Reporting, handling and assessing the risk of bias associated with missing participant data in systematic reviews: a methodological survey.
Reporting, handling and assessing the risk of bias associated with missing participant data in systematic reviews: a methodological survey.
复制标题
DOI：
10.1136/bmjopen-2015-009368
复制
发表时间：
2015-09-30
期刊：
影响因子：
2.9
通讯作者：
Alonso-Coello P
中科院分区：
文献类型：
--
作者：
Akl EA;Carrasco-Labra A;Brignardello-Petersen R;Neumann I;Johnston BC;Sun X;Briel M;Busse JW;Ebrahim S;Granados CE;Iorio A;Irfan A;Martínez García L;Mustafa RA;Ramírez-Morera A;Selva A;Solà I;Sanabria AJ;Tikkinen KA;Vandvik PO;Vernooij RW;Zazueta OE;Zhou Q;Guyatt GH;Alonso-Coello P
描述系统评价者如何报告二分结果的缺失数据、在分析中处理它们并评估相关偏倚的风险。我们检索了 MEDLINE 和 Cochrane 系统评价数据库，以获取 2010 年发表的随机试验的系统评价，并报告了二分结果的荟萃分析。我们随机选择了 98 篇 Cochrane 系统评价和 104 篇非 Cochrane 系统评价。由 2 名评审员组成的团队选择了合格的研究，并使用标准化的试点表格和随附的说明独立地重复提取数据。我们进行了回归分析，以探索与使用完整案例分析相关的因素以及判断与缺失参与者数据相关的偏倚风险。在 Cochrane 和非 Cochrane 综述中，分别有 47% 和 7% (p<0.0001) 报告了缺失数据的参与者数量，41% 和 9% 报告了处理缺失分类数据的计划。报告最多的两种处理缺失数据的方法是完整案例分析（8.5%，在 202 条评论中）和假设没有缺失数据的参与者发生过该事件（4%）。完整病例分析的使用仅与 Cochrane 综述相关（相对于非 Cochrane 综述：OR=7.25；95% CI 1.58 至 33.3，p=0.01）。 65% 的评论评估了与缺失数据相关的偏倚风险；这与 Cochrane 综述（相对于非 Cochrane：OR=6.63；95% CI 2.50 至 17.57，p=0.0001）以及建议分级评估、制定和评价（GRADE）方法的使用（OR=5.02；95% CI 1.02 至 24.75，p=0.047）有关。尽管 Cochrane 综述的问题较少，但大多数 Cochrane 和非 Cochrane 系统综述未能充分报告和处理缺失的数据，可能导致对偏倚风险做出误导性判断。
To describe how systematic reviewers are reporting missing data for dichotomous outcomes, handling them in the analysis and assessing the risk of associated bias. We searched MEDLINE and the Cochrane Database of Systematic Reviews for systematic reviews of randomised trials published in 2010, and reporting a meta-analysis of a dichotomous outcome. We randomly selected 98 Cochrane and 104 non-Cochrane systematic reviews. Teams of 2 reviewers selected eligible studies and abstracted data independently and in duplicate using standardised, piloted forms with accompanying instructions. We conducted regression analyses to explore factors associated with using complete case analysis and with judging the risk of bias associated with missing participant data. Of Cochrane and non-Cochrane reviews, 47% and 7% (p<0.0001), respectively, reported on the number of participants with missing data, and 41% and 9% reported a plan for handling missing categorical data. The 2 most reported approaches for handling missing data were complete case analysis (8.5%, out of the 202 reviews) and assuming no participants with missing data had the event (4%). The use of complete case analysis was associated only with Cochrane reviews (relative to non-Cochrane: OR=7.25; 95% CI 1.58 to 33.3, p=0.01). 65% of reviews assessed risk of bias associated with missing data; this was associated with Cochrane reviews (relative to non-Cochrane: OR=6.63; 95% CI 2.50 to 17.57, p=0.0001), and the use of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology (OR=5.02; 95% CI 1.02 to 24.75, p=0.047). Though Cochrane reviews are somewhat less problematic, most Cochrane and non-Cochrane systematic reviews fail to adequately report and handle missing data, potentially resulting in misleading judgements regarding risk of bias.