从临床样本到社区样本的发现的可推广性：ADNI 与 ARIC 的比较。
Generalizability of findings from a clinical sample to a community-based sample: A comparison of ADNI and ARIC.
机构信息
Department of Epidemiology, George Washington University, Washington, District of Columbia, USA.
Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, USA.
出版信息
Alzheimers Dement. 2021 Aug;17(8):1265-1276. doi: 10.1002/alz.12293. Epub 2021 Feb 1.
INTRODUCTION
Clinic-based study samples, including the Alzheimer's Disease Neuroimaging Initiative (ADNI), offer rich data, but findings may not generalize to community-based settings. We compared associations in ADNI to those in the Atherosclerosis Risk in Communities (ARIC) study to assess generalizability across the two settings.
METHODS
We estimated cohort-specific associations among risk factors, cognitive test scores, and neuroimaging outcomes to identify and quantify the extent of significant and substantively meaningful differences in associations between cohorts. We explored whether using more homogenous samples improved comparability in effect estimates.
RESULTS
The proportion of associations that differed significantly between cohorts ranged from 27% to 34% across sample subsets. Many differences were substantively meaningful (e.g., odds ratios [OR] for apolipoprotein E ε4 on amyloid positivity in ARIC: OR = 2.8, in ADNI: OR = 8.6).
DISCUSSION
A higher proportion of associations differed significantly and substantively than would be expected by chance. Findings in clinical samples should be confirmed in more representative samples.
简介
基于临床的研究样本，包括阿尔茨海默病神经影像学倡议（ADNI），提供了丰富的数据，但研究结果可能无法推广到基于社区的环境。我们将 ADNI 中的发现与动脉粥样硬化风险社区（ARIC）研究中的发现进行了比较，以评估两种环境之间的可推广性。
方法
我们估计了风险因素、认知测试分数和神经影像学结果之间的队列特异性关联，以确定和量化队列之间关联的显著和实质性差异的程度。我们探讨了使用更同质的样本是否可以改善效应估计的可比性。
结果
在样本子集中，差异显著的关联比例从 27%到 34%不等。许多差异具有实质性意义（例如，载脂蛋白 E ε4 对 ARIC 中淀粉样蛋白阳性的比值比 [OR]：OR=2.8，在 ADNI 中：OR=8.6）。
讨论
与预期相比，更多的关联存在显著和实质性差异。临床样本中的发现应在更具代表性的样本中得到证实。
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