Performance of the disease risk score in a cohort study with policy-induced selection bias. (November 2015)

• Record Type: Journal Article
• Authors: Tadrous, Mina; Mamdani, Muhammad M; Juurlink, David N; Krahn, Murray D; Lévesque, Linda E; Cadarette, Suzanne M
• Is Part Of: Journal of comparative effectiveness research. Volume 4:Number 6(2015)
• Page Start: 607
• Page End: 614
• Publication Date: 2015-11
• Subjects: cohort studies -- confounding factors (epidemiology) -- data interpretation -- multivariate analysis -- osteoporosis/epidemiology; Medical care -- Research -- Periodicals; Medical care -- Research -- Evaluation -- Periodicals; Medical care -- Decision making -- Periodicals; Evidence-based medicine -- Periodicals; Medicine, Comparative -- Periodicals; 362.1072
• DOI: 10.2217/cer.15.40
• Languages: English
• ISSNs: 2042-6305

Abstract

Aim: 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.Conclusion: Our findings suggest that caution may be warranted when using DRS methods in cohort studies with policy-induced selection bias, further research is needed.