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https://www.readbyqxmd.com/read/28239929/a-tutorial-on-the-use-of-instrumental-variables-in-pharmacoepidemiology
#1
REVIEW
Ashkan Ertefaie, Dylan S Small, James H Flory, Sean Hennessy
PURPOSE: Instrumental variable (IV) methods are used increasingly in pharmacoepidemiology to address unmeasured confounding. In this tutorial, we review the steps used in IV analyses and the underlying assumptions. We also present methods to assess the validity of those assumptions and describe sensitivity analysis to examine the effects of possible violations of those assumptions. METHODS: Observational studies based on regression or propensity score analyses rely on the untestable assumption that there are no unmeasured confounders...
February 27, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28239880/long-term-use-of-oral-nucleos-t-ide-analogues-for-chronic-hepatitis-b-does-not-increase-cancer-risk-a-cohort-study-of-44-494-subjects
#2
G L-H Wong, Y-K Tse, T C-F Yip, H L-Y Chan, K K-F Tsoi, V W-S Wong
BACKGROUND: Patients with chronic hepatitis B (CHB) need long-term antiviral treatment with nucleos(t)ide analogues (NA). Animal studies suggest that some NA may increase cancer risk, but human data are lacking. AIM: To investigate cancer risks in patients with or without NA treatment. METHODS: We conducted a territory-wide cohort study using the database from Hospital Authority in Hong Kong. The diagnosis of CHB and various malignancies was based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes between 2000 and 2012...
February 27, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28238691/early-invasive-versus-initial-conservative-strategies-for-women-with-non-st-elevation-acute-coronary-syndromes-propensity-matched-analysis
#3
Islam Y Elgendy, Ahmed N Mahmoud, Hend Mansoor, Anthony A Bavry
BACKGROUND: Studies conducted largely in men have shown improved outcomes with an early invasive strategy with non-ST-elevation acute coronary syndrome. In contrast, data have been less conclusive in women, with some trials demonstrating potential harm. This study aims to assess if an early invasive strategy in women is associated with better outcomes in real world data. METHODS: Women admitted with a primary diagnosis of non-ST-elevation myocardial infarction or unstable angina were identified from the National Inpatient Sample years 2012-2013...
February 24, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28238579/preoperative-coil-embolization-of-side-branches-and-postoperative-antifibrinolytic-therapy-in-endovascular-aneurysm-repair-a-propensity-score-analysis
#4
Arudo Hiraoka, Genta Chikazawa, Atsuhisa Ishida, Toshinori Totsugawa, Kentaro Tamura, Taichi Sakaguchi, Hidenori Yoshitaka
PURPOSE: To demonstrate feasibility and efficacy of preoperative coil embolization of side branches and postoperative tranexamic acid (TXA) therapy for management of type II endoleak and aneurysmal sac regression after endovascular aortic repair (EVAR). MATERIALS AND METHODS: This study included 284 patients who underwent EVAR between 2007 and 2014. In 133 patients (group A), since March 2012, preoperative coil embolization of side branches and postoperative TXA therapy had been introduced as a modified strategy after EVAR, including combined coil embolization and TXA therapy (n = 41), coil embolization only (n = 17), and TXA therapy only (n = 75)...
February 23, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28238500/evaluation-of-early-childhood-home-visiting-to-prevent-medically-attended-unintentional-injury
#5
Alonzo T Folger, Katherine A Bowers, Judith W Dexheimer, Ting Sa, Eric S Hall, Judith B Van Ginkel, Robert T Ammerman
STUDY OBJECTIVE: We evaluated the influence of home visiting on the risk for medically attended unintentional injury during home visiting (0 to 3 years) and subsequent to home visiting (3 to 5 years). METHODS: A retrospective, quasi-experimental study was conducted in a cohort of mother-child pairs in Hamilton County, OH. The birth cohort (2006 to 2012) was linked to administrative home visiting records and data from a population-based injury surveillance system containing records of emergency department (ED) visits and hospitalizations...
February 23, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28238219/prevalence-of-in-hospital-non-steroidal-anti-inflammatory-drug-exposure-in-patients-with-a-primary-diagnosis-of-heart-failure
#6
Paulino A Alvarez, David Putney, Richard Ogunti, Mamta Puppala, Cecilia Ganduglia, Guillermo Torre-Amione, Robert Schutt, Stephen Wong, Jerry D Estep
AIM: To determine the prevalence of in-hospital non-steroidal anti-inflammatory drug (NSAID) exposure and associated outcomes in patients admitted with a primary diagnosis of heart failure. METHODS: We performed a propensity-matched cohort analysis of patients admitted to Houston Methodist Hospital System with a primary diagnosis of heart failure according to the International Classification of Diseases-9-Clinical Modification (ICD-9-CM) from January 1(st) 2011 to December 31(st) 2014...
February 26, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28237215/comparison-of-outpatient-vs-inpatient-total-knee-arthroplasty-an-acs-nsqip-analysis
#7
Patawut Bovonratwet, Nathaniel T Ondeck, Stephen J Nelson, Jonathan J Cui, Matthew L Webb, Jonathan N Grauer
BACKGROUND: There has been a recent surge of interest in performing primary total knee arthroplasty (TKA) in the outpatient setting to reduce cost and increase patient satisfaction. Detailed information on the safety of outpatient TKA in large sample sizes is scarce. METHODS: Patients who underwent primary, elective TKA were identified in the 2005-2014 American College of Surgeons National Surgical Quality Improvement Program database. Outpatient procedure was defined as having a hospital length of stay of 0 days, whereas inpatient procedure was defined as having a length of stay ≥1 days...
February 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28236769/surgically-treated-oesophageal-cancer-developed-in-a-radiated-field-impact-on-peri-operative-and-long-term-outcomes
#8
Sheraz R Markar, Caroline Gronnier, Arnaud Pasquer, Alain Duhamel, Hélène Behal, Jérémie Théreaux, Johan Gagnière, Gil Lebreton, Cécile Brigand, Bernard Meunier, Denis Collet, Christophe Mariette
BACKGROUND: The objectives of this study were to compare peri-operative and long-term outcomes from oesophageal cancer (EC) (i) that arose in a previously radiated field (ECRF) versus primary (PEC) and among ECRF patients and (ii) radiotherapy-induced (RIEC) versus non-radiotherapy-induced EC (NRIEC). METHODS: Data were collected from 30 European centres from 2000 to 2010. Two thousand four hundred eighty nine EC patients surgically treated were included in the PEC group and 136 in the ECRF group, NRIEC group (n = 61) and RIEC group (n = 75)...
February 22, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28236174/prone-positioning-in-acute-respiratory-distress-syndrome-after-abdominal-surgery-a-multicenter-retrospective-study-sapronadonf-study-of-ards-and-prone-position-after-abdominal-surgery-in-france
#9
Stéphane Gaudry, Samuel Tuffet, Anne-Claire Lukaszewicz, Christian Laplace, Noémie Zucman, Marc Pocard, Bruno Costaglioli, Simon Msika, Jacques Duranteau, Didier Payen, Didier Dreyfuss, David Hajage, Jean-Damien Ricard
BACKGROUND: The recent demonstration of prone position's strong benefit on patient survival has rendered proning a major therapeutic intervention in severe ARDS. Uncertainties remain as to whether or not ARDS patients in the postoperative period of abdominal surgery should be turned prone because of the risk of abdominal complications. Our aim was to investigate the prevalence of surgical complications between patients with and without prone position after abdominal surgery. METHODS: This study was a multicenter retrospective cohort of patients with ARDS in a context of recent abdominal surgery...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28231678/-application-of-disease-risk-score-in-pharmacoepidemiologic-studies
#10
H Y Zhao, S Y Zhan
Disease risk score (DRS) can be used to adjust the confounding effects on data with high dimensions and can reduce related bias through balancing the risk or probability, regarding the development of some specific diseases, between the two compared groups. The DRS approach thus can be applied to studies of pharmacoepidemiology when administrative medical database is used for data analysis. Although DRS functions are similarly to the propensity scores (PS) under many situations, even with some advantages over PS or conventional analytical methods in some special exposure settings, the usage of DRS is far limited than the PS method...
February 10, 2017: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
https://www.readbyqxmd.com/read/28230852/single-locoregional-triamcinolone-injection-immediately-after-esophageal-endoscopic-submucosal-dissection-prevents-stricture-formation
#11
Yasuaki Nagami, Masatsugu Shiba, Masaki Ominami, Taishi Sakai, Hiroaki Minamino, Shusei Fukunaga, Satoshi Sugimori, Fumio Tanaka, Noriko Kamata, Tetsuya Tanigawa, Hirokazu Yamagami, Toshio Watanabe, Kazunari Tominaga, Yasuhiro Fujiwara, Tetsuo Arakawa
OBJECTIVES: Although endoscopic submucosal dissection (ESD) is an efficient treatment for superficial esophageal cancer, it is associated with stricture formation after wide-circumference resection that leads to a low quality of life. Although locoregional steroid injections prevent stricture formation, a randomized comparative study did not report any advantages associated with steroid injection. We evaluated the prophylactic efficacy of a single locoregional triamcinolone injection for stricture formation after esophageal ESD...
February 23, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28230312/five-year-cost-effectiveness-of-patient-empowerment-programme-pep-for-type-2-diabetes-mellitus-in-primary-care
#12
J X Lian, Sarah M McGhee, C So, J Chau, Carlos Kh Wong, William Cw Wong, Cindy Lk Lam
This study evaluated the short-term cost-effectiveness of the Patient Empowerment Programme (PEP) for diabetes mellitus in Hong Kong. Propensity score matching was used to select a matched group of PEP and non-PEP subjects. A societal perspective was adopted to estimate the cost of PEP. The outcome measures were the cumulative incidence of all-cause mortality and diabetic complication over a five-year follow-up and the number needed to treat (NNT) to avoid one event. The incremental cost-effectiveness ratio (ICER) of cost per event avoided was calculated using the PEP cost per subject multiplied by the NNT...
February 23, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28230248/effectiveness-of-early-administration-of-tranexamic-acid-in-patients-with-severe-trauma
#13
A Shiraishi, S Kushimoto, Y Otomo, H Matsui, A Hagiwara, K Murata
BACKGROUND: A reduction in mortality with the early use of tranexamic acid has been demonstrated in severely injured patients who are bleeding. However, the modest treatment effect with no reduction in blood transfusion has raised concerns. The aim of the present study was to estimate the effectiveness of regular use of tranexamic acid in severely injured patients. METHODS: This multicentre observational study used retrospectively collected data from consecutive injured patients (Injury Severity Score at least 16) treated in 15 Japanese academic institutions in 2012...
February 23, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28229124/functional-limitations-and-health-care-resource-utilization-for-individuals-with-cognitive-impairment-without-dementia-findings-from-a-united-states-population-based-survey
#14
J Scott Andrews, Urvi Desai, Noam Y Kirson, Caroline J Enloe, Ljubica Ristovska, Sarah King, Howard G Birnbaum, Adam S Fleisher, Wenyu Ye, Kristin Kahle-Wrobleski
INTRODUCTION: Little is known about functional limitations and health care resource utilization of people with cognitive impairment with no dementia (CIND). METHODS: Respondents with stable or progressive cognitive impairment (CI) after the first (index) indication of CIND in 2000-2010 were identified from the Health and Retirement Study (HRS). Respondents never exhibiting CI were identified as potential controls. Propensity score-based optimal matching was used to adjust for differences in demographics and history of stroke...
2017: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
https://www.readbyqxmd.com/read/28228118/the-association-of-kidney-function-with-repetitive-breath-hold-diving-activities-of-female-divers-from-korea-haenyeo
#15
Yun Jung Oh, Ji Yong Jung, Sung Soo Kim, Kyong-Suk Chae, Jiwon Rhu, Chungsik Lee
BACKGROUND: Voluntary apnea during breath-hold diving (BHD) induces cardiovascular changes including bradycardia, reduced cardiac output, and arterial hypertension. Although the impacts of repetitive BHD on cardiovascular health have been studied previously, the long-term risk for kidney dysfunction has never been investigated. METHODS: A cross-sectional propensity score-matched study was performed to evaluate the influence of repetitive long-lasting BHD on kidney function...
February 23, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28225746/atypical-antipsychotics-and-the-risk-of-falls-and-fractures-among-older-adults-an-emulation-analysis-and-an-evaluation-of-additional-confounding-control-strategies
#16
Darmendra Ramcharran, Hong Qiu, Martijn J Schuemie, Patrick B Ryan
PURPOSE: The aim of this study was to investigate the risk of falls and fractures among older adults receiving atypical antipsychotics. METHODS: An emulation analysis of a previously published study was performed using the US Truven MarketScan Medicare Supplemental database (MDCR). In addition, modified analyses were implemented to evaluate alternative confounding control strategies that (1) included all covariates used to fit propensity score models in outcome models and (2) required patients to have a mental health condition diagnosis and a health care visit within 90 days prior to the index date...
April 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28225011/early-spontaneous-abdominal-bleeding-is-associated-with-poor-outcome-in-moderate-to-severe-acute-pancreatitis-patients-a-propensity-matched-study
#17
Yizhe Chen, Jing Zhou, Gang Li, Zhihui Tong, Jie Dong, Yiyuan Pan, Lu Ke, Weiqin Li, Jieshou Li
Abdominal bleeding is a lethal complication in acute pancreatitis (AP) and it is commonly described as a late event. However, spontaneous intra-abdominal bleeding could occur very early but no study focusing on this phenomenon was published yet. In this study, 1137 AP patients were retrospectively screened and 24 subjects suffering early spontaneous bleeding (ESB) were selected. Meanwhile, a 1:1 well-balanced cohort of non-bleeding patients was generated by propensity score match. The clinical characteristics of these patients were compared and a multiple regression analysis was performed to assess the risk factors for ESB...
February 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28224366/comparison-of-short-term-outcomes-between-open-and-minimally-invasive-esophagectomy-for-esophageal-cancer-using-a-nationwide-database-in-japan
#18
Hiroya Takeuchi, Hiroaki Miyata, Soji Ozawa, Harushi Udagawa, Harushi Osugi, Hisahiro Matsubara, Hiroyuki Konno, Yasuyuki Seto, Yuko Kitagawa
PURPOSE: This study aimed to compare short-term outcomes of minimally invasive esophagectomy (MIE) with those of open esophagectomy (OE) for thoracic esophageal cancer using a nationwide Japanese database. METHODS: Overall, 9584 patients with thoracic esophageal cancer who underwent esophagectomy at 864 hospitals in 2011-2012 were evaluated. We performed one-to-one matching between the MIE and OE groups on the basis of estimated propensity scores for each patient...
February 21, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28222857/liver-fibrosis-assessed-with-transient-elastography-is-an-independent-risk-factor-for-ischemic-stroke
#19
Seung Up Kim, Dongbeom Song, Ji Hoe Heo, Joonsang Yoo, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang Joon Kim, Kwang-Hyub Han, Young Dae Kim
BACKGROUND AND AIMS: The relationship between liver fibrosis and the occurrence of ischemic stroke is unknown. We investigated the correlation between liver fibrosis assessed with transient elastography (TE) and the risk of ischemic stroke. METHODS: Between April 2013 and August 2014, patients with acute ischemic stroke and subjects who underwent a health check-up were included in the study. Liver fibrotic burden was assessed with TE in all participants. The degree of liver fibrosis was compared between groups by using various multiple logistic regression models and propensity-score matched analyses...
February 12, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28222041/a-comparison-of-short-term-therapeutic-efficacy-between-infliximab-and-tacrolimus-for-moderate-to-severe-ulcerative-colitis
#20
Hirokazu Yamagami, Yu Nishida, Yasuaki Nagami, Shuhei Hosomi, Tomomi Yukawa, Koji Otani, Fumio Tanaka, Koichi Taira, Noriko Kamata, Tetsuya Tanigawa, Masatsugu Shiba, Toshio Watanabe, Yasuhiro Fujiwara
INTRODUCTION: Both infliximab (IFX) and tacrolimus (Tac) are effective for inducing clinical remission in patients with ulcerative colitis (UC). However no randomized study has addressed the relative efficacies of IFX and Tac for patients with moderate to severe UC. This study aimed to conduct a retrospective study on the relative efficacy of IFX and Tac in patients with moderate to severe UC, using an inverse probability of treatment weighting (IPTW) technique to adjust background factors statistically...
February 1, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
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