Toranomon Hospital, Nephrology Center, 2-2-2, Toranomon, Minato-ku, Tokyo, 105-8470, Japan.
Clin Exp Nephrol. 2020 Jun;24(6):491-499. doi: 10.1007/s10157-020-01870-3. Epub 2020 Mar 24.
Over the past 20 years, recent advances in science technologies have dramatically changed the styles of clinical research. Currently, it has become more popular to use recent modern epidemiological techniques, such as propensity score, instrumental variable, competing risks, marginal structural modeling, mixed effects modeling, bootstrapping, and missing data analyses, than before. These advanced techniques, also known as modern epidemiology, may be strong tools for performing good clinical research, especially in large-scale observational studies, along with relevant research questions, good databases, and the passion of researchers. However, to use these methods effectively, we need to understand the basic assumptions behind them. Here, I will briefly introduce the concepts of these techniques and their implementation. In addition, I would like to emphasize that various types of clinical studies, not only large database studies but also small studies on rare and intractable diseases, are equally important because clinicians always do their best to take care of many kinds of patients who suffer from various kidney diseases and this is our most important mission.
在过去的 20 年中，科学技术的最新进展极大地改变了临床研究的方式。目前，使用最新的现代流行病学技术（如倾向评分、工具变量、竞争风险、边际结构模型、混合效应模型、自举法和缺失数据分析）比以往更为流行。这些先进的技术，也被称为现代流行病学，可能是进行良好临床研究的有力工具，尤其是在大规模观察性研究中，同时还需要相关的研究问题、良好的数据库和研究人员的热情。然而，要有效地使用这些方法，我们需要了解它们背后的基本假设。在这里，我将简要介绍这些技术的概念及其实现。此外，我想强调的是，各种类型的临床研究，不仅是大型数据库研究，还有针对罕见和疑难疾病的小型研究，都同样重要，因为临床医生总是竭尽全力照顾患有各种肾脏疾病的众多患者，这是我们最重要的使命。
