中国循证医学杂志

中国循证医学杂志

药物剂量-反应 Meta 分析中的三维模型初探

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剂量-反应 Meta 分析用于探讨不同暴露水平(如药物剂量)与结局之间的剂量效应关系。传统剂量-反应 Meta 分析通常考虑单个自变量暴露对结局的影响。但在药物临床评价中常涉及多个因素(如药物剂量和疗程),这些变量之间通常存在相关性,忽略了这些因素的相关性可能导致估计值出现偏倚。此外,在可能的情况下,同时考虑多个因素与结局之间的关系将更具有临床意义。本文在传统药物剂量-反应 Meta 分析模型的基础上,拟提出同时处理两个暴露因素(药物剂量和疗程)的三维剂量-反应 Meta 分析模型,以期解决上述传统剂量-反应 Meta 分析的问题。

Dose-response meta-analysis serves an important role in investigating the dose-response relationship between independent variable (e.g. dosage) and disease outcome. Traditional model for dose-response meta-analysis is based on one independent variable to consider its independent dose-specific effect on outcome. However, for drug clinical trials, generally involves two-dimension of the treatment, namely, intervene level (e.g. dosage) and intervene time. These two-dimensions tend to be associated with each other. When neglecting their correlations, the results may at risk of being biased. Moreover, taking account for the " combined effect” of the dosage and time on outcome is of more valuable clinically. Therefore, in this article, based on traditional dose-response meta-analysis model, we propose a three-dimension model for dose-response meta-analysis which consider both the effect of dosage and time, to provide a solution for the above mentioned problems of traditional model.

关键词: 剂量-反应 Meta 分析; 多变量模型; 协同作用

Key words: Dose-response meta-analysis; Multivariable model; Synergistic effect

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1. 徐畅, Suhail AR, 张超, 等. 剂量-反应 Meta 分析报告指南 (中文版). 中国循证医学杂志, 2016, 16(10): 1221-1226.0
2. Greenland S, Longnecker MP. Methods for trend estimation from summarized dose-response data, with applications to meta-analysis. Am J Epidemiol, 1992, 135(11): 1301-1309.
3. 徐畅, 张永刚, 韩芳芳, 等. 剂量-反应关系 Meta 分析的方法学简介. 中国循证医学杂志, 2015, 15(10): 1236-1239.0
4. Liu TZ, Xu C, Rota M, et al. Sleep duration and risk of all-cause mortality: A flexible, non-linear, meta-regression of 40 prospective cohort studies. Sleep Med Rev, 2017, 32: 28-36.
5. Sun X, Ioannidis JP, Agoritsas T, et al. How to use a subgroup analysis: users’ guide to the medical literature. JAMA, 2014, 311(4): 405-411.