目的 以脆性指数为工具指标评估心血管Meta分析的稳健性.方法 检索PubMed、EMbase及Web of Science数据库,收集2018-2022年心血管领域Meta分析相关文献,计算脆性指数;通过Spearman相关性分析探索脆性指数与样本量、总事件数、效应值及效应值置信区间宽度的关系.结果 共纳入29篇文献的212个Meta分析,中位脆性指数11(5,25),中位样本量10301(3384,48330)例,中位事件数360(129,1309)个.多数Meta分析选择相对危险度作为效应指标(179/212),选择Mantel-Haenszel方法(102/212)和随机效应模型(153/212);脆性指数与样本量(rs=0.56,P＜0.05)和总事件数(rs=0.61,P＜0.05)呈正相关关系,与效应值置信区间宽度呈负相关关系(rs=-0.52,P＜0.05),与效应值大小的相关性无统计学意义.结论 发表在高影响力综合性期刊与专业心血管期刊上的心血管Meta分析的脆性指数普遍较低,稳健性不高.在医学研究中可增加对脆性指数的报告,辅助说明P值.
Robustness assessment of cardiovascular meta-analysis
Objective To evaluate the robustness of cardiovascular meta-analysis with use of fragility index.Methods By searching PubMed,EMbase,and Web of Science databases from 2018 to 2022,relevant literature on cardiovascular meta-analysis was systematically collected and the fragility indexes were calculated;Spearman correlation analysis was used to explore the relationship between fragility index and sample size,total number of events,effect size and its confidence interval width.Results A total of 212 meta-analyses from 29 articles were included,with a median fragility index of 11(5,25),a median sample size of 10 301(3 384,48 330),and a median total number of events of 360(129,1 309).Most meta-analyses chose relative risk as the effect measure(179/212),and chose Mantel-Haenszel method(102/212)and random effects model(153/212).The fragility index was positively correlated with the sample size(rs=0.56,P＜0.05)and the total number of events(rs=0.61,P＜0.05),and negatively correlated with confidence interval width of the effect size(rs=-0.52,P＜0.05).No statistically significant results were obtained in the correlation between the fragility index and effect size.Conclusion The fragility indexes of cardiovascular meta-analyses published in comprehensive journals of high impact factors and professional cardiovascular journals are generally low,and therefore lack robustness.Fragility index is suggested to be reported in medical researches,assisting in explaining the P-value.
Cardiovascularmeta-analysisrobustnessfragility index
万方数据
维普
