罕见事件Meta分析中大型研究与小型研究之间的差异  

Discrepancy between mega-trial and small studies in meta-analysis of rare events

作　　者：于天琦 徐文涛 游月媛 李静[1] YU Tianqi;XU Wentao;YOU Yueyuan;LI Jing(Research Center of Evidence Based Medicine and Clinical Epidemiology,West China Hospital,Sichuan University,Chengdu 610041,P.R.China)

机构地区：[1]四川大学华西医院循证医学与临床流行病学研究中心,成都610041

出　　处：《中国循证医学杂志》2022年第1期97-102,共6页Chinese Journal of Evidence-based Medicine

摘　　要：目的以实证研究的方式探讨罕见事件Meta分析中大型研究与小型研究之间的差异。方法通过2003年1月至2018年5月The Cochrane数据库收集的系统评价数据,筛选出具有罕见事件、至少纳入5个研究和至少纳入1个大型研究的二分类结局变量的Meta分析。采用Peto和经典OR值作为效应量,比较包含大型研究与排除大型研究(仅小型研究)Meta分析OR值的大小、方向和P值。结果共纳入214个Meta分析。在214对OR值中,基于Peto OR值,有66对(30.84%)OR值的方向不一致(Kappa=0.33);基于经典OR值,有69对(32.24%)OR值的方向不一致。多数(83.18%)小型研究的Meta分析中,采用Peto方法与经典方法相比,得出的P值更小。结论对有罕见事件二分类变量结局指标的Meta分析,采用不同的效应量和统计方法,包含大型研究的结果和小型研究的结果之间存在较大差异。Objective To explore the differences between large and small studies in rare events meta-analysis.Methods Empirical data were collected from The Cochrane Systematic Review Database from January 2003 to May 2018.Meta-analyses with rare events,binary outcomes involving at least 5 studies,and at least 1 large study were screened.Peto and classical ORs were used to compare the magnitude,direction and P-value.Results A total of 214 meta-analyses were included.Among 214 pairs of ORs of large and small studies,66 pairs(30.84%)were inconsistent in the direction of ORs based on Peto OR(Kappa=0.33),and 69 pairs(32.24%)were inconsistent in the direction of ORs based on classical OR.The Peto ORs resulted in smaller P-values compared to classic ORs in a substantial(83.18%)number of cases.Conclusion There are considerable differences between large and small studies in the results of meta-analysis of rare events.

关 键 词：大型研究 小型研究 META分析 罕见事件 COCHRANE系统评价 

分 类 号：R-03[医药卫生]