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关于 mRNA-COVID 19 疫苗在孕妇中安全性数据的统计学呈现的争议。

Controversies around the statistical presentation of data on mRNA-COVID 19 vaccine safety in pregnant women.

机构信息

Department of Computer and Information Science, Linköping University, 581 83 Linköping, Sweden.

Department of Cell Biology and Immunology, Intercollegiate Faculty of Biotechnology, University of Gdańsk and Medical University of Gdańsk, Gdańsk, Poland.

出版信息

J Reprod Immunol. 2022 Jun;151:103503. doi: 10.1016/j.jri.2022.103503. Epub 2022 Mar 4.

Abstract

The work entitled "Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons" published on April 21, 2021, in The New England Journal of Medicine, presented data collected from American surveillance systems and registries. However, problems with an unanimous interpretation of those results appeared in the public debate and citing articles. Some stated that the risk of miscarriage in vaccinated women was similar to historical values reported before the vaccines' approval. The others stated that risk was highly above-normative in women vaccinated during the first and second trimesters. We found several problems with the statistical treatment/interpretation of the originally presented values: a substantial percentage (up to 95.6%) of missing data, an incorrect denominator used for risk estimation, and too short follow-up that disabled the evaluation of the study's endpoint in numerous participants. Eventually, the Authors published a corrigendum on September 8, 2021, and pointed to updated data. Herein, we explain the statistical controversies raised by the original presentation and stress that analyzing the trade-off between knowledge and confusion brought by the release of incomplete results of such a high social interest, should aid in solving the dilemma of whether to publish preliminary data or none.

摘要

标题为“mRNA 新冠疫苗在孕妇中安全性的初步发现”的研究报告于 2021 年 4 月 21 日发表在《新英格兰医学杂志》上,该报告的数据来源于美国的监测系统和注册中心。然而,在公众辩论和引用文章中,对于这些结果的解释存在分歧。一些人认为,接种疫苗的女性流产的风险与疫苗批准前报告的历史值相似。另一些人则表示,在第一和第二孕期接种疫苗的女性,风险高得离谱。我们发现原始报告中的统计处理/解释存在几个问题:大量(高达 95.6%)数据缺失,用于风险估计的错误分母,以及随访时间过短,导致许多参与者无法评估研究的终点。最终,作者于 2021 年 9 月 8 日发表了勘误,并指出了更新的数据。在此,我们解释了原始报告中提出的统计争议,并强调分析在发布如此高社会关注度的不完全结果时,在知识和混淆之间权衡取舍,应该有助于解决是否发布初步数据或不发布数据的困境。

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本文引用的文献

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