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A critical appraisal of epidemiological studies comes from basic knowledge: a readers guide to assess potential for biases

机译:流行病学研究的批判性评估来自基础知识:评估潜在偏见的读者指南

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摘要

Scientific literature may be biased because of the internal validity of studies being compromised by different forms of measurement error, and/or because of the selective reporting of positive and 'statistically significant' results. While the first source of bias might be prevented, and in some cases corrected to a degree, the second represents a pervasive problem afflicting the medical literature; a situation that can only be 'corrected' by a change in the mindset of authors, reviewers, and editors. This review focuses on the concepts of confounding, selection bias and information bias, utilising explanatory examples and simple rules to recognise and, when possible, to correct for them. Confounding is a mixing of effects resulting from an imbalance of some of the causes of disease across the compared groups. It can be prevented by randomization and restriction, and controlled by stratification, standardization or by using multivariable techniques. Selection bias stems from an absence of comparability among the groups being studied, while information bias arises from distorted information collection techniques. Publication bias of medical research results can invalidate evidence-based medicine, when a researcher attempting to collect all the published studies on a specific topic actually gathers only a proportion of them, usually the ones reporting 'positive' results. The selective publication of 'statistically significant' results represents a problem that researchers and readers have to be aware of in order to face the entire body of published medical evidence with a degree of scepticism.
机译:由于不同形式的测量误差会损害研究的内部有效性,和/或由于选择性报告阳性和“统计学意义”的结果,科学文献可能会产生偏差。虽然可以避免第一个偏见的来源,并且在某些情况下可以纠正到一定程度,但是第二个代表了困扰医学文献的普遍问题。只有通过改变作者,审稿人和编辑的思维方式才能“纠正”这种情况。这篇综述着重于混淆,选择偏向和信息偏向的概念,利用解释性示例和简单规则来识别并在可能的情况下对其进行纠正。混杂是由于各组人群中某些疾病原因失衡而产生的各种影响。可以通过随机化和限制来防止它,并可以通过分层,标准化或使用多变量技术进行控制。选择偏差源于正在研究的各组之间缺乏可比性,而信息偏差则源于扭曲的信息收集技术。当研究人员试图收集有关特定主题的所有已发表研究时,实际上只收集了一部分,通常是报告为“阳性”结果的医学研究结果,因此发表医学研究成果的偏见会使基于证据的医学无效。有选择地发表“具有统计意义的结果”表示研究人员和读者必须意识到的一个问题,以便以一定程度的怀疑态度来面对整个已发表的医学证据。

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