过度解读和错误报告诊断准确性研究：“炒作”的证据。
Overinterpretation and misreporting of diagnostic accuracy studies: evidence of "spin".
机构信息
Department of Clinical Epidemiology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
出版信息
Radiology. 2013 May;267(2):581-8. doi: 10.1148/radiol.12120527. Epub 2013 Jan 29.
PURPOSE
To estimate the frequency of distorted presentation and overinterpretation of results in diagnostic accuracy studies.
MATERIALS AND METHODS
MEDLINE was searched for diagnostic accuracy studies published between January and June 2010 in journals with an impact factor of 4 or higher. Articles included were primary studies of the accuracy of one or more tests in which the results were compared with a clinical reference standard. Two authors scored each article independently by using a pretested data-extraction form to identify actual overinterpretation and practices that facilitate overinterpretation, such as incomplete reporting of study methods or the use of inappropriate methods (potential overinterpretation). The frequency of overinterpretation was estimated in all studies and in a subgroup of imaging studies.
RESULTS
Of the 126 articles, 39 (31%; 95% confidence interval [CI]: 23, 39) contained a form of actual overinterpretation, including 29 (23%; 95% CI: 16, 30) with an overly optimistic abstract, 10 (8%; 96% CI: 3%, 13%) with a discrepancy between the study aim and conclusion, and eight with conclusions based on selected subgroups. In our analysis of potential overinterpretation, authors of 89% (95% CI: 83%, 94%) of the studies did not include a sample size calculation, 88% (95% CI: 82%, 94%) did not state a test hypothesis, and 57% (95% CI: 48%, 66%) did not report CIs of accuracy measurements. In 43% (95% CI: 34%, 52%) of studies, authors were unclear about the intended role of the test, and in 3% (95% CI: 0%, 6%) they used inappropriate statistical tests. A subgroup analysis of imaging studies showed 16 (30%; 95% CI: 17%, 43%) and 53 (100%; 95% CI: 92%, 100%) contained forms of actual and potential overinterpretation, respectively.
CONCLUSION
Overinterpretation and misreporting of results in diagnostic accuracy studies is frequent in journals with high impact factors.
SUPPLEMENTAL MATERIAL
http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120527/-/DC1.
目的
评估诊断准确性研究中结果呈现失真和过度解读的频率。
材料与方法
在影响因子为 4 或更高的期刊上，检索 2010 年 1 月至 6 月发表的诊断准确性研究。纳入的文章为一项或多项检测准确性的原始研究，其中将检测结果与临床参考标准进行比较。两名作者使用预测试的数据提取表独立评分，以确定实际的过度解读和促进过度解读的做法，例如研究方法的不完整报告或使用不适当的方法（潜在的过度解读）。在所有研究中和影像学研究的亚组中，估计过度解读的频率。
结果
在 126 篇文章中，39 篇（31%；95%置信区间[CI]：23，39）存在某种形式的实际过度解读，其中 29 篇（23%；95% CI：16，30）的摘要过于乐观，10 篇（8%；96% CI：3%，13%）的研究目的与结论存在差异，8 篇的结论基于选择的亚组。在我们对潜在过度解读的分析中，89%（95% CI：83%，94%）的研究未进行样本量计算，88%（95% CI：82%，94%）未陈述检验假设，57%（95% CI：48%，66%）未报告准确性测量的置信区间。在 43%（95% CI：34%，52%）的研究中，作者对检测的预期作用不明确，3%（95% CI：0%，6%）的研究使用了不适当的统计检验。影像学研究的亚组分析显示，16 篇（30%；95% CI：17%，43%）和 53 篇（100%；95% CI：92%，100%）分别存在实际和潜在过度解读的形式。
结论
在高影响因子的期刊中，诊断准确性研究中存在过度解读和结果误报的情况较为常见。
补充材料
http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120527/-/DC1.
Zotero 插件