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对32项肺癌病例对照研究和2项氡气生态学研究的荟萃分析。

Meta-analysis of thirty-two case-control and two ecological radon studies of lung cancer.

作者信息

Dobrzynski Ludwik, Fornalski Krzysztof W, Reszczynska Joanna

机构信息

National Centre for Nuclear Research (NCBJ), ul. A. Soltana 7, 05-400 Otwock-Swierk, Poland.

PGE EJ 1, ul. Mysia 2, 00-496 Warszawa, Poland.

出版信息

J Radiat Res. 2018 Mar 1;59(2):149-163. doi: 10.1093/jrr/rrx061.

Abstract

A re-analysis has been carried out of thirty-two case-control and two ecological studies concerning the influence of radon, a radioactive gas, on the risk of lung cancer. Three mathematically simplest dose-response relationships (models) were tested: constant (zero health effect), linear, and parabolic (linear-quadratic). Health effect end-points reported in the analysed studies are odds ratios or relative risk ratios, related either to morbidity or mortality. In our preliminary analysis, we show that the results of dose-response fitting are qualitatively (within uncertainties, given as error bars) the same, whichever of these health effect end-points are applied. Therefore, we deemed it reasonable to aggregate all response data into the so-called Relative Health Factor and jointly analysed such mixed data, to obtain better statistical power. In the second part of our analysis, robust Bayesian and classical methods of analysis were applied to this combined dataset. In this part of our analysis, we selected different subranges of radon concentrations. In view of substantial differences between the methodology used by the authors of case-control and ecological studies, the mathematical relationships (models) were applied mainly to the thirty-two case-control studies. The degree to which the two ecological studies, analysed separately, affect the overall results when combined with the thirty-two case-control studies, has also been evaluated. In all, as a result of our meta-analysis of the combined cohort, we conclude that the analysed data concerning radon concentrations below 1000 Bq/m3 (20 mSv/year of effective dose to the whole body) do not support the thesis that radon may be a cause of any statistically significant increase in lung cancer incidence.

摘要

针对放射性气体氡对肺癌风险影响的32项病例对照研究和2项生态学研究进行了重新分析。测试了三种数学上最简单的剂量反应关系(模型):恒定(零健康效应)、线性和抛物线(线性 - 二次)。分析研究中报告的健康效应终点是比值比或相对风险比,与发病率或死亡率相关。在我们的初步分析中,我们表明,无论应用这些健康效应终点中的哪一个,剂量反应拟合的结果在定性上(在给定为误差线的不确定性范围内)都是相同的。因此,我们认为将所有反应数据汇总为所谓的相对健康因子并对这些混合数据进行联合分析以获得更好的统计功效是合理的。在我们分析的第二部分,将稳健的贝叶斯分析方法和经典分析方法应用于这个合并数据集。在我们分析的这一部分中,我们选择了不同的氡浓度子范围。鉴于病例对照研究和生态学研究的作者所使用方法存在重大差异,数学关系(模型)主要应用于32项病例对照研究。还评估了两项生态学研究在与32项病例对照研究合并时单独分析对总体结果的影响程度。总之,作为我们对合并队列的荟萃分析结果,我们得出结论,关于氡浓度低于约1000 Bq/m³(全身有效剂量约20 mSv/年)的分析数据不支持氡可能导致肺癌发病率有任何统计学显著增加的论点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c6a/5950923/73c0ba8a1c07/rrx061f01.jpg

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