{"id":219,"date":"2019-03-07T16:11:21","date_gmt":"2019-03-07T07:11:21","guid":{"rendered":"https:\/\/info.zanet.biz\/?p=219"},"modified":"2019-03-08T13:43:05","modified_gmt":"2019-03-08T04:43:05","slug":"%e3%83%90%e3%82%a4%e3%82%a2%e3%82%b9%e3%83%aa%e3%82%b9%e3%82%af%e3%81%ae%e3%83%89%e3%83%a1%e3%82%a4%e3%83%b3%e5%90%8d","status":"publish","type":"post","link":"https:\/\/info.zanet.biz\/?p=219","title":{"rendered":"\u30d0\u30a4\u30a2\u30b9\u30ea\u30b9\u30af\u306e\u30c9\u30e1\u30a4\u30f3\u540d"},"content":{"rendered":"\n

Cochrane Handbook for Systematic Reviews of Interventions\u306fVersion 6.0\u304c2019\u5e74\u4e2d\u3054\u308d\u306b\u5b8c\u6210\u4e88\u5b9a\u3068\u3055\u308c\u3066\u3044\u308b\u3002\u305d\u308c\u306b\u5148\u7acb\u3061\u3001A revised tool to assess risk of bias in randomized trials (RoB 2)\u304cindividually-randomized, parallel-group trials\u306b\u5bfe\u3059\u308b\u30c4\u30fc\u30eb\u3068\u3057\u30662018\u5e7410\u6708\u306b\u6700\u7d42\u7248\u304c\u767a\u8868\u3055\u308c\u305f\u3002RoB 2 tool\u3068\u975e\u30e9\u30f3\u30c0\u30e0\u5316\u6bd4\u8f03\u8a66\u9a13\u306e\u30d0\u30a4\u30a2\u30b9\u30ea\u30b9\u30af\u8a55\u4fa1\u30c4\u30fc\u30eb\u3067\u3042\u308bROBINS-I tool\u306b\u95a2\u3059\u308b\u60c5\u5831\u306f Cochrane Collaboration\u306eriskofbias.info<\/a> \u3067\u5f97\u3089\u308c\u308b\u3002ROBINS-I\u306f Risk Of Bias In Non-randomised Studies – of Interventions\u306e\u3053\u3068\u3067\u3042\u308b\u3002<\/p>\n\n\n\n

\u307e\u305f\u3001\u7c73AHRQ\u30822017\u5e7412\u670813\u65e5\u306b Assessing the Risk of Bias in Systematic Reviews of Health Care Interventions. <\/a>\u3092\u767a\u8868\u3057\u3001Cochrane RoB 2 tool\u3068ROBINS-I\u3092\u7d71\u5408\u3057\u305f\u3088\u3046\u306a\u30d0\u30a4\u30a2\u30b9\u8a55\u4fa1\u6cd5\u3092\u767a\u8868\u3057\u3066\u3044\u308b\u3002\u3053\u306e\u5831\u544a\u66f8\u306eTable 3. Description of risk-of-bias categories and study design-specific assessment criteria for randomized and nonrandomized studies of interventions (adapted from ROBINS-I)\u306b\u30d0\u30a4\u30a2\u30b9\u30ea\u30b9\u30af\u306e\u30c9\u30e1\u30a4\u30f3\u3068\u9069\u7528\u3059\u3079\u304d\u7814\u7a76\u30c7\u30b6\u30a4\u30f3\u304c\u307e\u3068\u3081\u3089\u308c\u3066\u3044\u308b\u3002<\/p>\n\n\n\n

\u7814\u7a76\u30c7\u30b6\u30a4\u30f3\u306fRCTs\u3001Nonrandomized studies\u3001Case-controls\u306e\uff13\u3064\u3001\u30d0\u30a4\u30a2\u30b9\u30ea\u30b9\u30af\u306e\u30c9\u30e1\u30a4\u30f3\u306fRCT\u7528\u306b\uff15\u3064\u3001\u305d\u308c\u4ee5\u5916\u306b\u5bfe\u3057\u3066\uff12\u3064\u306b\u5206\u985e\u3055\u308c\u3066\u3044\u308b\u3002<\/p>\n\n\n\n

Bias arising in the randomization process or due to confounding
Bias due to departures from intended interventions
Bias in measurement of outcomes
Bias from missing data
Bias in reporting results selectively
+
Bias in selecting participants into the study
Bias in classifying interventions <\/p>\n\n\n\n

\u5f93\u6765\u306e\u540d\u79f0\u306f\u3001\u305d\u308c\u305e\u308cSelection bias\u9078\u629e\u30d0\u30a4\u30a2\u30b9\u3001Performance bias\u5b9f\u884c\u30d0\u30a4\u30a2\u30b9\u3001Detection bias\u691c\u51fa\u30d0\u30a4\u30a2\u30b9\u3001Attrition bias\u75c7\u4f8b\u6e1b\u5c11\u30d0\u30a4\u30a2\u30b9\u3001Selective outcome reporting\u9078\u629e\u7684\u30a2\u30a6\u30c8\u30ab\u30e0\u5831\u544a\u30d0\u30a4\u30a2\u30b9\u3067\u3042\u308b\u304c\u3001\u6982\u5ff5\u306f\u540c\u3058\u3067\u3042\u308b\u3002<\/p>\n\n\n\n

\u4e00\u65b9Cochrane\u306eRoB 2\u304a\u3088\u3073ROBINS-I\u306fAHRQ\u3068\u307b\u3068\u3093\u3069\u540c\u3058\u3067\u3042\u308b\u304c\u3001\u8a00\u8449\u9063\u3044\u304c\u82e5\u5e72\u7570\u306a\u3063\u3066\u3044\u308b\u3002\u307e\u305f\u3001\u305d\u308c\u305e\u308c\u306e\u30c9\u30e1\u30a4\u30f3\u306e\u8a55\u4fa1\u306e\u305f\u3081\u306eSignalling questions\u304c\u7528\u610f\u3055\u308c\u3066\u3044\u3066\u3001\u305d\u308c\u3089\u306bYes\/Probably yes\/Probably no\/No\/No information\u307e\u305f\u306fNot applicable\u3067\u7b54\u3048\u3066\u7d50\u679c\u304c\u5f97\u3089\u308c\u308b\u3088\u3046\u306b\u69cb\u6210\u3055\u308c\u3066\u3044\u308b\u3002<\/p>\n\n\n\n

RoB 2:
Bias arising from the randomization process
Bias due to deviations from intended interventions
Bias due to missing outcome data
Bias in measurement of the outcome
Bias in selection of the reported result <\/p>\n\n\n\n

ROBINS-I:
Pre-intervention
    Bias due to confounding
    Bias in selection of participants into the study
At intervention
    Bias in classsification of interventions
Post-intervention
    Bias due to deviations from intended interventions
    Bias due to missing data
    Bias in measurement of outcomes
    Bias in selection of the reported result <\/p>\n\n\n\n

Post-interventio\u306e4\u30c9\u30e1\u30a4\u30f3\u306f\u30e9\u30f3\u30c0\u30e0\u5316\u6bd4\u8f03\u8a66\u9a13\u3068\u540c\u3058\u3067\u3042\u308b\u3002\u3059\u306a\u308f\u3061\u3001\u201d\u9078\u629e\u30d0\u30a4\u30a2\u30b9\u201d\u306b\u8a72\u5f53\u3059\u308b\u30d0\u30a4\u30a2\u30b9\u306e\u30c9\u30e1\u30a4\u30f3\u304c\u30e9\u30f3\u30c0\u30e0\u5316\u6bd4\u8f03\u8a66\u9a13\u3068\u975e\u30e9\u30f3\u30c0\u30e0\u5316\u6bd4\u8f03\u8a66\u9a13\u3067\u7570\u306a\u308b\u304c\u3001\u305d\u308c\u4ee5\u5916\u306f\u5171\u901a\u306e\u6982\u5ff5\u3092\u6709\u3059\u308b\u30c9\u30e1\u30a4\u30f3\u3067\u3042\u308b\u3002<\/p>\n\n\n\n

AHRQ\u306e\u5831\u544a\u66f8\u3067\u306fDirection and Magnitude of Bias\u306b\u95a2\u3057\u3066\u6b21\u306e\u3088\u3046\u306b\u8a18\u8ff0\u3055\u308c\u3066\u3044\u308b\uff1a
“In rating risk of bias, reviewers should judge (either implicitly or explicitly) both the direction and magnitude of possible bias. Regarding direction, reviewers should be careful not to assume that all study biases result in overestimation of effect sizes. As defined earlier, bias is any mis-estimation of an effect size, and both underestimations and overestimations are problematic for decision makers.  ” \u30d0\u30a4\u30a2\u30b9\u30ea\u30b9\u30af\u306e\u30ec\u30fc\u30c6\u30a3\u30f3\u30b0\u3092\u3059\u308b\u969b\u306f\u3001\u53ef\u80fd\u6027\u306e\u3042\u308b\u30d0\u30a4\u30a2\u30b9\u306e\u65b9\u5411\u3068\u5927\u304d\u3055\u306e\u4e21\u65b9\u3092\u5224\u5b9a\u3059\u3079\u304d\u3067\u3042\u308b\uff08\u6697\u306b\u3042\u308b\u3044\u306f\u660e\u793a\u7684\u306b\uff09\u3002\u65b9\u5411\u306b\u95a2\u3057\u3066\u306f\u3001\u3059\u3079\u3066\u306e\u7814\u7a76\u306e\u30d0\u30a4\u30a2\u30b9\u304c\u52b9\u679c\u30b5\u30a4\u30ba\u306e\u904e\u5927\u8a55\u4fa1\u306e\u7d50\u679c\u3092\u3082\u305f\u3089\u3059\u3068\u307f\u306a\u3055\u306a\u3044\u3088\u3046\u306b\u6ce8\u610f\u3059\u3079\u304d\u3067\u3042\u308b\u3002\u3055\u3089\u306b\u30d0\u30a4\u30a2\u30b9\u3068\u306f\u52b9\u679c\u30b5\u30a4\u30ba\u306e\u3069\u306e\u3088\u3046\u306a\u3082\u306e\u3067\u3042\u308c\u8aa4\u3063\u305f\u63a8\u5b9a\u3067\u3042\u308a\u3001\u904e\u5927\u8a55\u4fa1\u3082\u904e\u5c0f\u8a55\u4fa1\u3082\u3069\u3061\u3089\u3082\u610f\u601d\u6c7a\u5b9a\u306b\u3068\u3063\u3066\u554f\u984c\u3067\u3042\u308b<\/strong>“\u3068\u8ff0\u3079\u3066\u3044\u308b\u3002<\/p>\n\n\n\n

\u4e00\u65b9\u3067Cochrane RoB 2 tool\u3067\u306f\u3001The tool includes optional judgements of the direction of the bias for each domain and overall. \uff08\u4e2d\u7565\uff09If review authors do not have a clear rationale for judging the likely direction of the bias, they should not guess it.\u3068\u3001\u30d0\u30a4\u30a2\u30b9\u52b9\u679c\u306e\u65b9\u5411\u306e\u8a55\u4fa1\u306f\u30aa\u30d7\u30b7\u30e7\u30ca\u30eb\u3068\u306a\u3063\u3066\u3044\u308b\u3002\u3055\u3089\u306b\u3001Cochrane RoB 2 tool\u3067\u306f\u3001Risk of bias\u306f\u201d\u5b9f\u8cea\u7684\u30d0\u30a4\u30a2\u30b9\u306e\u30ea\u30b9\u30af\u201d\u3067\u3042\u308a\u3001\u201cRisk of bias\u201d is to be interpreted as \u201crisk of material bias\u201d\u3001\u3068\u8ff0\u3079\u3089\u308c\u3066\u3044\u308b\u3002\u305d\u3057\u3066\u3001”That is, concerns should be expressed only about issues that are likely to affect the ability to draw reliable conclusions from the study.””\u305d\u306e\u7814\u7a76\u304b\u3089\u4fe1\u983c\u3067\u304d\u308b\u7d50\u8ad6\u3092\u5f15\u304d\u51fa\u3059\u3053\u3068\u306b\u5f71\u97ff\u3057\u305d\u3046\u306a\u554f\u984c\u306b\u3064\u3044\u3066\u306e\u307f\u61f8\u5ff5\u304c\u8868\u660e\u3055\u308c\u308b\u3079\u304d\u3067\u3042\u308b\u201d\u3068\u3057\u3066\u3044\u308b\u3002<\/p>\n\n\n\n

AHRQ\u306f\u4ecb\u5165\u306e\u52b9\u679c\u3092\u6bd4\u8f03\u3059\u308b\u30e9\u30f3\u30c0\u30e0\u5316\u6bd4\u8f03\u8a66\u9a13\u3068\u89b3\u5bdf\u7814\u7a76\u306e\u4e21\u65b9\u306b\u9069\u7528\u3067\u304d\u308b\u5171\u901a\u306e\u67a0\u7d44\u307f\u3092\u76ee\u6307\u3057\u305f\u30a2\u30d7\u30ed\u30fc\u30c1\u3068\u3057\u3066\u958b\u767a\u3057\u305f\u8003\u3048\u3089\u308c\u308b\u3002\u3059\u306a\u308f\u3061Comparative Effectiveness Research (CER)\u6bd4\u8f03\u52b9\u679c\u7814\u7a76\u3092\u5bfe\u8c61\u3068\u3057\u3066\u3044\u308b\u3002<\/p>\n\n\n\n

\u3044\u305a\u308c\u3082\u500b\u3005\u306e\u7814\u7a76\u306e\u8a55\u4fa1\u306e\u6bb5\u968e\u3067\u7528\u3044\u3089\u308c\u308b\u3082\u306e\u3067\u3042\u308b\u3002<\/p>\n","protected":false},"excerpt":{"rendered":"

Cochrane Handbook for Systematic Reviews of Interventions\u306fVersion 6.0\u304c2019\u5e74\u4e2d\u3054\u308d\u306b\u5b8c\u6210\u4e88\u5b9a\u3068\u3055\u308c\u3066\u3044\u308b\u3002\u305d\u308c\u306b\u5148\u7acb\u3061\u3001A revised too … “\u30d0\u30a4\u30a2\u30b9\u30ea\u30b9\u30af\u306e\u30c9\u30e1\u30a4\u30f3\u540d” \u306e<\/span>\u7d9a\u304d\u3092\u8aad\u3080<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5,2],"tags":[],"class_list":["post-219","post","type-post","status-publish","format-standard","hentry","category-cpg","category-sr"],"_links":{"self":[{"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/posts\/219","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=219"}],"version-history":[{"count":17,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/posts\/219\/revisions"}],"predecessor-version":[{"id":241,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/posts\/219\/revisions\/241"}],"wp:attachment":[{"href":"https:\/\/info.zanet.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=219"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=219"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=219"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}