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多变量荟萃分析有助于检查 Cochrane 类风湿关节炎综述中结局报告偏倚的影响。

Multivariate meta-analysis helps examine the impact of outcome reporting bias in Cochrane rheumatoid arthritis reviews.

机构信息

Department of Biostatistics, University of Liverpool, 1st Floor Duncan Building, Daulby Street, Liverpool, L69 3GA, United Kingdom.

School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom.

出版信息

J Clin Epidemiol. 2015 May;68(5):542-50. doi: 10.1016/j.jclinepi.2014.11.017. Epub 2014 Nov 28.

DOI:10.1016/j.jclinepi.2014.11.017
PMID:25537265
Abstract

OBJECTIVES

Outcome reporting bias (ORB) is a threat to validity of systematic reviews. Multivariate meta-analysis (MVMA) can potentially reduce the impact of ORB when outcomes are correlated. The aim of this study was to assess ORB in Cochrane systematic reviews of rheumatoid arthritis and to demonstrate how MVMA may examine its impact.

STUDY DESIGN AND SETTING

Reviews were assessed for ORB in relation to eight outcomes for rheumatoid arthritis using a nine-point classification system. Impact of ORB was assessed by comparing estimates from univariate meta-analysis and MVMA models.

RESULTS

ORB assessment was applied in 21 included reviews, and all contained missing data on at least one of the eight outcomes. ORB was highly suspected in 247 (22%) of the 1,118 evaluable outcomes from 155 assessable trials. MVMA and univariate results sometimes differed importantly. The maximum change in treatment effect estimate between MVMA and univariate meta-analysis approach was found to be 176% for one of the outcome considered.

CONCLUSION

ORB has the potential to affect the conclusions in meta-analyses. This could be avoided if trialists reported on all measured outcomes in full. If missing outcome data are unobtainable, MVMA is useful to examine the impact of missing outcomes and ORB on conclusions.

摘要

目的

结局报告偏倚（outcome reporting bias，ORB）是系统评价有效性的威胁。当结局相关时，多变量 meta 分析（multivariate meta-analysis，MVMA）可能会降低 ORB 的影响。本研究旨在评估类风湿关节炎 Cochrane 系统评价中的 ORB，并展示 MVMA 如何检验其影响。

研究设计和设置

使用九点分类系统，对 21 篇纳入的评价中与 8 项类风湿关节炎结局相关的 ORB 进行评估。通过比较单变量 meta 分析和 MVMA 模型的估计值来评估 ORB 的影响。

结果

21 篇纳入的评价均进行了 ORB 评估，155 项可评估试验中 1118 个可评估结局中有 247 个（22%）高度怀疑存在 ORB。MVMA 和单变量结果有时差异显著。在考虑的一个结局中，MVMA 和单变量 meta 分析方法之间治疗效果估计值的最大变化为 176%。

结论

ORB 有可能影响 meta 分析的结论。如果试验者完整报告所有测量的结局，就可以避免这种情况。如果无法获得缺失结局数据，MVMA 可用于检验缺失结局和 ORB 对结论的影响。

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