Department of Epidemiology, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA
Program in Quantitative Biomedical Sciences, Dartmouth College Geisel School of Medicine, Hanover, NH, USA.
Reg Anesth Pain Med. 2021 Nov;46(11):936-940. doi: 10.1136/rapm-2020-101984. Epub 2021 May 21.
Observational clinical research studies aim to assess which exposures (treatments or other factors; independent variable) affect patient outcomes (dependent variable). These exposures include medical interventions in situations where clinical trials are not possible or prior to their conduct and completion. However, the assessment of the relationship between exposures and outcomes is not straightforward, as other variables may need to be considered prior to reaching valid conclusions. Here, we present three hypothetical scenarios in regional anesthesia to review the epidemiological concepts of confounding, mediation, and effect modification. Understanding these concepts is critical for assessing the design, analysis, and interpretation of clinical studies. These terms may be confusing to anesthesiologists and researchers alike, where such confusion could affect the conclusions of a clinical study, mislead the target audience, and ultimately impact patient health.
观察性临床研究旨在评估哪些暴露因素（治疗或其他因素；自变量）会影响患者的结局（因变量）。这些暴露因素包括在临床试验不可行或在临床试验进行和完成之前的情况下的医疗干预。然而，评估暴露因素和结局之间的关系并不简单，因为在得出有效结论之前可能需要考虑其他变量。在这里，我们提出了区域麻醉中的三个假设情况，以回顾混杂、中介和效应修饰的流行病学概念。理解这些概念对于评估临床研究的设计、分析和解释至关重要。这些术语可能会让麻醉师和研究人员感到困惑，如果这种混淆会影响临床研究的结论，误导目标受众，并最终影响患者的健康。
