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Commentary: When, where, and why do preventive home visits work?

机译:评论:预防性家访在何时,何地以及为什么起作用?

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摘要

This is the second of two reviews of trials of preventive home visits to elderly people published in the BMJ in the past 18 months. Elkan et al conclude that home visits reduce mortality and admissions to nursing homes, whereas last year's review found no evidence supporting their effectiveness and argued that existing programmes should be reconsidered. Why did the two reviews reach such contrasting conclusions? The main reason is the different methodological approaches adopted by the two groups. Van Haastregt et al reported the results from individual trials as "no significant effects" or "significant favourable effects." For example, they found a "significant" reduction (P < 0.05) in admissions to institutions in only two out of seven trials and that overall effects were "modest and inconsistent" This "vote counting" approach is clearly unsound as it ignores the direction and size of effects from individual studies and their confidence intervals. If the BMJ and other journals adopt the recent recommendation that "the description of differences as statistically significant is not acceptable," then the confusion created by such analyses could be avoided.
机译:这是过去18个月在BMJ上发表的有关对老年人进行预防性家访试验的两篇评论的第二篇。艾尔坎(Elkan)等人得出的结论是,家访降低了死亡率,并减少了疗养院的住院人数,而去年的审查未发现任何证据支持他们的有效性,并认为应重新考虑现有计划。为什么两次审查得出如此相反的结论?主要原因是两组采用的方法不同。 Van Haastregt等人将个别试验的结果报告为“无明显影响”或“显着有利影响”。例如,他们在七项试验中只有两项发现机构录取人数“显着”减少(P <0.05),并且总体效果是“适度且不一致的”。这种“投票计数”方法显然是不合理的,因为它忽略了方向个别研究的影响大小,置信区间。如果BMJ和其他期刊采纳了最近的建议,即“对差异进行统计学上的描述是不可接受的”,那么可以避免这种分析所造成的混淆。

著录项

  • 来源
    《British Medical Journal》 |2001年第7315期|p.724-725|共2页
  • 作者

    Matthias Egger;

  • 作者单位
  • 收录信息 美国《科学引文索引》(SCI);美国《化学文摘》(CA);
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 医药、卫生;
  • 关键词

  • 入库时间 2022-08-18 00:12:52

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