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移植研究的分析方法。

Analytical approaches for transplant research.

作者信息

Wolfe Robert A, Schaubel Douglas E, Webb Randall L, Dickinson David M, Ashby Valarie B, Dykstra Dawn M, Hulbert-Shearon Tempie E, McCullough Keith P

机构信息

Scientific Registry of Transplant Recipients/University of Michigan, Ann Arbor, MI, USA.

出版信息

Am J Transplant. 2004;4 Suppl 9:106-13. doi: 10.1111/j.1600-6135.2004.00402.x.

Abstract

It is highly desirable to base decisions designed to improve medical practice or organ allocation policies on the analyses of the most recent data available. Yet there is often a need to balance this desire with the added value of evaluating long-term outcomes (e.g. 5-year mortality rates), which requires the use of data from earlier years. This article explains the methods used by the Scientific Registry of Transplant Recipients in order to achieve these goals simultaneously. The analysis of waiting list and transplant outcomes depends strongly on statistical methods that can combine data from different cohorts of patients that have been followed for different lengths of time. A variety of statistical methods have been designed to address these goals, including the Kaplan-Meier estimator, Cox regression models, and Poisson regression. An in-depth description of the statistical methods used for calculating waiting times associated with the various types of organ transplants is provided. Risk of mortality and graft failure, adjusted analyses, cohort selection, and the many complicating factors surrounding the calculation of follow-up time for various outcomes analyses are also examined.

摘要

基于对现有最新数据的分析来做出旨在改善医疗实践或器官分配政策的决策是非常可取的。然而,通常需要在这种愿望与评估长期结果(如5年死亡率)的附加价值之间取得平衡,而这需要使用早年的数据。本文解释了移植受者科学登记处为同时实现这些目标所采用的方法。对等待名单和移植结果的分析在很大程度上依赖于统计方法,这些方法可以将来自不同患者队列、随访时间不同的数据结合起来。为实现这些目标设计了多种统计方法,包括Kaplan-Meier估计器、Cox回归模型和Poisson回归。本文还深入描述了用于计算与各种器官移植相关等待时间的统计方法。还研究了死亡风险和移植物失败风险、校正分析、队列选择以及各种结果分析随访时间计算周围的许多复杂因素。

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