THE RISK OF DETERMINING RISK WITH MULTIVARIABLE MODELS

被引:943
作者
CONCATO, J [1 ]
FEINSTEIN, AR [1 ]
HOLFORD, TR [1 ]
机构
[1] YALE UNIV, SCH MED, NEW HAVEN, CT 06510 USA
关键词
MULTIVARIATE ANALYSIS; STATISTICAL MODELS; RISK FACTORS; PROPORTIONAL HAZARDS MODELS; LOGISTIC MODELS;
D O I
10.7326/0003-4819-118-3-199302010-00009
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose: To review the principles of multivariable analysis and to examine the application of multivariable statistical methods in general medical literature. Data Sources: A computer-assisted search of articles in The Lancet and The New England Journal of Medicine identified 451 publications containing multivariable methods from 1985 through 1989. A random sample of 60 articles that used the two most common methods-logistic regression or proportional hazards analysis-was selected for more intensive review. Data Extraction: During review of the 60 randomly selected articles, the focus was on generally accepted methodologic guidelines that can prevent problems affecting the accuracy and interpretation of multivariable analytic results. Results: From 1985 to 1989, the relative frequency of multivariable statistical methods increased annually from about 10% to 18% among all articles in the two journals. In 44 (73%) of 60 articles using logistic or proportional hazards regression, risk estimates were quantified for individual variables (''risk factors''). Violations and omissions of methodologic guidelines in these 44 articles included overfitting of data; no test of conformity of variables to a linear gradient; no mention of pertinent checks for proportional hazards; no report of testing for interactions between independent variables; and unspecified coding or selection of independent variables. These problems would make the reported results potentially inaccurate, misleading, or difficult to interpret. Conclusions: The findings suggest a need for improvement in the reporting and perhaps conducting of multivariable analyses in medical research.
引用
收藏
页码:201 / 210
页数:10
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