Spiegelhalter D J, Freedman L S, Parmar M K
MRC Biostatistics Unit, Institute of Public Health, Cambridge, U.K.
Stat Med. 1993 Aug;12(15-16):1501-11; discussion 1513-7. doi: 10.1002/sim.4780121516.
The Bayesian paradigm emphasizes that studies are not performed in isolation, and that external evidence can be used formally in the design, monitoring and reporting of clinical trials. A variety of tools for assessing the current evidence for treatment efficacy are presented, making use of graphical display to provide insight into ethical and efficiency issues in starting and stopping trials--these are illustrated with a trial in osteosarcoma that is currently taking place. Finally we recommend that an additional 'interpretation' section is placed in clinical reports to provide a bridge between 'results' and 'discussion'--it is this section that would contain the Bayesian perspective.
贝叶斯范式强调，研究并非孤立进行，外部证据可正式用于临床试验的设计、监测和报告。本文介绍了多种评估当前治疗效果证据的工具，利用图形展示来深入了解启动和停止试验中的伦理和效率问题——以目前正在进行的一项骨肉瘤试验为例进行说明。最后，我们建议在临床报告中增设一个“解读”部分，以在“结果”和“讨论”之间架起一座桥梁——正是这一部分将包含贝叶斯观点。
