实验流行病学文献评阅学习资料.ppt

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1、实验流行病学文献评阅B.Internalvalidity—considerationofnon-causalexplanations内部真实性——考虑是否有非因果解释Aretheresultslikelytobeaffectedbyselectionbias?是否由于选择偏移所致Aretheresultslikelytobeaffectedbyobservationbias?是否由于观察偏移所致Aretheresultslikelytobeaffectedbyconfounding?是否由混杂偏移所致A

2、retheresultslikelytobeaffectedbychancevariation?是否出于偶然因素C.Internalvalidity—considerationofpositivefeaturesofcausation内部真实性——因果关系阳性特征的考虑1.Isthereacorrecttimerelationship?是否存在前因后果的时间关系2.Istherelationshipstrong?联系强度3.Isthereadose-responserelationship?是否存在剂量

3、反应关系？Aretheresultsconsistentwithinthestudy?不同的相关研究指标结果是否一致5.Isthereanyspecificitywithinthestudy?研究是否存在特异性？D.Externalvalidity—generalizationoftheresults外部特异性—结果能否外推Canthestudyresultsbeappliedtotheeligiblepopulation?结果能否适用于合格研究人群Canthestudyresultsbeapplie

4、dtothesourcepopulation?结果能否适用于源人群Canthestudyresultsbeappliedtootherrelevantpopulations?结果是否适用于其他相关人群E.Comparisonoftheresultswithotherevidence与其它证据的比较1.Aretheresultsconsistwithotherevidence,particularlyevidencefromstudiesofsimilarormorepowerfulstudydesign

5、?研究结果是否与其它研究(尤其是设计更好，证据更强的)结果相似或一致？2.Doesthetotalevidencesuggestanyspecificity?研究结果是否存在特异性？3.Aretheresultsplausible,intermsofabiologicalmechanism?研究结果是否合理，能否用生物学机制解释4.Ifamajoreffectisshown,isitcoherentwiththedistributionoftheexposureandtheoutcome?如果存在联系，

6、该联系与人群的暴露与结局分布是否一致？TheRevisedCONSORTStatementforReportingRandomizedTrials:ExplanationandElaborationAnnInternMed.2001Apr17;134(8):663-94.INCOMPLETEANDINACCURATEEPORTINGinformationonwhetherassessmentofoutcomes*wasblindedwasreportedinonly30%of67trialreport

7、sinfourleadingjournalsin1979and1980only27%of45reportspublishedin1985definedaprimaryendpoint*(14),andonly43%of37trialswithnegativefindingspublishedin1990reportedasamplesize*calculationOf119reportsstatingthatallparticipants*wereincludedintheanalysisinthegr

8、oupstowhichtheywereoriginallyassigned(intention-to-treat*analysis),15(13%)excludedpatientsordidnotanalyzeallpatientsasallocatedChecklistofItemsToIncludeWhenReportingaRandomizedTrialTitleandAbstractHowparticipantswerealloca