Statistical methods

统计方法
  • 文章类型: Journal Article
    饮食和运动行为(身体活动[PA],久坐行为[SED],和睡眠)发生在24小时的一天中,涉及多种环境。了解这些24小时行为的时间模式及其背景决定因素是确定其对健康的综合影响的关键。进行了范围审查,以确定用于确定时间行为模式及其上下文相关关系的新颖分析方法。我们搜查了Embase,2022年7月的ProQuest和EBSCOhost数据库,以确定1997年至2022年之间发表的关于时间模式及其上下文相关的研究(例如,locational,社会,环境,personal).我们在标题和摘要(n=33,292)和全文(n=135)筛选后纳入了14项研究,其中11个是在2018年之后发布的。大多数研究(成人n=4;儿童和青少年n=5),检查清醒行为模式(即,PA和SED),其中三个还包括睡眠,六个包括上下文相关因素。仅在一项成人研究中一起检查了PA和饮食。饮食的上下文相关因素,还检查了PA和睡眠时间行为模式。具有各种聚类算法和基于模型的聚类技术的机器学习最多用于确定24小时的时间行为模式。虽然纳入的研究使用了多种方法,行为变量和评估时间段,结果表明,以高SED和低PA为特征的时间模式与较差的健康结果有关,与低SED和高PA相比。这篇评论确定了时间行为模式,以及它们的上下文关联,这与肥胖和心脏代谢疾病风险相关,表明这些方法有望发现对健康重要的整体生活方式暴露。方法和模式的标准化报告以及营养学之间的多学科合作,身体活动和睡眠研究人员,统计学家,计算机科学家被确定为推进未来与健康相关的时间行为模式研究的关键途径。
    Dietary and movement behaviors [physical activity (PA), sedentary behavior (SED), and sleep] occur throughout a 24-h day and involve multiple contexts. Understanding the temporal patterning of these 24-h behaviors and their contextual determinants is key to determining their combined effect on health. A scoping review was conducted to identify novel analytic methods for determining temporal behavior patterns and their contextual correlates. We searched Embase, ProQuest, and EBSCOhost databases in July 2022 to identify studies published between 1997 and 2022 on temporal patterns and their contextual correlates (e.g., locational, social, environmental, personal). We included 14 studies after title and abstract (n = 33,292) and full-text (n = 135) screening, of which 11 were published after 2018. Most studies (n = 4 in adults; n = 5 in children and adolescents), examined waking behavior patterns (i.e., both PA and SED) of which 3 also included sleep and 6 included contextual correlates. PA and diet were examined together in only 1 study of adults. Contextual correlates of dietary, PA, and sleep temporal behavior patterns were also examined. Machine learning with various clustering algorithms and model-based clustering techniques were most used to determine 24-h temporal behavior patterns. Although the included studies used a diverse range of methods, behavioral variables, and assessment periods, results showed that temporal patterns characterized by high SED and low PA were linked to poorer health outcomes, than those with low SED and high PA. This review identified temporal behavior patterns, and their contextual correlates, which were associated with adiposity and cardiometabolic disease risk, suggesting these methods hold promise for the discovery of holistic lifestyle exposures important to health. Standardized reporting of methods and patterns and multidisciplinary collaboration among nutrition, PA, and sleep researchers; statisticians; and computer scientists were identified as key pathways to advance future research on temporal behavior patterns in relation to health.
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  • 文章类型: Journal Article
    医学研究提供了疾病预测的潜力,像多发性硬化症(MS)。这种神经紊乱会损害神经细胞鞘,治疗的重点是缓解症状。手动MS检测耗时且容易出错。尽管已经研究了MS病变检测,对临床分析和计算风险因素预测的关注有限。人工智能(AI)技术和机器学习(ML)方法为映射MS进展提供了准确有效的替代方案。然而,在获取临床数据和跨学科合作方面存在挑战.通过分析103篇论文,我们认识到趋势,人工智能的优点和缺点,ML,和统计学方法应用于MS诊断。建议使用基于AI/ML的方法来识别MS风险因素,选择重要的MS功能,提高诊断的准确性,如基于规则的模糊逻辑(RBFL),自适应模糊推理系统(ANFIS),人工神经网络方法(ANN),支持向量机(SVM)和贝叶斯网络(BNs)。同时,扩展的残疾状态量表(EDSS)和磁共振成像(MRI)的应用可以提高MS诊断的准确性。通过检查肥胖等既定风险因素,吸烟,和教育,一些研究解决了疾病进展的问题。绩效指标在MS研究的不同方面有所不同:诊断:灵敏度范围从60%到98%,特异性从60%到98%,准确率从61%到97%。预测:敏感度从76%到98%,特异性从65%到98%,准确率从62%到99%。分割:准确率高达96.7%。分类:敏感度从78%到97.34%,特异性从65%到99.32%,准确率从71%到97.94%。此外,文献表明,组合技术可以提高效率,利用他们的优势获得更好的整体表现。
    Medical research offers potential for disease prediction, like Multiple Sclerosis (MS). This neurological disorder damages nerve cell sheaths, with treatments focusing on symptom relief. Manual MS detection is time-consuming and error prone. Though MS lesion detection has been studied, limited attention has been paid to clinical analysis and computational risk factor prediction. Artificial intelligence (AI) techniques and Machine Learning (ML) methods offer accurate and effective alternatives to mapping MS progression. However, there are challenges in accessing clinical data and interdisciplinary collaboration. By analyzing 103 papers, we recognize the trends, strengths and weaknesses of AI, ML, and statistical methods applied to MS diagnosis. AI/ML-based approaches are suggested to identify MS risk factors, select significant MS features, and improve the diagnostic accuracy, such as Rule-based Fuzzy Logic (RBFL), Adaptive Fuzzy Inference System (ANFIS), Artificial Neural Network methods (ANN), Support Vector Machine (SVM), and Bayesian Networks (BNs). Meanwhile, applications of the Expanded Disability Status Scale (EDSS) and Magnetic Resonance Imaging (MRI) can enhance MS diagnostic accuracy. By examining established risk factors like obesity, smoking, and education, some research tackled the issue of disease progression. The performance metrics varied across different aspects of MS studies: Diagnosis: Sensitivity ranged from 60 % to 98 %, specificity from 60 % to 98 %, and accuracy from 61 % to 97 %. Prediction: Sensitivity ranged from 76 % to 98 %, specificity from 65 % to 98 %, and accuracy from 62 % to 99 %. Segmentation: Accuracy ranged up to 96.7 %. Classification: Sensitivity ranged from 78 % to 97.34 %, specificity from 65 % to 99.32 %, and accuracy from 71 % to 97.94 %. Furthermore, the literature shows that combining techniques can improve efficiency, exploiting their strengths for better overall performance.
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  • 文章类型: Journal Article
    2016年建立了分析患者报告结果和生活质量终点数据的国际标准(SISAQOL)计划,以评估晚期乳腺癌随机对照试验(RCT)中患者报告结果(PRO)数据分析的质量和标准化。该计划发现了PRO数据报告中的缺陷,包括处理缺失数据的非标准化方法。这项研究评估了日本癌症RCT中与健康相关的生活质量(HRQOL)的报告,以提供对日本PRO报告状况的见解。该研究回顾了PubMed从2010年到2018年发表的文章。符合条件的研究包括日本癌症RCT,其中50名成人患者(日本人≥50%)接受抗癌治疗的实体瘤。评价标准包括HRQOL假设的清晰度,多重性测试,主要分析方法,并报告有临床意义的差异。确定了27项HRQOL试验。只有15%的人提供了明确的HRQOL假设,63%的人检查了多个HRQOL域,没有调整多重性。基于模型的方法是主要HRQOL分析最常见的统计方法。只有22%的试验明确报告了HRQOL的临床意义差异。大多数试验都报告了基线评估,但只有26%的人报告了治疗组之间的比较.HRQOL分析基于19%的试验中的意向治疗人群,74%的人在后续行动中报告合规;然而,41%的人没有指定如何处理缺失值。尽管报告临床假设和临床意义差异的比率相对较低,日本癌症RCT中HRQOL评估的现状似乎与以前的研究相当.
    The Setting International Standards in Analyzing Patient-Reported Outcomes and Quality of Life Endpoints Data (SISAQOL) initiative was established in 2016 to assess the quality and standardization of patient-reported outcomes (PRO) data analysis in randomized controlled trials (RCTs) on advanced breast cancer. The initiative identified deficiencies in PRO data reporting, including nonstandardized methods for handling missing data. This study evaluated the reporting of health-related quality of life (HRQOL) in Japanese cancer RCTs to provide insights into the state of PRO reporting in Japan. The study reviewed PubMed articles published from 2010 to 2018. Eligible studies included Japanese cancer RCTs with ≥50 adult patients (≥50% were Japanese) with solid tumors receiving anticancer treatments. The evaluation criteria included clarity of the HRQOL hypotheses, multiplicity testing, primary analysis methods, and reporting of clinically meaningful differences. Twenty-seven HRQOL trials were identified. Only 15% provided a clear HRQOL hypothesis, and 63% examined multiple HRQOL domains without adjusting for multiplicity. Model-based methods were the most common statistical methods for the primary HRQOL analysis. Only 22% of the trials explicitly reported clinically meaningful differences in HRQOL. Baseline assessments were reported in most trials, but only 26% reported comparisons between the treatment groups. HRQOL analysis was based on the intention-to-treat population in 19% of the trials, and 74% reported compliance at follow-up; however, 41% did not specify how missing values were handled. Although the rates of reporting clinical hypotheses and clinically meaningful differences were relatively low, the current state of HRQOL evaluation in the Japanese cancer RCT appears comparable to that of previous studies.
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  • 文章类型: Journal Article
    背景:缺少结果数据在试验中很常见,和强大的方法来解决这个问题是需要的。大多数试验报告目前使用适用于完全随机缺失假设(MCAR)的方法,尽管这种强烈的假设往往是不恰当的。
    目的:确定和总结目前关于处理随机对照试验(RCT)中缺失结果数据的分析方法的文献,强调适合随机缺失(MAR)或非随机缺失(MNAR)数据的方法。
    方法:我们进行了方法学范围审查,并通过搜索四个数据库(MEDLINE,Embase,中部,和CINAHL)从2015年1月到2023年3月。我们还进行了向前和向后引文搜索。符合条件的论文讨论了在RCT或RCT设计的模拟研究中处理缺失结果数据的方法或框架。
    结果:从筛选的1878条记录中,我们的搜索确定了101份符合条件的论文.90篇(89%)论文描述了解决缺失结果数据的具体方法,11篇(11%)描述了总体方法学方法的框架。在90篇方法论文中,30(33%)描述了MAR假设下的方法,48(53%)在MNAR假设下探索了方法,11(12%)在MAR和MNAR假设的混合下讨论了方法。MNAR假设下的基于控制的方法是最常用的方法,其次是MAR假设下的多重插补。
    结论:本综述为处理缺失结果数据的可用分析方法提供了指导,特别是在MNAR假设下。这些发现可能支持试验人员使用适当的方法来解决缺失的结果数据。
    BACKGROUND: Missing outcome data is common in trials, and robust methods to address this are needed. Most trial reports currently use methods applicable under a missing completely at random assumption (MCAR), although this strong assumption can often be inappropriate.
    OBJECTIVE: To identify and summarise current literature on the analytical methods for handling missing outcome data in randomised controlled trials (RCTs), emphasising methods appropriate for data missing at random (MAR) or missing not at random (MNAR).
    METHODS: We conducted a methodological scoping review and identified papers through searching four databases (MEDLINE, Embase, CENTRAL, and CINAHL) from January 2015 to March 2023. We also performed forward and backward citation searching. Eligible papers discussed methods or frameworks for handling missing outcome data in RCTs or simulation studies with an RCT design.
    RESULTS: From 1878 records screened, our search identified 101 eligible papers. 90 (89%) papers described specific methods for addressing missing outcome data and 11 (11%) described frameworks for overall methodological approach. Of the 90 methods papers, 30 (33%) described methods under the MAR assumption, 48 (53%) explored methods under the MNAR assumption and 11 (12%) discussed methods under a hybrid of MAR and MNAR assumptions. Control-based methods under the MNAR assumption were the most common method explored, followed by multiple imputation under the MAR assumption.
    CONCLUSIONS: This review provides guidance on available analytic approaches for handling missing outcome data, particularly under the MNAR assumption. These findings may support trialists in using appropriate methods to address missing outcome data.
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  • 文章类型: Journal Article
    传统的环境流行病学一直专注于研究单一暴露对特定健康结果的影响,将并发暴露视为要控制的变量。然而,随着环境的不断变化,人类越来越面临着更复杂的多污染物混合物的暴露。在这种情况下,准确评估多污染物混合物对健康的影响已成为当前环境研究的核心问题。同时,统计方法的不断发展和优化为处理大型数据集提供了强大的支持,加强对多种暴露对健康的影响进行深入研究的能力。为了检查复杂的暴露混合物,我们介绍常用的统计方法及其发展,如加权分位数和,贝叶斯核机回归,毒性当量分析,和其他人。描绘他们的应用,优势,弱点,和结果的可解释性。它还为参与研究多污染物混合物的研究人员提供指导,帮助他们选择适当的统计方法,并利用R软件更准确和全面地评估多污染物混合物对人类健康的影响。
    Traditional environmental epidemiology has consistently focused on studying the impact of single exposures on specific health outcomes, considering concurrent exposures as variables to be controlled. However, with the continuous changes in environment, humans are increasingly facing more complex exposures to multi-pollutant mixtures. In this context, accurately assessing the impact of multi-pollutant mixtures on health has become a central concern in current environmental research. Simultaneously, the continuous development and optimization of statistical methods offer robust support for handling large datasets, strengthening the capability to conduct in-depth research on the effects of multiple exposures on health. In order to examine complicated exposure mixtures, we introduce commonly used statistical methods and their developments, such as weighted quantile sum, bayesian kernel machine regression, toxic equivalency analysis, and others. Delineating their applications, advantages, weaknesses, and interpretability of results. It also provides guidance for researchers involved in studying multi-pollutant mixtures, aiding them in selecting appropriate statistical methods and utilizing R software for more accurate and comprehensive assessments of the impact of multi-pollutant mixtures on human health.
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  • 文章类型: Journal Article
    目的描述可用于评估随机对照试验(RCT)组的出版物完整性的统计工具。对于连续变量,工具评估基线手段,基线p值,以及相同手段和/或SD的出现。对于分类变量,他们评估基线p值,单个或所有变量的频率计数,随机或退出的试验参与者数量,并将报告的p值与独立计算的p值进行比较。这些工具已用于识别各个组的RCT中的出版物完整性问题,并在可接受的水平上区分有意捏造的基线汇总数据与真实随机对照试验的数据。当个人/团体对RCT(s)提出担忧时,以及当他们的整个工作正在接受检查时,可以使用这些工具,在进行系统审查时,并且可以在期刊提交时进行调整以帮助筛查RCT。结论统计工具可用于评估RCT组的出版物完整性。
    OBJECTIVE: To describe statistical tools available for assessing publication integrity of groups of randomized controlled trials (RCTs).
    METHODS: Narrative review.
    RESULTS: Freely available statistical tools have been developed that compare the observed distributions of baseline variables with the expected distributions that would occur if successful randomization occurred. For continuous variables, the tools assess baseline means, baseline P values, and the occurrence of identical means and/or standard deviation. For categorical variables, they assess baseline P values, frequency counts for individual or all variables, numbers of trial participants randomized or withdrawing, and compare reported with independently calculated P values. The tools have been used to identify publication integrity concerns in RCTs from individual groups, and performed at an acceptable level in discriminating intentionally fabricated baseline summary data from genuine RCTs. The tools can be used when concerns have been raised about RCT(s) from an individual/group and when the whole body of their work is being examined, when conducting systematic reviews, and could be adapted to aid screening of RCTs at journal submission.
    CONCLUSIONS: Statistical tools are useful for the assessment of publication integrity of groups of RCTs.
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  • 文章类型: Journal Article
    健康和疾病背后的生物过程本质上是动态的,当以时间知情的方式进行表征时,可以得到最好的理解。在这次全面审查中,我们讨论了时间序列微生物组数据分析中固有的挑战,并比较了克服这些挑战的可用方法和方法。适当处理纵向微生物组数据可以揭示重要的作用,功能,模式,以及在健康背景下大量微生物分类群或基因之间的潜在相互作用,疾病,或干预措施。我们对现有的微生物组时间序列分析方法进行了全面的回顾和比较,对于预处理和下游分析,包括差异分析,聚类,网络推理,和性状分类。我们认为,仔细选择和适当利用计算工具进行纵向微生物组分析可以帮助我们更好地理解维持健康稳态的动态宿主-微生物组关系。进展为促进疾病的失调,以及童年时遇到的生理发展阶段。
    Biological processes underlying health and disease are inherently dynamic and are best understood when characterized in a time-informed manner. In this comprehensive review, we discuss challenges inherent in time-series microbiome data analyses and compare available approaches and methods to overcome them. Appropriate handling of longitudinal microbiome data can shed light on important roles, functions, patterns, and potential interactions between large numbers of microbial taxa or genes in the context of health, disease, or interventions. We present a comprehensive review and comparison of existing microbiome time-series analysis methods, for both preprocessing and downstream analyses, including differential analysis, clustering, network inference, and trait classification. We posit that the careful selection and appropriate utilization of computational tools for longitudinal microbiome analyses can help advance our understanding of the dynamic host-microbiome relationships that underlie health-maintaining homeostases, progressions to disease-promoting dysbioses, as well as phases of physiologic development like those encountered in childhood.
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  • 文章类型: Systematic Review
    背景:不遵守是研究人员面临的共同挑战,可能会降低意向治疗分析的能力。虽然每个协议的方法试图解决这个问题,这可能会导致有偏差的估计。在以前的审查中已经确定了解决此问题的几种方法,但有有限的证据支持他们的使用。这篇综述旨在确定比较这些方法的模拟研究,评估某些方法的研究程度,并确定其在各种情况下的性能。
    方法:从构想到2022年11月30日,对包括MEDLINE和Scopus在内的几个电子数据库进行了系统搜索。包括的论文发表在同行评审的期刊上,在一项模拟研究中,在一项优势随机对照试验中,重点比较了相关方法。使用这些标准和用于识别相关信息的预定提取表筛选文章。质量评估评估了个别研究中的偏倚风险。提取的数据是使用表格合成的,数字和叙述性总结。筛选和数据提取均由两名独立的审阅者进行,分歧通过共识解决。
    结果:在确定的2325篇论文中,筛选了267篇全文,最终纳入了17项研究。在论文中确定了12种方法。通常考虑工具变量方法,但是许多作者发现它们在某些情况下存在偏见。不遵守通常被认为是全有或全无,并且仅在干预组中发生,尽管有些方法认为它是时变的。模拟研究通常会改变不遵守的水平和类型以及影响大小和混杂强度等因素。论文质量总体上是好的,尽管有些缺乏细节和理由。因此,他们的结论被认为不太可靠。
    结论:论文通常会考虑工具变量方法,但需要更多的研究来考虑G方法,并在实际情况下比较各种方法。由于证据有限,并且难以结合独立模拟研究的结果,因此很难得出关于处理不遵守的最佳方法的结论。
    CRD4202237910。
    Non-compliance is a common challenge for researchers and may reduce the power of an intention-to-treat analysis. Whilst a per protocol approach attempts to deal with this issue, it can result in biased estimates. Several methods to resolve this issue have been identified in previous reviews, but there is limited evidence supporting their use. This review aimed to identify simulation studies which compare such methods, assess the extent to which certain methods have been investigated and determine their performance under various scenarios.
    A systematic search of several electronic databases including MEDLINE and Scopus was carried out from conception to 30th November 2022. Included papers were published in a peer-reviewed journal, readily available in the English language and focused on comparing relevant methods in a superiority randomised controlled trial under a simulation study. Articles were screened using these criteria and a predetermined extraction form used to identify relevant information. A quality assessment appraised the risk of bias in individual studies. Extracted data was synthesised using tables, figures and a narrative summary. Both screening and data extraction were performed by two independent reviewers with disagreements resolved by consensus.
    Of 2325 papers identified, 267 full texts were screened and 17 studies finally included. Twelve methods were identified across papers. Instrumental variable methods were commonly considered, but many authors found them to be biased in some settings. Non-compliance was generally assumed to be all-or-nothing and only occurring in the intervention group, although some methods considered it as time-varying. Simulation studies commonly varied the level and type of non-compliance and factors such as effect size and strength of confounding. The quality of papers was generally good, although some lacked detail and justification. Therefore, their conclusions were deemed to be less reliable.
    It is common for papers to consider instrumental variable methods but more studies are needed that consider G-methods and compare a wide range of methods in realistic scenarios. It is difficult to make conclusions about the best method to deal with non-compliance due to a limited body of evidence and the difficulty in combining results from independent simulation studies.
    CRD42022370910.
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  • 文章类型: Journal Article
    传统上,在剂量发现临床试验中,治疗毒性和耐受性由临床医生评估。研究表明,临床医生报告的评分者间可靠性可能不足,与患者报告的结果相关性较差,并在捕获真正的毒性负担下。引入患者报告的结果(PRO),患者可以评估自己的症状不良事件或生活质量,有可能补充目前的做法,以帮助剂量优化。没有国际建议为将PRO纳入剂量发现试验设计和分析提供指导。我们的评论旨在识别和描述当前的统计方法和数据可视化技术,用于分析和可视化已发表的早期剂量发现肿瘤学试验(DFOTs)中的PRO数据。
    2016年6月至2022年12月发布的DFOTs,其中介绍了PRO分析方法,被纳入本方法学综述。我们在PubMed中提取了35篇符合条件的论文。提取的研究特征包括:PRO目标,PRO措施,统计分析和可视化技术,以及PRO是否参与中期和最终剂量选择决定。
    大多数论文(30,85.7%)没有明确的PRO目标。20篇(57.1%)论文使用推理统计技术来分析PRO,包括生存分析和混合效应模型。一项试验使用PRO对临床医生评估的剂量限制性毒性(DLT)进行分类。三项(8.6%)试验使用PRO来确认推荐剂量的耐受性。25份试验报告在其出版物中的图形或表格中直观地呈现PRO数据,其中12篇论文纵向呈现PRO评分。
    这篇评论强调了DFOT中PRO分析的统计方法和报告通常描述得很差,并且不一致。许多试验的PRO目标没有明确描述,这使得评估所使用的统计技术的适当性具有挑战性。根据不为PRO供电的DFOT得出结论可能会产生误导。由于没有早期DFOT中PROs分析方法的指导和标准化,比较不同试验的研究结果具有挑战性.因此,迫切需要建立国际指南,以增强剂量发现环境中PRO分析的统计方法和图形表示。
    EA已被支持作为MRC/NIHR试验方法学研究伙伴关系中癌症研究所博士研究生的一部分进行这项工作。AM由皇家马斯登NHS基金会信托基金的国家健康研究所(NIHR)生物医学研究中心支持,癌症研究所和帝国理工学院。
    UNASSIGNED: Traditionally, within dose-finding clinical trials, treatment toxicity and tolerability are assessed by clinicians. Research has shown that clinician reporting may have inadequate inter-rater reliability, poor correlation with patient reported outcomes, and under capture the true toxicity burden. The introduction of patient-reported outcomes (PROs), where the patient can assess their own symptomatic adverse events or quality of life, has potential to complement current practice to aid dose optimisation. There are no international recommendations offering guidance for the inclusion of PROs in dose-finding trial design and analysis. Our review aimed to identify and describe current statistical methods and data visualisation techniques employed to analyse and visualise PRO data in published early phase dose-finding oncology trials (DFOTs).
    UNASSIGNED: DFOTs published from June 2016-December 2022, which presented PRO analysis methods, were included in this methodological review. We extracted 35 eligible papers indexed in PubMed. Study characteristics extracted included: PRO objectives, PRO measures, statistical analysis and visualisation techniques, and whether the PRO was involved in interim and final dose selection decisions.
    UNASSIGNED: Most papers (30, 85.7%) did not include clear PRO objectives. 20 (57.1%) papers used inferential statistical techniques to analyse PROs, including survival analysis and mixed-effect models. One trial used PROs to classify a clinicians\' assessed dose-limiting toxicities (DLTs). Three (8.6%) trials used PROs to confirm the tolerability of the recommended dose. 25 trial reports visually presented PRO data within a figure or table within their publication, of which 12 papers presented PRO score longitudinally.
    UNASSIGNED: This review highlighted that the statistical methods and reporting of PRO analysis in DFOTs are often poorly described and inconsistent. Many trials had PRO objectives which were not clearly described, making it challenging to evaluate the appropriateness of the statistical techniques used. Drawing conclusions based on DFOTs which are not powered for PROs may be misleading. With no guidance and standardisation of analysis methods for PROs in early phase DFOTs, it is challenging to compare study findings across trials. Therefore, there is a crucial need to establish international guidance to enhance statistical methods and graphical presentation for PRO analysis in the dose-finding setting.
    UNASSIGNED: EA has been supported to undertake this work as part of a PhD studentship from the Institute of Cancer Research within the MRC/NIHR Trials Methodology Research Partnership. AM is supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at the Royal Marsden NHS Foundation Trust, the Institute of Cancer Research and Imperial College.
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  • 文章类型: Review
    背景:每年发表许多科学论文,并花费大量资源来开发基于生物标志物的精确肿瘤学测试。然而,目前只有少数测试用于日常临床实践,因为发展具有挑战性。在这种情况下,适当的统计方法的应用至关重要,但对所用方法的范围知之甚少。
    方法:PubMed搜索确定了乳腺癌女性的临床研究,比较了至少两个不同的治疗组,其中一种化疗或内分泌治疗,通过至少一种生物标志物的水平。2019年在15种选定期刊之一发表的原始数据的研究符合本次审查的资格。临床和统计特征由三个审阅者提取,并报告每个研究的特征选择。
    结果:在查询确定的164项研究中,31人符合条件。评估了超过70种不同的生物标志物。22项研究(71%)评估了治疗与生物标志物之间的乘法相互作用。28项研究(90%)评估了生物标志物亚组的治疗效果或治疗亚组的生物标志物效果。八项研究(26%)报告了一项预测性生物标志物分析的结果,虽然大多数人进行了多次评估,对于几种生物标志物,结果和/或亚群。21项研究(68%)声称发现生物标志物水平的治疗效果存在显着差异。14项研究(45%)提到该研究并非旨在评估治疗效果的异质性。
    结论:大多数研究通过单独分析生物标志物特异性治疗效果和/或乘法相互作用分析来评估治疗异质性。需要应用更有效的统计方法来评估临床研究中的治疗异质性。
    Many scientific papers are published each year and substantial resources are spent to develop biomarker-based tests for precision oncology. However, only a handful of tests is currently used in daily clinical practice, since development is challenging. In this situation, the application of adequate statistical methods is essential, but little is known about the scope of methods used.
    A PubMed search identified clinical studies among women with breast cancer comparing at least two different treatment groups, one of which chemotherapy or endocrine treatment, by levels of at least one biomarker. Studies presenting original data published in 2019 in one of 15 selected journals were eligible for this review. Clinical and statistical characteristics were extracted by three reviewers and a selection of characteristics for each study was reported.
    Of 164 studies identified by the query, 31 were eligible. Over 70 different biomarkers were evaluated. Twenty-two studies (71%) evaluated multiplicative interaction between treatment and biomarker. Twenty-eight studies (90%) evaluated either the treatment effect in biomarker subgroups or the biomarker effect in treatment subgroups. Eight studies (26%) reported results for one predictive biomarker analysis, while the majority performed multiple evaluations, either for several biomarkers, outcomes and/or subpopulations. Twenty-one studies (68%) claimed to have found significant differences in treatment effects by biomarker level. Fourteen studies (45%) mentioned that the study was not designed to evaluate treatment effect heterogeneity.
    Most studies evaluated treatment heterogeneity via separate analyses of biomarker-specific treatment effects and/or multiplicative interaction analysis. There is a need for the application of more efficient statistical methods to evaluate treatment heterogeneity in clinical studies.
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