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随机对照试验证据的价值取决于统计分析的质量。

The value of RCT evidence depends on the quality of statistical analysis.

作者信息

Faulkner Cathy, Fidler Fiona, Cumming Geoff

机构信息

School of Psychological Science, La Trobe University, Melbourne, Victoria 3086, Australia.

出版信息

Behav Res Ther. 2008 Feb;46(2):270-81. doi: 10.1016/j.brat.2007.12.001. Epub 2007 Dec 5.

Abstract

The authors examined statistical practices in 193 randomized controlled trials (RCTs) of psychological therapies published in prominent psychology and psychiatry journals during 1999-2003. Statistical significance tests were used in 99% of RCTs, 84% discussed clinical significance, but only 46% considered-even minimally-statistical power, 31% interpreted effect size and only 2% interpreted confidence intervals. In a second study, 42 respondents to an email survey of the authors of RCTs analyzed in the first study indicated they consider it very important to know the magnitude and clinical importance of the effect, in addition to whether a treatment effect exists. The present authors conclude that published RCTs focus on statistical significance tests ("Is there an effect or difference?"), and neglect other important questions: "How large is the effect?" and "Is the effect clinically important?" They advocate improved statistical reporting of RCTs especially by reporting and interpreting clinical significance, effect sizes and confidence intervals.

摘要

作者们对1999年至2003年期间发表在著名心理学和精神病学杂志上的193项心理治疗随机对照试验(RCT)中的统计方法进行了研究。99%的RCT使用了统计显著性检验,84%讨论了临床意义,但只有46%的研究——哪怕只是最低限度地——考虑了统计功效,31%解释了效应大小,只有2%解释了置信区间。在第二项研究中,对第一项研究中分析的RCT作者进行电子邮件调查,42名受访者表示,除了治疗效果是否存在外,他们认为了解效应的大小和临床重要性非常重要。本文作者得出结论,已发表的RCT侧重于统计显著性检验(“是否存在效应或差异?”),而忽略了其他重要问题:“效应有多大?”以及“该效应在临床上是否重要?”他们主张改进RCT的统计报告,特别是通过报告和解释临床意义、效应大小和置信区间。

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