Saha Sukanta, Chant David, McGrath John
Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Locked Bag 500, Richlands, Q4077, Australia.
Int J Methods Psychiatr Res. 2008;17(1):55-61. doi: 10.1002/mpr.240.
While meta-analytic techniques are routine in the synthesis of data from randomized controlled trials, there are no clear guidelines on how best to summarize frequency data such as incidence and prevalence estimates. Based on data from two recent systematic reviews of the incidence and prevalence of schizophrenia, this paper explores some of the conceptual and methodological issues related to the meta-analyses of frequency estimates in epidemiology. Because variations in the incidence and prevalence of disorders such as schizophrenia can be informative, there is a case against collapsing data into one pooled estimate. Variations in frequency estimates can be displayed graphically, or summarized with quantiles around measures of central tendency. If pooled estimated are of interest, then researchers need to be aware that studies based on large samples will leverage greater weight on the pooled value. Based on systematic reviews of the incidence and prevalence of schizophrenia, we explore if these and related issues are of practical concern. When used with appropriate caution, meta-analysis can complement the synthesis of frequency data in epidemiology; however, researchers interested in variation should not rely on meta-analysis alone.
虽然荟萃分析技术在综合随机对照试验的数据时很常见，但对于如何最好地总结发病率和患病率估计等频率数据，却没有明确的指导方针。基于最近两项关于精神分裂症发病率和患病率的系统评价数据，本文探讨了与流行病学中频率估计的荟萃分析相关的一些概念和方法问题。由于精神分裂症等疾病的发病率和患病率变化可能具有参考价值，因此反对将数据合并为一个汇总估计值。频率估计的变化可以用图形显示，或用围绕集中趋势度量的分位数进行总结。如果汇总估计值是感兴趣的内容，那么研究人员需要意识到，基于大样本的研究会对汇总值产生更大的权重。基于对精神分裂症发病率和患病率的系统评价，我们探讨这些及相关问题是否具有实际意义。当谨慎使用时，荟萃分析可以补充流行病学中频率数据的综合分析；然而，对变异感兴趣的研究人员不应仅依赖荟萃分析。
