Tetrault Jeanette M, Sauler Maor, Wells Carolyn K, Concato John
Veterans Affairs Clinical Epidemiology Research Center, 950 Campbell Avenue, West Haven, CT 06516, USA.
J Investig Med. 2008 Oct;56(7):954-7. doi: 10.2310/JIM.0b013e31818914ff.
Multivariable models are frequently used in the medical literature, but many clinicians have limited training in these analytic methods. Our objective was to assess the prevalence of multivariable methods in medical literature, quantify reporting of methodological criteria applicable to most methods, and determine if assumptions specific to logistic regression or proportional hazards analysis were evaluated.
We examined all original articles in Annals of Internal Medicine, British Medical Journal, Journal of the American Medical Association, Lancet, and New England Journal of Medicine, from January through June 2006. Articles reporting multivariable methods underwent a comprehensive review; reporting of methodological criteria was based on each article's primary analysis.
Among 452 articles, 272 (60%) used multivariable analysis; logistic regression (89 [33%] of 272) and proportional hazards (76 [28%] of 272) were most prominent. Reporting of methodological criteria, when applicable, ranged from 5% (12/265) for assessing influential observations to 84% (222/265) for description of variable coding. Discussion of interpreting odds ratios occurred in 13% (12/89) of articles reporting logistic regression as the primary method and discussion of the proportional hazards assumption occurred in 21% (16/76) of articles using Cox proportional hazards as the primary method.
More complete reporting of multivariable analysis in the medical literature can improve understanding, interpretation, and perhaps application of these methods.
多变量模型在医学文献中经常被使用,但许多临床医生对这些分析方法的培训有限。我们的目的是评估多变量方法在医学文献中的流行程度,量化适用于大多数方法的方法学标准的报告情况,并确定是否对逻辑回归或比例风险分析的特定假设进行了评估。
我们检查了2006年1月至6月期间发表在《内科学年鉴》《英国医学杂志》《美国医学会杂志》《柳叶刀》和《新英格兰医学杂志》上的所有原创文章。报告多变量方法的文章接受了全面审查;方法学标准的报告基于每篇文章的主要分析。
在452篇文章中,272篇(60%)使用了多变量分析;逻辑回归(272篇中的89篇[33%])和比例风险分析(272篇中的76篇[28%])最为突出。适用时,方法学标准的报告范围从评估有影响的观察值的5%(12/265)到变量编码描述的84%(222/265)。将逻辑回归作为主要方法的文章中有13%(12/89)讨论了比值比的解释,将Cox比例风险分析作为主要方法的文章中有21%(16/76)讨论了比例风险假设。
医学文献中多变量分析的更完整报告可以提高对这些方法的理解、解释,或许还能促进其应用。