Bertrand P
Département de radiologie adultes, Hôpital Bretonneau, CHU de Tours, France.
Sante. 1996 May-Jun;6(3):139-44.
A scientific article should convey valid information to the reader. To reach this goal, the article must meet several criteria. First, the problem must be clearly stated. For example with medical imaging, the two types of studies are: -a descriptive study depicting a particular situation; -a comparative analytical study, either evaluating a diagnostic method or searching for prognostic factors. The process of defining the sample population can be distinguished: -Experimental studies can compare two groups of people who, after drawing lots, received differential treatment. -Alternatively, observational studies can investigate either representative samples, exposed versus nonexposed cases, or control cases. Characteristics of the variables are very important. Statistical methods facilitate the analysis of three types of variables: qualitative, quantitative and survival variables. Statistical analysis is used to extrapolate the results of the sample population of the study to the target population. Then, presentation, interpretation and extrapolation of the results must be done using three methods: First, the descriptive study should accurately depict the disease. It must be representative of the pathology relative to the clinical manifestations and avoid any bias. Then, the comparative analytical study for revealing the prognostic factors. These types of studies can be divided into three steps: -by performing the suitable statistical tests, a significant correlation between the prognostic factors and the outcome of the disease can or cannot be demonstrated; -any bias must be eliminated; -this correlation can be quantified by measuring it as a risk; Finally, the evaluation of the diagnostic methods are mostly used in medical imaging to determine which factors need to be measured. Five criteria can be followed for these types of studies: -to obtain good technical quality; -to interpret the results consistently; -to give valid information (requiring proper classification of the clinical signs of the patients according to the definition of disease); -to be helpful in determining the treatment; -to be efficient for the patient and the population. The results of a study on the diagnostic value of a medical test must be expressed as an index of sensitivity, or the rate of true positives versus negatives. This facilitates the calculation of the positive predictive value, i.e. the probability for a patient to become ill if the medical test is positive, versus the negative predictive value, i.e. the probability for a patient to remain healthy if the test is negative. The rigorous methodology of scientific work requires: -clear formulation of the problem; -good definition of the situation and the variables to be measured; -the proper method to collect the data; -the description of the study protocol.
一篇科学文章应向读者传达有效的信息。为实现这一目标,文章必须满足若干标准。首先,问题必须明确阐述。例如在医学成像方面,有两种研究类型:——描述特定情况的描述性研究;——评估诊断方法或寻找预后因素的比较分析研究。定义样本群体的过程可加以区分:——实验性研究可以比较两组在抽签后接受不同治疗的人群。——或者,观察性研究可以调查代表性样本、暴露组与非暴露组病例或对照组病例。变量的特征非常重要。统计方法有助于分析三种类型的变量:定性变量、定量变量和生存变量。统计分析用于将研究的样本群体结果外推至目标群体。然后,必须使用三种方法进行结果的呈现、解释和外推:首先,描述性研究应准确描述疾病。它必须相对于临床表现具有病理学代表性,并避免任何偏差。其次,用于揭示预后因素的比较分析研究。这类研究可分为三个步骤:——通过进行适当的统计检验,可证明或无法证明预后因素与疾病结局之间存在显著相关性;——必须消除任何偏差;——这种相关性可通过将其作为风险进行测量来量化;最后,诊断方法的评估主要用于医学成像以确定需要测量哪些因素。对于这类研究可遵循五条标准:——获得良好的技术质量;——一致地解释结果;——提供有效的信息(要求根据疾病定义对患者的临床体征进行适当分类);——有助于确定治疗方案;——对患者和人群有效。一项关于医学检验诊断价值的研究结果必须表示为敏感性指数,即真阳性率与真阴性率之比。这便于计算阳性预测值,即医学检验呈阳性时患者患病的概率,以及阴性预测值,即检验呈阴性时患者保持健康的概率。科学工作的严谨方法要求:——明确阐述问题;——很好地定义情况和要测量的变量;——收集数据的恰当方法;——描述研究方案。