Vitrai J, Czobor P
Országos Pszichiátriai és Neurológiai Intézet, Budapest.
Orv Hetil. 1996 Mar 3;137(9):465-72.
The objective was to assess the level of use of statistics in the articles of the Orvosi Hetilap (OH). Eight clinical and 25 randomly selected general medical papers (published in 1992) were evaluated with the help of checklists used in the British Medical Journal (BMJ). The result was compared with the survey conducted in the BMJ (Gardner and Bond, JAMA, 1990, 263, 1355-1357). Two clinical studies were found suitable for publication without further revision. All the general papers needed revision and in 8 studies no changes appeared to be sufficient for publication. For the clinical and general articles, respectively, loglinear modelling showed a 4 and 6 times higher likelihood for satisfactory qualification in the BMJ than in the OH. In the OH, the quality of the analysis and presentation was rated the least satisfactory while the design was assessed the best among all checklist items. The main source of methodological flaws were either the lack of any statistical method or the inappropriate selection of them. The validity of the results published in the papers evaluated was often diminished by multiple testing or neglecting potential confounders. Contribution of statisticians appears desirable in planning and evaluating the investigation. Following the practice in the major medical journals, introduction of statistical review in the OH was suggested. In the view of the authors, reforms in medical education and research seem to be unavoidable for responding to the challenge of today's medical methodology.
目的是评估《匈牙利医学周报》(OH)刊载文章中统计学的应用水平。借助《英国医学杂志》(BMJ)使用的清单,对8篇临床论文和25篇随机选取的普通医学论文(发表于1992年)进行了评估。将结果与在BMJ上进行的调查(Gardner和Bond,《美国医学会杂志》,1990年,263卷,1355 - 1357页)进行了比较。发现2篇临床研究无需进一步修改即可发表。所有普通论文都需要修改,8项研究中似乎没有任何修改足以达到发表要求。对于临床和普通文章,对数线性模型显示,在BMJ上获得满意评分的可能性分别比在OH上高4倍和6倍。在OH中,分析和呈现的质量被评为最不满意,而在所有清单项目中设计被评估为最佳。方法学缺陷的主要来源要么是缺乏任何统计方法,要么是对统计方法选择不当。所评估论文中发表结果的有效性常常因多重检验或忽视潜在混杂因素而降低。统计学家参与研究设计和评估似乎是可取的。遵循主要医学期刊的做法,建议在OH中引入统计学审查。作者认为,为应对当今医学方法学的挑战,医学教育和研究改革似乎不可避免。