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本期BMJ登载了两篇有关外科死亡的文章(见本期379页)。第一篇侧重于大家都熟悉的外科治疗中的统计学监测问题,第二篇则是很少有人提到的外科死亡对医生的影响问题。Poloniecki等用7种不同的统计学检验方法,对一项移植研究的死亡率与标准死亡率进行回顾性比较,该研究由于死亡率过高受到关注而已停止。这些资料显示,作为前瞻性分析的预警点随着选用的统计学方法不同而有所不同;只有早期运用最科学可取的方法(根据累积危险因素调整后的死亡率图表)才可能监测到死亡率的下降。本文提请读者思考有关统计学分析在监督医疗卫生工作中的目的和作用。
This issue of BMJ contains two articles on surgical death (see page 379 of this issue). The first focuses on the statistical monitoring of surgical treatment that is familiar to all, and the second one is the question of the impact of surgical death on physicians, which is rarely mentioned. Poloniecki et al. Used seven different statistical tests to retrospectively compare the mortality rate of a transplant study with the standard mortality rate, which was stopped due to concerns that the mortality rate was too high. These data show that the point of preperation used as a prospective analysis varies according to the statistical method chosen; mortality is only likely to be detected by early use of the most scientifically-acceptable method (adjusted for cumulative risk factors) Decline. This article draws readers to think about the purpose and role of statistical analysis in monitoring health care.