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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Pharmacoepidemiol+Drug+Saf
2016 ; 25
(4
): 453-61
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Evaluation of propensity scores, disease risk scores, and regression in
confounder adjustment for the safety of emerging treatment with group sequential
monitoring
#MMPMID26875591
Xu S
; Shetterly S
; Cook AJ
; Raebel MA
; Goonesekera S
; Shoaibi A
; Roy J
; Fireman B
Pharmacoepidemiol Drug Saf
2016[Apr]; 25
(4
): 453-61
PMID26875591
show ga
PURPOSE: The objective of this study was to evaluate regression, matching, and
stratification on propensity score (PS) or disease risk score (DRS) in a setting
of sequential analyses where statistical hypotheses are tested multiple times.
METHODS: In a setting of sequential analyses, we simulated incident users and
binary outcomes with different confounding strength, outcome incidence, and the
adoption rate of treatment. We compared Type I error rate, empirical power, and
time to signal using the following confounder adjustments: (i) regression; (ii)
treatment matching (1:1 or 1:4) on PS or DRS; and (iii) stratification on PS or
DRS. We estimated PS and DRS using lookwise and cumulative methods (all data up
to the current look). We applied these confounder adjustments in examining the
association between non-steroidal anti-inflammatory drugs and bleeding. RESULTS:
Propensity score and DRS methods had similar empirical power and time to signal.
However, DRS methods yielded Type I error rates up to 17% for 1:4 matching and
15.3% for stratification methods when treatment and outcome were common and
confounding strength with treatment was stronger. When treatment and outcome were
not common, stratification on PS and DRS and regression yielded 8-10% Type I
error rates and inflated empirical power. However, when outcome and treatment
were common, both regression and stratification on PS outperformed other matching
methods with Type I error rates close to 5%. CONCLUSIONS: We suggest regression
and stratification on PS when the outcomes and/or treatment is common and use of
matching on PS with higher ratios when outcome or treatment is rare or moderately
rare.
|*Computer Simulation
[MESH]
|*Confounding Factors, Epidemiologic
[MESH]
|Anti-Inflammatory Agents, Non-Steroidal/*adverse effects/therapeutic use
[MESH]