有向无环图的构建规范：ESC-DAGs方法介绍及脑血管病研究案例解读

doi:10.3969/j.issn.1673-5765.2024.10.016

中国卒中杂志 ›› 2024, Vol. 19 ›› Issue (10): 1221-1229.DOI: 10.3969/j.issn.1673-5765.2024.10.016

• 卒中医疗质量管理专栏 • 上一篇下一篇

有向无环图的构建规范：ESC-DAGs方法介绍及脑血管病研究案例解读

郝允逸¹，夏雪^2，3，胥芹^2，3，赵性泉^1，3，王安心^2，3

1 北京 100070 首都医科大学附属北京天坛医院神经病学中心
2 首都医科大学附属北京天坛医院，北京市神经外科研究所流行病学研究室
3 首都医科大学临床流行病学与临床试验学系

收稿日期:2024-01-22 出版日期:2024-10-20 发布日期:2024-10-20
通讯作者: 王安心 wanganxin@bjtth.org
基金资助:
北京市自然科学基金-海淀原始创新联合基金（L222123）

Construction Specification of Directed Acyclic Graphs: An Introduction to the ESC-DAGs Method and Case Interpretation in Cerebrovascular Disease Research

HAO Yunyi¹, XIA Xue^2,3, XU Qin^2,3, ZHAO Xingquan^1,3, WANG Anxin^2,3

1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; 2Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; 3Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing 100070, China

Received:2024-01-22 Online:2024-10-20 Published:2024-10-20
Contact: WANG Anxin, E-mail: wanganxin@bjtth.org

摘要/Abstract

摘要： 有向无环图（directed acyclic graph，DAG）是构建因果推断中因果假设的可视化工具，可通过后门准则筛选需要校正的最小校正子集，控制观察性研究中的混杂偏倚。然而现有研究在绘制DAG时缺乏规范，文献中使用的DAG质量良莠不齐，在应用上存在困境。ESC-DAGs方法的出现为构建DAG提供了标准化流程。该方法基于系统综述的基本思想广泛检索相关文献，并将构建过程分为映射（mapping）、转化（translation）和整合（integration）三个阶段：首先基于检索出来的每项研究构建饱和DAG，然后根据希尔准则和潜在结果框架筛选图中的有向边，最后将所有保留的有向边整合在一张DAG中。ESC-DAGs方法充分利用了文献信息和研究者的专业知识，为DAG的应用提供了合理可行的标准，具有重要的指导意义。本文将介绍ESC-DAGs方法的基本内容，并通过卒中临床研究示例展示构建DAG的具体过程。

文章导读： 本研究介绍的ESC-DAGs方法为构建有向无环图提供了标准化流程，帮助研究者在开展真实世界研究的过程中正确识别混杂偏倚，为药物、治疗方案等临床干预措施在真实世界环境下疗效评价提供高级别证据。

关键词: 有向无环图; 混杂偏倚; 因果推断; 缺血性卒中

Abstract: Directed acyclic graph (DAG) is a visualization tool to construct causal hypotheses in causal inference, which can be used to control confounding bias in observational studies by screening the minimal adjustment subsets that need to be adjusted through the backdoor criterion. However, existing studies lack standardization in drawing DAGs and the quality of DAGs used in the literature varies, which causes application dilemmas. The emergence of the ESC-DAGs method provides a standardized process for constructing DAGs. Based on the basic idea of systematic review, ESC-DAGs extensively searches relevant literature and divides the construction process into three phases: mapping, translation, and integration. Firstly, a saturated DAG is constructed based on each retrieved study. The directed edges are screened in the graph according to the Hill criterion and the potential outcome framework, and finally, all the retained directed edges are integrated into one DAG. The ESC-DAGs method makes full use of the literature information and the expertise of researchers. It provides a reasonable and feasible criterion for applying DAGs, which has important guiding significance. This article presents the content of the ESC-DAGs method and elucidates the specific process of constructing a DAG using an example from a clinical study on stroke.

Key words: Directed acyclic graph; Confounding bias; Causal inference; Ischemic stroke

中图分类号:

郝允逸, 夏雪, 胥芹, 赵性泉, 王安心. 有向无环图的构建规范：ESC-DAGs方法介绍及脑血管病研究案例解读[J]. 中国卒中杂志, 2024, 19(10): 1221-1229.

HAO Yunyi, XIA Xue, XU Qin, ZHAO Xingquan, WANG Anxin. Construction Specification of Directed Acyclic Graphs: An Introduction to the ESC-DAGs Method and Case Interpretation in Cerebrovascular Disease Research[J]. Chinese Journal of Stroke, 2024, 19(10): 1221-1229.

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有向无环图的构建规范：ESC-DAGs方法介绍及脑血管病研究案例解读

Construction Specification of Directed Acyclic Graphs: An Introduction to the ESC-DAGs Method and Case Interpretation in Cerebrovascular Disease Research

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