Brookhart Maurice Alan, Todd Jonathan V, Li Xiaojuan, Reams B Diane, Pate Virginia, Kshirsagar Abhijit V
Department of Epidemiology, UNC Gillings School of Global Public Health, UNC Chapel Hill, Chapel Hill, NC; Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill.
Department of Epidemiology, UNC Gillings School of Global Public Health, UNC Chapel Hill, Chapel Hill, NC.
Ann Epidemiol. 2014 Oct;24(10):754-61. doi: 10.1016/j.annepidem.2014.07.013. Epub 2014 Aug 6.
To examine the extent to which commonly ordered laboratory values obtained from large health care databases are representative of the distribution of laboratory values from the general population as reflected in the National Health and Nutrition Examination Survey.
Means of test values from commercial insurance laboratory data and National Health and Nutrition Examination Survey data were compared. Inverse probability of selection weighting was used to account for possible selection bias and to create comparability between the two data sources.
The average values of most of the laboratory results from routine care were very close to their population means as estimated from NHANES. Tests that were more selectively ordered tended to differ. The inverse probability of selection weighting approach generally had a small effect on the estimated means but did improve estimation of some of the more selected tests.
Commonly ordered laboratory tests appear to be representative of values from the underlying population. This suggests that trends and other patterns in biomarker levels in the population may be reasonably studied using data collected during the routine delivery of medical care.
研究从大型医疗保健数据库中获取的常用实验室检查值在多大程度上能代表全国健康和营养检查调查所反映的一般人群的实验室检查值分布。
比较了商业保险实验室数据和全国健康和营养检查调查数据中的检查值均值。采用选择加权的逆概率来考虑可能的选择偏倚，并使两个数据源具有可比性。
常规护理中大多数实验室检查结果的平均值与根据美国国家健康与营养检查调查（NHANES）估计的总体均值非常接近。更具选择性地进行的检查往往存在差异。选择加权的逆概率方法通常对估计均值影响较小，但确实改善了一些更具选择性的检查的估计。
常用的实验室检查似乎能代表基础人群的值。这表明，利用医疗护理常规提供过程中收集的数据，可以合理地研究人群中生物标志物水平的趋势和其他模式。
