基于增强型漏斗图与试验序贯分析的Meta分析结果稳定性评价  

Robustness assessment of meta-analysis results based on enhanced funnel plots and trial sequential analysis

作　　者：谢纬华 戴品远 孙金芳[1] 王莉娜[1] 余小金[1] XIE Weihua;DAI Pinyuan;SUN Jinfang;WANG Lina;YU Xiaojin(Department of Epidemiology and Health Statistics,School of Public Health,Southeast University,Nanjing 210009,P.R.China)

机构地区：[1]东南大学公共卫生学院流行病与卫生统计学系,南京210009

出　　处：《中国循证医学杂志》2020年第6期713-718,共6页Chinese Journal of Evidence-based Medicine

基　　金：国家自然科学基金项目(编号:81673274)。

摘　　要：目的探讨增强型漏斗图与试验序贯分析在Meta分析结果稳定性评价中的应用。方法从已发表的Meta分析中提取相关数据,采用增强型漏斗图评价Meta分析结果效应量显著性与异质性的稳定性,采用试验序贯分析判断当前Meta分析累积证据量是否足够,从而判断基于当前证据结论的稳定性。结果增强型漏斗图提示低密度脂蛋白的Meta分析结果较为稳定,甘油三酯、总胆固醇与高密度脂蛋白的Meta分析结果尚不稳定。试验序贯分析显示低密度脂蛋白的累积证据量已达到期望信息量,当前结论已稳定;甘油三酯、总胆固醇与高密度脂蛋白的累积证据量未达期望信息量,且累积Z值均未穿过TSA监测限或无效限,当前结论尚不稳定。结论结合增强型漏斗图与试验序贯分析可对当前Meta分析结果的稳定性做出综合判断,为今后系统评价与Meta分析结果稳定性评价提供了方法学支持。Objective To explore the application of enhanced funnel plots(EFP)and trial sequential analysis(TSA)in robustness assessment of meta-analysis results.Methods Data were extracted from published meta-analysis.The EFP was used to evaluate the robustness of the significance and heterogeneity of the current meta-analysis.The TSA was used to judge the sufficiency of the cumulative sample size of the current meta-analysis and to assess the robustness of conclusions based on current evidence.Results The EFP showed that the meta-analysis results of low-density lipoprotein(LDL)was robust,and the meta-analysis results of triglyceride(TG),total cholesterol(TC)and high-density lipoprotein(HDL)were not stable.The TSA showed that the cumulative sample size of LDL had reached the required information size(RIS),and the current conclusion was stable.The cumulative Z value of TG,TC and HDL neither reached the RIS nor passed through the TSA monitoring boundary or futility boundary,indicating that current conclusions were not robust.Conclusions The combination of EFP and TSA can make a comprehensive judgment on the robustness of current metaanalysis results,and provide methodological support in the robustness assessment of results for future systematic reviews and meta-analyses.

关 键 词：增强型漏斗图 试验序贯分析 Meta分析 稳定性 绿茶 脂代谢 

分 类 号：R-03[医药卫生]