Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
Int J Methods Psychiatr Res. 2013 Dec;22(4):288-302. doi: 10.1002/mpr.1399.
The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) is a multi-component epidemiological and neurobiological study designed to generate actionable recommendations to reduce US Army suicides and increase knowledge about determinants of suicidality. Three Army STARRS component studies are large-scale surveys: one of new soldiers prior to beginning Basic Combat Training (BCT; n = 50,765 completed self-administered questionnaires); another of other soldiers exclusive of those in BCT (n = 35,372); and a third of three Brigade Combat Teams about to deploy to Afghanistan who are being followed multiple times after returning from deployment (n = 9421). Although the response rates in these surveys are quite good (72.0-90.8%), questions can be raised about sample biases in estimating prevalence of mental disorders and suicidality, the main outcomes of the surveys based on evidence that people in the general population with mental disorders are under-represented in community surveys. This paper presents the results of analyses designed to determine whether such bias exists in the Army STARRS surveys and, if so, to develop weights to correct for these biases. Data are also presented on sample inefficiencies introduced by weighting and sample clustering and on analyses of the trade-off between bias and efficiency in weight trimming.
陆军军人风险与韧性评估研究（Army STARRS）是一项多组成部分的流行病学和神经生物学研究，旨在提出切实可行的建议，以降低美国陆军的自杀率，并增加对自杀倾向决定因素的了解。陆军 STARRS 的三个组成部分研究是大规模调查：一项是在开始基础战斗训练（BCT）之前对新兵进行的调查（完成了 50765 份自我管理问卷）；另一项是对 BCT 以外的其他士兵进行的调查（完成了 35372 份问卷）；第三项是对即将部署到阿富汗的三个旅战斗队进行的调查，他们在部署后多次被跟踪（完成了 9421 份问卷）。尽管这些调查的回复率相当高（72.0-90.8%），但仍存在一些问题，例如在估计精神障碍和自杀倾向的患病率时，样本可能存在偏差，而这些正是调查的主要结果，这是基于人群中患有精神障碍的人群在社区调查中代表性不足的证据。本文介绍了旨在确定陆军 STARRS 调查中是否存在这种偏差的分析结果，如果存在，还将开发权重来纠正这些偏差。还介绍了加权和样本聚类引入的样本效率低下的情况，以及在权重修剪中权衡偏差和效率的分析结果。
