Propensity scores for confounder adjustment when assessing the effects of medical interventions using nonexperimental study designs

Journal of Internal Medicine - Tập 275 Số 6 - Trang 570-580 - 2014
Til Stürmer‎1, Richard Wyss1, Robert J. Glynn2, M. Alan Brookhart1
1Department of Epidemiology, UNC Gillings School of Global Public Health University of North Carolina at Chapel Hill Chapel Hill NC USA
2Division of Preventive Medicine & Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women's Hospital Harvard Medical School Boston MA USA

Tóm tắt

AbstractTreatment effects, especially when comparing two or more therapeutic alternatives as in comparative effectiveness research, are likely to be heterogeneous across age, gender, co‐morbidities and co‐medications. Propensity scores (PSs), an alternative to multivariable outcome models to control for measured confounding, have specific advantages in the presence of heterogeneous treatment effects. Implementing PSs using matching or weighting allows us to estimate different overall treatment effects in differently defined populations. Heterogeneous treatment effects can also be due to unmeasured confounding concentrated in those treated contrary to prediction. Sensitivity analyses based on PSs can help to assess such unmeasured confounding. PSs should be considered a primary or secondary analytic strategy in nonexperimental medical research, including pharmacoepidemiology and nonexperimental comparative effectiveness research.

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Journal of Internal Medicine

Tập 275 Số 6

570-580

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