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临床医生对漏斗图的理解与解读

Understanding and interpreting funnel plots for the clinician.

作者信息

Godavitarne Charles, Robertson Alastair, Ricketts David M, Rogers Benedict A

机构信息

Registrar, Department of Trauma and Orthopaedics, Princess Royal Hospital, Brighton and Sussex University Hospitals NHS Trust, Haywards Heath, Sussex.

Consultant Surgeon, Department of Trauma and Orthopaedics, Princess Royal Hospital, Brighton and Sussex University Hospitals NHS Trust, Haywards Heath, Sussex.

出版信息

Br J Hosp Med (Lond). 2018 Oct 2;79(10):578-583. doi: 10.12968/hmed.2018.79.10.578.

Abstract

Funnel plots are an increasingly common graphical tool which are widely used in the literature. They were first introduced by Light and Pillemer in 1984 . In scientific literature, funnel plots are used to identify the probability of bias in meta-analyses and compare institutional performance. The ability to identify variation is better with graphical than tabular display. In addition, the way data are presented can directly influence the interpretation of results. This was demonstrated by Marshall et al (2004) , who presented institutional mortality data in both a league table and control chart format. This study illustrated that when displayed as a league table, a greater number of units were identified for investigation than were actually required. The use of control charts or funnel plots may therefore show benefit in reducing the number of inappropriately labelled outliers. This article explains how clinicians should read and interpret funnel plots, and discusses their considerations and limitations.

摘要

漏斗图是一种越来越常见的图形工具,在文献中被广泛使用。它们于1984年由莱特和皮尔默首次提出。在科学文献中,漏斗图用于识别荟萃分析中的偏倚概率并比较机构绩效。通过图形显示比表格显示更能识别变异。此外,数据呈现的方式会直接影响结果的解释。马歇尔等人(2004年)证明了这一点,他们以排行榜和控制图两种格式呈现机构死亡率数据。这项研究表明,当以排行榜形式显示时,被确定需要调查的单位数量比实际需要的更多。因此,使用控制图或漏斗图可能有助于减少被不恰当地标记为异常值的数量。本文解释了临床医生应如何阅读和解释漏斗图,并讨论了它们的注意事项和局限性。

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