关于医学科研设计的若干要点

2014-06-20 Hiu 医学统计分析精粹

科研设计,讲求精准,即同时控制系统误差和随机误差,追求更高的准确度和精确度。以打靶为例: 下面一组图,上图为系统误差(准确度),下图为随机误差(精确度)。 在上述基础上,将问题进一步细分: 于是,就谈到了科研设计最高端的一点东西,三大常见偏倚。通俗讲,偏倚,就是指影响你估计准确性的东西,让你回回打靶都朝某个特定方向偏的东西。

转自医学统计分析精粹微信,此文涵盖医学研究设计内容较广,已获得转载许可,作为交流学习之用。



科研设计,讲求精准,即同时控制系统误差和随机误差,追求更高的准确度和精确度。以打靶为例:

下面一组图,上图为系统误差(准确度),下图为随机误差(精确度)。

在上述基础上,将问题进一步细分:

于是,就谈到了科研设计最高端的一点东西,三大常见偏倚。通俗讲,偏倚,就是指影响你估计准确性的东西,让你回回打靶都朝某个特定方向偏的东西。

控制偏倚是技术活儿,也是最能体现审稿人,答辩委员能力的地方。如果实在控制不了,在讨论中自曝短处,也可以让他们无话可说,但若你偷偷的避而不谈,遇到真专家,可就不好过关了。

这三大偏倚,以后再继续详细阐述。

研究设计的基本要素、基本原则,都是老生长谈的问题了:

以下,是常用的实验研究的设计方法(本来是有动画的):

完全随机设计:

配对设计:

配伍组设计:

交叉设计:

交叉设计要求同一个对象,既要做实验组,又要做对照组,中间还要休息下(避免它自己也忘了自己是实验组还是对照组——洗脱期)。

析因设计:

然后他们各自又有一定的优缺点:

临床研究,名气最大的就是RCT了,随机对照试验。

高大上的东西,我一贯都是不愿意讲的。除了Trial,用的多的,就是观察性研究设计了。常见以下几种:

依次介绍下(原来也是有动画的哦~):

Case Report:

现况调查,就是常见的调查型文章:

调查就涉及到样本获取,抽样方法:

病例对照研究:

这种研究实施的难度并不高,但高大上的名字使其尊贵很多,多找几个患者,回顾一下病史,便是一篇文章。

注意图中箭头,研究时从右向左展开。过去靠回忆,即是上文提到的,信息偏倚。

队列研究:

队列研究近几年在国内也是雨后春笋般。。。研究质量就不评论了,但国内学者确实有钱了。

几个经典研究讲完了,后面就是一个比较,不同研究的身份地位是不同的。

但其实有一点是永恒的:你作为一个研究者,付出的努力越大,证据级别就越高。

——这句话是我自己说的,不用给我纠正。


挑出来的片子就这几张吧,以后有时间给大家一一展开。大概每张片子,都可以说上几个钟头。

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    2015-11-12 crystal 丁

    正想找些资料看看

    0

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    2014-08-07 oubaochi

    算是基础知识吧,需要牢固掌握

    0

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    2014-07-27 zgarycn

    非常受用,珍藏学习

    0

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    2014-06-29 superDrZhang

    正是我想找的资料,学习了

    0