关键词: cohort studies confounding factors (epidemiology) data interpretation multivariate analysis osteoporosis/epidemiology

Mesh : Bone Density Conservation Agents Cohort Studies Diphosphonates Female Hip Fractures Humans Insurance, Health, Reimbursement Models, Statistical Ontario Organizational Policy Osteoporosis / drug therapy Policy Risk Adjustment Selection Bias

来  源:   DOI:10.2217/cer.15.40

Abstract:
OBJECTIVE: To examine the performance of the disease risk score (DRS) in a cohort study with evidence of policy-induced selection bias.
METHODS: We examined two cohorts of new users of bisphosphonates. Estimates for 1-year hip fracture rates between agents using DRS, exposure propensity scores and traditional multivariable analysis were compared.
RESULTS: The results for the cohort with no evidence of policy-induced selection bias showed little variation across analyses (-4.1-2.0%). Analysis of the cohort with evidence of policy-induced selection bias showed greater variation (-13.5-8.1%), with the greatest difference seen with DRS analyses.
CONCLUSIONS: Our findings suggest that caution may be warranted when using DRS methods in cohort studies with policy-induced selection bias, further research is needed.
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