Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Am J Public Health. 2012 Feb;102(2):309-18. doi: 10.2105/AJPH.2011.300343. Epub 2011 Dec 15.
We used individual participant data from multiple studies to conduct a comprehensive meta-analysis of mechanical exposures in the workplace and low back pain.
We conducted a systematic literature search and contacted an author of each study to request their individual participant data. Because outcome definitions and exposure measures were not uniform across studies, we conducted 2 substudies: (1) to identify sets of outcome definitions that could be combined in a meta-analysis and (2) to develop methods to translate mechanical exposure onto a common metric. We used generalized estimating equation regression to analyze the data.
The odds ratios (ORs) for posture exposures ranged from 1.1 to 2.0. Force exposure ORs ranged from 1.4 to 2.1. The magnitudes of the ORs differed according to the definition of low back pain, and heterogeneity was associated with both study-level and individual-level characteristics.
We found small to moderate ORs for the association of mechanical exposures and low back pain, although the relationships were complex. The presence of individual-level OR modifiers in such an area can be best understood by conducting a meta-analysis of individual participant data.
我们利用来自多项研究的个体参与者数据，对工作场所的机械暴露与下背痛进行了全面的荟萃分析。
我们进行了系统的文献检索，并联系了每项研究的作者，请求获取他们的个体参与者数据。由于研究之间的结局定义和暴露测量并不统一，我们进行了 2 项亚研究：（1）确定可在荟萃分析中组合的结局定义集；（2）制定将机械暴露转化为通用指标的方法。我们使用广义估计方程回归分析数据。
姿势暴露的比值比（ORs）范围为 1.1 至 2.0。力暴露的 ORs 范围为 1.4 至 2.1。OR 的大小取决于下背痛的定义，异质性与研究水平和个体水平的特征有关。
我们发现机械暴露与下背痛之间存在小到中度的 OR，尽管关系较为复杂。在这种情况下，通过对个体参与者数据进行荟萃分析，可以更好地理解个体水平 OR 修饰因子的存在。
