了审查更新、诊断测试准确性审查、撤回审查和审查概述。总结了关于审查、协变量和分析的数据。52篇综述中的每一篇都包括计划或进行的交互分析; 51篇综述（98%）计划分析，33篇综述（63%）应用分析。计划的分析类型和随后应用的类型（例如，敏感性或亚组分析）在24篇综述（46%）中存在差异。没有综述报告如何或为什么选择每个协变量; 22篇综述（42%）确实在方案中预先说明了每个协变量，但没有综述确定了每个事后协变量。11篇综述（21%）提到了5个或更少的协变量。1篇综述报告计划使用一种方法来检测相互作用（即，交互作用检验）;另一篇综述报告了对每个协变量应用该方法。关于解释，只有一项审查报告了每个协变量是否检测到相互作用，没有审查讨论了结果的重要性或可解释性，或每个协变量混杂的可能性。科克伦评价中的相互作用分析可以得到实质性的改进。拟议标准可用于帮助指导报告和分析工作。
Treatment by covariate interactions can be explored in reviews using interaction analyses (e.g., subgroup analysis). Such analyses can provide information on how the covariate modifies the treatment effect and is an important methodological approach for personalising medicine. Guidance exists regarding how to apply such analyses but little is known about whether authors follow the guidance. Using published recommendations, we developed criteria to assess how well interaction analyses were designed, applied, interpreted, and reported. The Cochrane Database of Systematic Reviews was searched (8th August 2013). We applied the criteria to the most recently published review, with an accessible protocol, for each Cochrane Review Group. We excluded review updates, diagnostic test accuracy reviews, withdrawn reviews, and overviews of reviews. Data were summarised regarding reviews, covariates, and analyses. Each of the 52 included reviews planned or did interaction analyses; 51 reviews (98%) planned analyses and 33 reviews (63%) applied analyses. The type of analysis planned and the type subsequently applied (e.g., sensitivity or subgroup analysis) was discrepant in 24 reviews (46%). No review reported how or why each covariate had been chosen; 22 reviews (42%) did state each covariate a priori in the protocol but no review identified each post-hoc covariate as such. Eleven reviews (21%) mentioned five covariates or less. One review reported planning to use a method to detect interactions (i.e., interaction test) for each covariate; another review reported applying the method for each covariate. Regarding interpretation, only one review reported whether an interaction was detected for each covariate and no review discussed the importance, or plausibility, of the results, or the possibility of confounding for each covariate. Interaction analyses in Cochrane Reviews can be substantially improved. The proposed criteria can be used to help guide the reporting and conduct of analyses.
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影响因子：
120.7
作者：
YUSUF, S;WITTES, J;TYROLER, HA
通讯作者：
TYROLER, HA
影响因子：
2.4
作者：
Higgins, Julian;Thompson, Simon;Altman, Douglas
通讯作者：
Altman, Douglas
DOI：
10.1177/0272989x13485157
发表时间：
2013-07
期刊：
Medical decision making : an international journal of the Society for Medical Decision Making
影响因子：
--
作者：
Dias S;Sutton AJ;Welton NJ;Ades AE
通讯作者：
Ades AE
影响因子：
4
作者：
Gagnier JJ;Moher D;Boon H;Beyene J;Bombardier C
通讯作者：
Bombardier C
影响因子：
2
作者：
Thompson, SG;Higgins, JPT
通讯作者：
Higgins, JPT