敏感性分析的E值应用进展及解读

Application progress and interpretation of E-value in sensitivity analysis

目的 在观察性研究中进行因果关系的推断时,为提高研究结果的稳健性,常需要使用统计分析技术对未测量到的潜在混杂因素的影响进行估计。本研究通过系统回顾敏感性分析E值的应用进展,探讨使用E值的优点和局限性,为在各类研究设计中应用、报告和解读E值提供参考。方法 在PubMed数据库中先后使用“E-value”作为关键词进行标题、摘要检索和关键论文被引检索,筛选2016-2021年期间使用E值分析方法进行敏感性分析的文献。结果 E值不但广泛应用于队列研究(n=215)和病例-对照研究(n=15),而且在横断面研究(n=28)、随机对照试验(n=6)和Meta分析(n=16)中均有应用。E值也常联合其他敏感性分析方法,如分层分析、工具变量、校正不同协变量的多元统计回归模型等,用于进一步探索结果的可靠性和稳健性。结论 使用E值对观察性研究进行混杂因素评估时,可结合可信区间及P值结果,对研究结果的敏感性进行更全面地评估。

Objective When making causal inferences in observational studies,in order to improve the robustness of the results of observational studies,statistical analysis techniques are often used to estimate the impact of unmeasured potential confounding factors.By systematically reviewing the application progress of the E-value,one of the sensitivity analysis methods,the advantages and limitations of using the E-value were discussed,to provide references for the application,reporting and interpretation of the E-value.Methods In the PubMed database,E-value was used as a keyword for title,abstract and key paper citation retrieval,and the literature that used the E-value analysis method for sensitivity analysis during 2016-2021 was screened.Results The E-value was widely used not only in cohort studies(n=215)and case-control studies(n=15),but also in cross-sectional studies(n=28),randomized controlled trials(n=6)and meta-analysis(n=16).The E-value was often combined with other sensitivity analysis methods,such as hierarchical analysis,instrumental variables,and multiple statistical regression models that correct different covariates,to further explore the reliability and robustness of the results.Conclusion When the E-value is used to evaluate the confounding factors in observational studies,the confidence interval and P value can be combined to evaluate the sensitivity of the results more comprehensively.