Division of Acute Care Surgery, Department of Surgery, McGovern Medical School at UTHealth, Houston, Texas, USA.
Center for Surgical Trials and Evidence-based Practice, McGovern Medical School at UTHealth, Houston, Texas, USA.
Surg Infect (Larchmt). 2021 Aug;22(6):620-625. doi: 10.1089/sur.2020.391. Epub 2020 Dec 31.
Application of clinical study findings to surgical decision making requires accurate interpretation of the results, integration of the findings within the context of pre-existing knowledge and use of statistics to answer clinically relevant questions. Bayesian analyses are optimally suited for interpretation of study findings, supporting translation to the bedside. Surgical decision making is a complex process that draws on an individual clinician's medical knowledge, experience, data, and the patient's unique characteristics and preferences. Subjective and objective knowledge may be merged to derive a probability of benefit or harm of a treatment under consideration. Bayesian reasoning complements the clinical decision-making process by incorporating known evidence and data from a new study to determine the probability of an outcome of interest. Bayesian analyses are statistically robust and intuitive when translating findings of a study into clinical care. In contrast, frequentist statistics are poorly suited to translate study findings to clinical application. This review aims to highlight the benefits of incorporating Bayesian analyses into clinical research. Bayesian analyses offer clinically relevant information including the probability of benefit or harm of a treatment under consideration while accounting for uncertainty. This information may be incorporated easily and accurately into surgical decision making.
临床研究结果在外科决策中的应用需要对结果进行准确的解读,将研究结果与现有知识背景相结合,并运用统计学来回答临床相关问题。贝叶斯分析最适合用于解读研究结果,支持将研究结果转化为临床实践。外科决策是一个复杂的过程,需要综合考虑个体临床医生的医学知识、经验、数据以及患者的独特特征和偏好。主观知识和客观知识可以合并,以得出考虑中的治疗方法的获益或危害的概率。贝叶斯推理通过整合已知的证据和来自新研究的数据来确定感兴趣的结果的概率,从而补充临床决策过程。贝叶斯分析在将研究结果转化为临床护理方面具有统计学稳健性和直观性。相比之下,频率统计学方法不适合将研究结果转化为临床应用。本文旨在强调将贝叶斯分析纳入临床研究的益处。贝叶斯分析提供了与临床相关的信息,包括考虑中的治疗方法的获益或危害的概率,同时考虑了不确定性。这些信息可以方便、准确地纳入外科决策中。