Illescas Alex, Zhong Haoyan, Cozowicz Crispiana, Gonzalez Della Valle Alejandro, Liu Jiabin, Memtsoudis Stavros G, Poeran Jashvant
From the Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, New York.
Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria.
Anesth Analg. 2022 Mar 1;134(3):540-547. doi: 10.1213/ANE.0000000000005884.
The use of large data sources such as registries and claims-based data sets to perform health services research in anesthesia has increased considerably, ultimately informing clinical decisions, supporting evaluation of policy or intervention changes, and guiding further research. These observational data sources come with limitations that must be addressed to effectively examine all aspects of health care services and generate new individual- and population-level knowledge. Several statistical methods are growing in popularity to address these limitations, with the goal of mitigating confounding and other biases. In this article, we provide a brief overview of common statistical methods used in health services research when using observational data sources, guidance on their interpretation, and examples of how they have been applied to anesthesia-related health services research. Methods described involve regression, propensity scoring, instrumental variables, difference-in-differences, interrupted time series, and machine learning.
利用诸如登记处和基于索赔的数据集等大型数据源来开展麻醉领域的卫生服务研究的情况已大幅增加,最终为临床决策提供依据、支持对政策或干预措施变化的评估并指导进一步研究。这些观察性数据源存在一些局限性,必须加以解决才能有效审视卫生保健服务的各个方面并产生新的个体层面和人群层面的知识。有几种统计方法越来越受欢迎,旨在解决这些局限性,以减轻混杂因素和其他偏差。在本文中,我们简要概述了在使用观察性数据源进行卫生服务研究时常用的统计方法、对其解读的指导以及它们在麻醉相关卫生服务研究中的应用示例。所描述的方法包括回归、倾向评分、工具变量、差异中的差异、中断时间序列和机器学习。