Brophy J M, Joseph L
Department of Medicine, Centre Hospitalier de Verdun, Quebec, Canada.
JAMA. 1995 Mar 15;273(11):871-5.
Standard statistical analyses of randomized clinical trials fail to provide a direct assessment of which treatment is superior or the probability of a clinically meaningful difference. A Bayesian analysis permits the calculation of the probability that a treatment is superior based on the observed data and prior beliefs. The subjectivity of prior beliefs in the Bayesian approach is not a liability, but rather explicitly allows different opinions to be formally expressed and evaluated. The usefulness of this approach is demonstrated using the results of the recent GUSTO study of various thrombolytic strategies in acute myocardial infarction. This analysis suggests that the clinical superiority of tissue-type plasminogen activator over streptokinase remains uncertain.
随机临床试验的标准统计分析无法直接评估哪种治疗方法更优，也无法评估出现具有临床意义差异的概率。贝叶斯分析允许根据观察到的数据和先验信念来计算一种治疗方法更优的概率。贝叶斯方法中先验信念的主观性并非缺点，而是明确允许不同观点得到正式表达和评估。利用近期急性心肌梗死各种溶栓策略的GUSTO研究结果证明了这种方法的实用性。该分析表明，组织型纤溶酶原激活剂相对于链激酶的临床优越性仍不确定。
