O'Rourke Killian, Walsh Cathal, Hutchinson Michael
Department of Neurology, St. Vincent's University Hospital, Dublin 4, Ireland.
J Neurol. 2007 Nov;254(11):1547-54. doi: 10.1007/s00415-007-0584-x. Epub 2007 Aug 14.
Observational studies of the effect of beta-interferon (IFNbeta) on accumulation of fixed disability in relapsing remitting multiple sclerosis (RRMS) in clinical practice have been difficult to interpret due to bias. The aim of this study of 175 RRMS patients was to use Bayesian analysis to establish whether IFNbeta attenuates disability relative to a cohort of matched historical control subjects from the Sylvia Lawry Centre for MS Research. A sensitivity analysis was based on a range of prior probability distributions for IFNbeta efficacy derived from a published meta-analysis of randomised controlled trials (RCTs) of IFNbeta, and the data were interpreted both unmodified and using variance inflation and point estimate bias correction; the corrected data interpreted in the light of the most likely prior probability distribution yielded a 95 % posterior credible interval for the odds ratio of accumulation of fixed disability after two years of IFNbeta therapy of 0.52, 0.94. It is concluded that two years of IFNbeta therapy for RRMS reduces accumulation of fixed disability in clinical practice.
在临床实践中，由于存在偏差，关于β-干扰素（IFNβ）对复发缓解型多发性硬化症（RRMS）中固定残疾累积影响的观察性研究难以解释。这项针对175例RRMS患者的研究旨在使用贝叶斯分析，确定与来自西尔维亚·劳里多发性硬化症研究中心的一组匹配历史对照受试者相比，IFNβ是否能减轻残疾程度。敏感性分析基于从已发表的IFNβ随机对照试验（RCT）荟萃分析得出的一系列IFNβ疗效先验概率分布，数据在未修正以及使用方差膨胀和点估计偏差校正的情况下进行解释；根据最可能的先验概率分布解释校正后的数据，得出IFNβ治疗两年后固定残疾累积比值比的95%后验可信区间为0.52至0.94。得出的结论是，在临床实践中，RRMS患者接受两年的IFNβ治疗可减少固定残疾的累积。
