Glynn R J, Rosner B
Brigham and Women's Hospital and Harvard Medical School, and Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA.
Am J Epidemiol. 2000 May 15;151(10):965-74. doi: 10.1093/oxfordjournals.aje.a010140.
The authors compared, in the context of diabetic retinopathy, alternative methods of quantifying the extent to which disease progression in one eye increases the risk of subsequent progression in the other eye. Data were gathered on 478 US patients with insulin-dependent diabetes mellitus who participated in the 1983-1988 Sorbinil Retinopathy Trial and were followed up for a median of 41 months. During that time, diabetic retinopathy progressed in 93 right eyes and 77 left eyes. Crude incidence rates of progression for right eyes were 7.7 times higher after the left eye had progressed and, for left eyes, were 4.4 times higher after the right eye had progressed. In eye-specific proportional hazards models that adjusted for increasing rates of progression over time and for baseline risk factors, the comparable relative risks associated with progression in the other eye were 2.6 (95% confidence interval (CI): 1.5, 4.7) for right eyes and 1.4 (95% CI: 0.72, 2.9) for left eyes. Two alternative proportional hazards models that included data on both eyes and accounted for their correlation produced estimated relative risks of 1.9 (95% CI: 1.2, 2.9) and 2.7 (95% CI: 1.8, 3.5), respectively. The more complex models for joint survival integrate information on both eyes and provide more stable estimates than do separate analyses of right or left eyes.
在糖尿病视网膜病变的背景下，作者比较了量化一只眼睛疾病进展增加另一只眼睛后续进展风险程度的替代方法。收集了478名美国胰岛素依赖型糖尿病患者的数据，这些患者参加了1983 - 1988年的Sorbinil视网膜病变试验，随访时间中位数为41个月。在此期间，93只右眼和77只左眼出现了糖尿病视网膜病变进展。左眼进展后右眼的粗进展发病率高7.7倍，右眼进展后左眼的粗进展发病率高4.4倍。在针对随时间增加的进展率和基线风险因素进行调整的特定眼睛比例风险模型中，与另一只眼睛进展相关的可比相对风险，右眼为2.6（95%置信区间（CI）：1.5，4.7），左眼为1.4（95%CI：0.72，2.9）。两个包含双眼数据并考虑其相关性的替代比例风险模型分别产生的估计相对风险为1.9（95%CI：1.2，2.9）和2.7（95%CI：1.8，3.5）。用于联合生存的更复杂模型整合了双眼信息，比单独分析右眼或左眼能提供更稳定的估计。
