Pocock Stuart J, Collier Timothy J, Dandreo Kimberley J, de Stavola Bianca L, Goldman Marlene B, Kalish Leslie A, Kasten Linda E, McCormack Valerie A
Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT.
BMJ. 2004 Oct 16;329(7471):883. doi: 10.1136/bmj.38250.571088.55. Epub 2004 Oct 6.
To review current practice in the analysis and reporting of epidemiological research and to identify limitations.
Examination of articles published in January 2001 that investigated associations between risk factors/exposure variables and disease events/measures in individuals.
Eligible English language journals including all major epidemiological journals, all major general medical journals, and the two leading journals in cardiovascular disease and cancer.
Each article was evaluated with a standard proforma.
We found 73 articles in observational epidemiology; most were either cohort or case-control studies. Most studies looked at cancer and cardiovascular disease, even after we excluded specialty journals. Quantitative exposure variables predominated, which were mostly analysed as ordered categories but with little consistency or explanation regarding choice of categories. Sample selection, participant refusal, and data quality received insufficient attention in many articles. Statistical analyses commonly used odds ratios (38 articles) and hazard/rate ratios (23), with some inconsistent use of terminology. Confidence intervals were reported in most studies (68), though use of P values was less common (38). Few articles explained their choice of confounding variables; many performed subgroup analyses claiming an effect modifier, though interaction tests were rare. Several investigated multiple associations between exposure and outcome, increasing the likelihood of false positive claims. There was evidence of publication bias.
This survey raises concerns regarding inadequacies in the analysis and reporting of epidemiological publications in mainstream journals.
回顾流行病学研究分析与报告的当前实践情况并确定其局限性。
审查2001年1月发表的研究个体中风险因素/暴露变量与疾病事件/指标之间关联的文章。
符合条件的英文期刊,包括所有主要的流行病学期刊、所有主要的综合医学期刊以及心血管疾病和癌症领域的两大领先期刊。
每篇文章均采用标准格式进行评估。
我们在观察性流行病学中发现了73篇文章;大多数是队列研究或病例对照研究。即使我们排除了专业期刊,大多数研究仍着眼于癌症和心血管疾病。定量暴露变量占主导地位,大多作为有序类别进行分析,但在类别选择方面缺乏一致性或解释。许多文章对样本选择、参与者拒绝和数据质量关注不足。统计分析常用比值比(38篇文章)和风险/率比(23篇),术语使用存在一些不一致。大多数研究(68篇)报告了置信区间,而使用P值的情况较少见(38篇)。很少有文章解释其对混杂变量的选择;许多文章进行亚组分析并声称有效应修饰因素,尽管交互作用检验很少见。有几项研究调查了暴露与结局之间的多种关联,增加了假阳性结果的可能性。有证据表明存在发表偏倚。
本次调查引发了对主流期刊中流行病学出版物分析与报告不足之处的担忧。