首页|用于评估随机对照试验结果稳健性的脆弱指数

用于评估随机对照试验结果稳健性的脆弱指数

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临床试验完成后,其结论一般取决于主要结局的统计分析结果,即假设检验中P值是否小于假设检验的水准α,通常α=0.05.P值的大小说明作出假设判断的理由的充分程度,可解释为某一结论是否具有统计学意义.但不涉及药物效应或其他效应的差异程度.脆弱指数,即将统计上显著的结果变为不显著的结果所需的、由发生目标结局事件变为发生非目标结局事件的最小患者人数,脆弱指数的数值反映的是具有统计学意义的研究结果的稳健性,可用于辅助临床试验统计推断结果的理解,辅助临床决策.本文将对脆弱指数的概念、计算方法和临床应用等方面进行论述,并建议在未来随机对照试验的结果中,考虑将脆弱指数作为敏感性分析的内容之一,以帮助患者、临床医生、政策制定者做出适当和最佳的决策.
Fragility index for assessing the robustness of randomized controlled trials
After the completion of a clinical trial,its conclusion generally depends on the results of statistical analysis of the main outcome,that is,whether the P-value in the hypothesis test is less than the α level of the hypothesis test,usually α=0.05.The size of the P-value indicates the sufficient degree of reason for making the hypothesis judgment,and can be interpreted as to determine whether a conclusion is statistically significant but does not involve the difference in the degree of drug effects or other effects.Fragility index,which is,the minimum number of patients required to change the occurrence of a target outcome event to a non-target outcome event from a statistically significant outcome to a non-significant outcome,can be used to assist in understanding of clinical trial statistical inference results and assisting in clinical decision making This paper discusses the concept,calculation method and clinical application of the fragility index,and recommends that the fragility index be routinely reported in all future randomized controlled trials to help patient clinicians and policymakers make appropriate and optimal decisions.

Randomized controlled trialFragility indexStatistical significanceClinical significanceClinical decision

罗慜婧、刘芷含、黄菁涵、王映乔、李一琳、刘美君、陶耘慈、曹蕊、王雅琪、刘建平、张颖、费宇彤

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北京中医药大学循证医学中心(北京 100029)

北京中医药大学国际循证中医药研究院(北京 100029)

北京GRADE中心(北京 100029)

北京中医药大学(北京 100029)

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随机对照试验 脆弱指数 统计学意义 临床意义 临床决策

国家自然科学基金

81830115

2024

中国循证医学杂志
四川大学

中国循证医学杂志

CSTPCD北大核心
影响因子:1.761
ISSN:1672-2531
年,卷(期):2024.24(2)
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