从结构上描述产生不朽时间的偏差。

IF 4.7 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Epidemiology Pub Date : 2024-11-04 DOI:10.1097/EDE.0000000000001808
Miguel A Hernán, Jonathan A C Sterne, Julian P T Higgins, Ian Shrier, Sonia Hernández-Díaz
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引用次数: 0

摘要

当分析中的个体根据分配后的资格标准进行选择或根据资格后的信息分配治疗策略时,就会出现不死时间。明确的目标试验模拟可以防止在观察数据的生存分析中引入不朽时间,因为它在随访开始时同步了资格和治疗分配。明确目标试验有助于描述产生不死时间的偏差结构,从而对确定资格和分配的程序进行适当的评估。在随访开始时,根据治疗分配后应用的资格标准进行选择,会导致在分配时开始随访分析时产生不死时间。根据随访开始后接受的治疗,对治疗策略的分配进行错误分类,导致在随访开始时无法区分治疗策略,从而造成永恒的时间。上述选择和错误分类可以用因果图来表示。我们总结了一些分析方法,这些方法可以在有从治疗分配开始的纵向数据时防止不朽时间。不朽时间偏差 "一词表明,偏差的来源是不朽时间,但产生不朽时间并导致偏差的是选择或错误分类。
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A structural description of biases that generate immortal time.

Immortal time arises when individuals in the analysis are either selected based on post-assignment eligibility criteria or assigned to treatment strategies based on post-eligibility information. Explicit target trial emulation prevents the introduction of immortal time in survival analyses of observational data because it synchronizes eligibility and treatment assignment at the start of follow-up. Describing the structure of the biases that generate immortal time is facilitated by specifying the target trial so that the procedures to determine eligibility and assignment can be appropriately evaluated. Selection based on eligibility criteria applied after treatment assignment at the start of follow-up results in immortal time when the analysis starts the follow-up at assignment. Misclassification of assignment to treatment strategies based on treatment received after the start of follow-up results in immortal time when the treatment strategies are not distinguishable at the start of follow-up. The above selection and misclassification can be represented using causal diagrams. We summarize analytic approaches that prevent immortal time when longitudinal data are available from the time of treatment assignment. The term "immortal time bias" suggests that the source of the bias is the immortal time, but it is selection or misclassification that generates the immortal time, leading to bias.

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来源期刊
Epidemiology
Epidemiology 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.70
自引率
3.70%
发文量
177
审稿时长
6-12 weeks
期刊介绍: Epidemiology publishes original research from all fields of epidemiology. The journal also welcomes review articles and meta-analyses, novel hypotheses, descriptions and applications of new methods, and discussions of research theory or public health policy. We give special consideration to papers from developing countries.
期刊最新文献
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