Meta分析中的异质性(heterogeneity)及其处理原则和方法

2017-12-20 MedSci MedSci原创

Meta 分析又称荟萃分析、汇总分析、整合分析,是对具有相同研究题目的多个医学研究进行综合分析。meta分析的目的在于增大样本含量,减少随机误差所致的差异,增大检验效能。一个高质量的Meta分析相当于开展了一个多中心的研究,理想情况下,Meta分析纳入的各项研究均指向同一个结果,即各研究间具有同质性。尽管,我们试图通过严格的入选和排除标准,以保证纳入研究的同质性。然而,实际情况往往不尽如意。会

Meta 分析又称荟萃分析、汇总分析、整合分析,是对具有相同研究题目的多个医学研究进行综合分析。meta分析的目的在于增大样本含量,减少随机误差所致的差异,增大检验效能。一个高质量的Meta分析相当于开展了一个多中心的研究,理想情况下,Meta分析纳入的各项研究均指向同一个结果,即各研究间具有同质性。尽管,我们试图通过严格的入选和排除标准,以保证纳入研究的同质性。然而,实际情况往往不尽如意。会造成“合并萝卜、白菜、西红柿”的错误,就算是勉强合并统计量,得出的结论也不可信。meta就没有意义了。所以,合并效应量之前,一定要进行异质性检验。可以明确的说,纳入Meta分析的所有研究都存在异质性。当异质性较大时,超出了随机误差,Meta分析的结果就不太可靠。我们需要通过适当的方法识别它,对其进行检验,以决定后续的处理策略。梅斯医学提供有关异质性处理的策略。   我们在做meta分析前,必须要做的事有两件:A 确定文献的纳入和排除标准;B 纳入文章的质量评分,例如jadad评分、QUADAS评分等。   临床异质性、方法学异质性和统计学异质性三者是相互独立又相互关联的,临床或

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    2023-11-19 ms5000000698886517 来自湖南省

    #异质性# 学习一下

    0

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    2020-12-18 ms4000000691326991

    谢谢

    0

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    2018-03-18 guojianrong
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    2018-10-11 爆笑小医
  5. [GetPortalCommentsPageByObjectIdResponse(id=2169548, encodeId=4288216954837, content=<a href='/topic/show?id=8fb34983282' target=_blank style='color:#2F92EE;'>#异质性#</a> 学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49832, encryptionId=8fb34983282, topicName=异质性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=be258804288, createdName=ms5000000698886517, createdTime=Sun Nov 19 21:20:50 CST 2023, time=2023-11-19, status=1, ipAttribution=湖南省), GetPortalCommentsPageByObjectIdResponse(id=909070, encodeId=213c9090e0db, content=谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=69da5445579, createdName=ms4000000691326991, createdTime=Fri Dec 18 10:34:54 CST 2020, time=2020-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1887794, encodeId=a9b6188e794c5, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Sun Mar 18 16:25:00 CST 2018, time=2018-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896227, encodeId=6ade189622e7b, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Thu Oct 11 00:25:00 CST 2018, time=2018-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284444, encodeId=dcfa2844441c, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Fri Feb 02 10:26:09 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280154, encodeId=90342801546e, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Fri Jan 19 21:34:15 CST 2018, time=2018-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2048948, encodeId=f26b20489483f, content=<a href='/topic/show?id=4363e929ad' target=_blank style='color:#2F92EE;'>#Gene#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7929, encryptionId=4363e929ad, topicName=Gene)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=63a4277, createdName=cy0324, createdTime=Thu Nov 29 23:25:00 CST 2018, time=2018-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=270950, encodeId=bd092e095029, content=学习了.收藏之后再好好学习一遍, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=114d2217109, createdName=snail 3680, createdTime=Wed Dec 20 16:53:06 CST 2017, time=2017-12-20, status=1, ipAttribution=)]
    2018-02-02 戒馋,懒,贪

    谢谢分享学习了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2169548, encodeId=4288216954837, content=<a href='/topic/show?id=8fb34983282' target=_blank style='color:#2F92EE;'>#异质性#</a> 学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49832, encryptionId=8fb34983282, topicName=异质性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=be258804288, createdName=ms5000000698886517, createdTime=Sun Nov 19 21:20:50 CST 2023, time=2023-11-19, status=1, ipAttribution=湖南省), GetPortalCommentsPageByObjectIdResponse(id=909070, encodeId=213c9090e0db, content=谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=69da5445579, createdName=ms4000000691326991, createdTime=Fri Dec 18 10:34:54 CST 2020, time=2020-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1887794, encodeId=a9b6188e794c5, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Sun Mar 18 16:25:00 CST 2018, time=2018-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896227, encodeId=6ade189622e7b, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Thu Oct 11 00:25:00 CST 2018, time=2018-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284444, encodeId=dcfa2844441c, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Fri Feb 02 10:26:09 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280154, encodeId=90342801546e, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Fri Jan 19 21:34:15 CST 2018, time=2018-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2048948, encodeId=f26b20489483f, content=<a href='/topic/show?id=4363e929ad' target=_blank style='color:#2F92EE;'>#Gene#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7929, encryptionId=4363e929ad, topicName=Gene)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=63a4277, createdName=cy0324, createdTime=Thu Nov 29 23:25:00 CST 2018, time=2018-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=270950, encodeId=bd092e095029, content=学习了.收藏之后再好好学习一遍, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=114d2217109, createdName=snail 3680, createdTime=Wed Dec 20 16:53:06 CST 2017, time=2017-12-20, status=1, ipAttribution=)]
    2018-01-19 戒馋,懒,贪

    谢谢分享学习了

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=2169548, encodeId=4288216954837, content=<a href='/topic/show?id=8fb34983282' target=_blank style='color:#2F92EE;'>#异质性#</a> 学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49832, encryptionId=8fb34983282, topicName=异质性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=be258804288, createdName=ms5000000698886517, createdTime=Sun Nov 19 21:20:50 CST 2023, time=2023-11-19, status=1, ipAttribution=湖南省), GetPortalCommentsPageByObjectIdResponse(id=909070, encodeId=213c9090e0db, content=谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=69da5445579, createdName=ms4000000691326991, createdTime=Fri Dec 18 10:34:54 CST 2020, time=2020-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1887794, encodeId=a9b6188e794c5, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Sun Mar 18 16:25:00 CST 2018, time=2018-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896227, encodeId=6ade189622e7b, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Thu Oct 11 00:25:00 CST 2018, time=2018-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284444, encodeId=dcfa2844441c, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Fri Feb 02 10:26:09 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280154, encodeId=90342801546e, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Fri Jan 19 21:34:15 CST 2018, time=2018-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2048948, encodeId=f26b20489483f, content=<a href='/topic/show?id=4363e929ad' target=_blank style='color:#2F92EE;'>#Gene#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7929, encryptionId=4363e929ad, topicName=Gene)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=63a4277, createdName=cy0324, createdTime=Thu Nov 29 23:25:00 CST 2018, time=2018-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=270950, encodeId=bd092e095029, content=学习了.收藏之后再好好学习一遍, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=114d2217109, createdName=snail 3680, createdTime=Wed Dec 20 16:53:06 CST 2017, time=2017-12-20, status=1, ipAttribution=)]
    2018-11-29 cy0324
  8. [GetPortalCommentsPageByObjectIdResponse(id=2169548, encodeId=4288216954837, content=<a href='/topic/show?id=8fb34983282' target=_blank style='color:#2F92EE;'>#异质性#</a> 学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49832, encryptionId=8fb34983282, topicName=异质性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=be258804288, createdName=ms5000000698886517, createdTime=Sun Nov 19 21:20:50 CST 2023, time=2023-11-19, status=1, ipAttribution=湖南省), GetPortalCommentsPageByObjectIdResponse(id=909070, encodeId=213c9090e0db, content=谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=69da5445579, createdName=ms4000000691326991, createdTime=Fri Dec 18 10:34:54 CST 2020, time=2020-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1887794, encodeId=a9b6188e794c5, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Sun Mar 18 16:25:00 CST 2018, time=2018-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896227, encodeId=6ade189622e7b, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Thu Oct 11 00:25:00 CST 2018, time=2018-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284444, encodeId=dcfa2844441c, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Fri Feb 02 10:26:09 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280154, encodeId=90342801546e, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Fri Jan 19 21:34:15 CST 2018, time=2018-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2048948, encodeId=f26b20489483f, content=<a href='/topic/show?id=4363e929ad' target=_blank style='color:#2F92EE;'>#Gene#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7929, encryptionId=4363e929ad, topicName=Gene)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=63a4277, createdName=cy0324, createdTime=Thu Nov 29 23:25:00 CST 2018, time=2018-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=270950, encodeId=bd092e095029, content=学习了.收藏之后再好好学习一遍, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=114d2217109, createdName=snail 3680, createdTime=Wed Dec 20 16:53:06 CST 2017, time=2017-12-20, status=1, ipAttribution=)]
    2017-12-20 snail 3680

    学习了.收藏之后再好好学习一遍

    0

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无论是定性变量数据还是定量变量数据,Meta分析的基本步骤是相同的。若异质性过大,应放弃Meta分析,只对结果作统计描述。Meta分析本身并不能提高原始研究质量,并不能克服低质量原始研究的自身缺陷。系统评价遵循设计清晰、有据可循、方法学完善的原则,注意是否存在系统误差(偏倚)和随机误差(由机遇产生),减少其对科研质量的影响,更加客观、更加全面地反映了原始研究文献的观点。 一、循证医学与研究证

BMJ Open:中文Meta分析论文的质量问题仍较明显

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Nat Genet:遗传meta分析揭示胶质瘤与非胶质瘤的分子奥秘

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诊断试验Meta分析怎么做?有图有真相

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Int J Cancer:我国学者Meta分析称,他汀或可提高癌症患者生存率,确诊后应用似更有益

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Circulation:做Meta分析,警惕生产“医学假新闻”

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