Schaaf B, Linden M, Weber H J
Factum-Gesellschaft für Statistik, wissenschaftliche Information und Kommunikation mbH, Offenbach, Germany.
Pharmacopsychiatry. 1997 Jan;30(1 Suppl):44-51. doi: 10.1055/s-2007-979516.
This study presents a methodological approach to an expost facto investigation of sample bias in drug utilization observation (DUO) studies using the example of a DUO with the nontricyclic antidepressant fluoxetine. A total of 479 psychiatrists and neurologists and 2,401 patients were investigated. The purpose of the study was to judge the representativeness of our DUO sample for two populations: first, for all psychiatrics and neurologists prescribing fluoxetine or all patients being treated with fluoxetine in Germany and, second, for all psychiatrists and neurologists prescribing antidepressants or all patients being treated with antidepressants in Germany. Criteria for the representativeness test were physician variables (gender, size of community where practicing, federal state, age, volume of prescriptions) and patient variables (gender, age, prescription-related diagnosis, concurrent illnesses, concomitant medications). The study shows that the DUO sample can rightfully claim representativeness in the majority of parameters for the psychiatrists and neurologists prescribing fluoxetine and for the patients being treated with fluoxetine. There are more noticeable discrepancies with regard to the psychiatrists and neurologists in general and to the patients being treated with antidepressants in general. The methodological problems of pharmacoepidemiological investigation of representativeness are discussed.
本研究以非三环类抗抑郁药氟西汀的药物利用观察（DUO）为例，提出了一种对药物利用观察研究中的样本偏差进行事后调查的方法。共对479名精神科医生和神经科医生以及2401名患者进行了调查。该研究的目的是判断我们的DUO样本对两个人群的代表性：第一，对于德国所有开具氟西汀处方的精神科医生和神经科医生或所有接受氟西汀治疗的患者；第二，对于德国所有开具抗抑郁药处方的精神科医生和神经科医生或所有接受抗抑郁药治疗的患者。代表性测试的标准包括医生变量（性别、执业社区规模、联邦州、年龄、处方量）和患者变量（性别、年龄、与处方相关的诊断、并发疾病、伴随用药）。研究表明，DUO样本在大多数参数上可以合理地声称对开具氟西汀处方的精神科医生和神经科医生以及接受氟西汀治疗的患者具有代表性。对于一般的精神科医生和神经科医生以及一般接受抗抑郁药治疗的患者，差异更为明显。讨论了药物流行病学代表性调查的方法学问题。
