Propensity Scores: A Practical Introduction Using R

Olmos, Antonio; Govindasamy, Priyalatha

doi:10.56645/jmde.v11i25.431

Cited by 94 publications

(18 citation statements)

References 29 publications

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“…28 Specifically, the propensity score matching implemented in this study reduces the dependence of causal inferences on statistical modeling assumptions, which may not always be justified in an observational study. 29 However, propensity scores are sensitive to the choice of observed covariates and modeling techniques, both of which are arbitrary. 30 In addition, the use of matching has reduced the number of patients by approximately 25% in both categories, which may lead to bias.…”

Section: Discussionmentioning

confidence: 99%

Early Clinical Variables Associated With Refractory Convulsive Status Epilepticus in Children

Peariso,

Arya,

Glauser

et al. 2023

Neurology

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Objective:Determine patient-specific factors known proximate to the presentation to emergency care associated with the development of refractory convulsive status epilepticus (RSE) in children.Methods:An observational case-control study was conducted comparing pediatric patients (1 month – 21 years) with convulsive SE whose seizures stopped after benzodiazepines (BZD) and a single second-line antiseizure medication (ASM) (responsive established status epilepticus; rESE) with patients requiring more than a BZD and a single second-line ASM to stop their seizures (RSE). These sub-populations were obtained from the pediatric Status Epilepticus Research Group (pSERG) study cohort. We explored clinical variables that could be acquired early after presentation to emergency medical services with univariate analysis of the raw data. Variables with p<0.1 were retained for univariable and multivariable regression analysis. Multivariable logistic regression models were fit to age and sex- matched data to obtain variables associated with RSE.Results:We compared data from a total of 595 episodes of pediatric SE. Univariate analysis demonstrated no differences in time to the first BZD (RSE 16 min (IQR 5-45); rESE 18 min (IQR 6-44), p=0.068). Time to second-line ASM was shorter in RSE patients (RSE 65 min; rESE 70 min; p=0.021). Both univariable and multivariable regression analysis revealed a family history of seizures (OR 0.37; 95% CI 0.20 -0.70, p = 0.0022) or a prescription for rectal diazepam (OR 0.21; 95% CI 0.078 - 0.53, p = 0.0012) were associated with decreased odds of RSE.Conclusions:Time to initial BZD or second-line ASM was not associated with progression to RSE in our cohort of patients with rESE. A family history of seizures and a prescription for rectal diazepam were associated with a decreased likelihood of progression to RSE. Early attainment of these variables may help care for pediatric rESE in a more patient-tailored manner.COE:This study provides class II evidence that patient and clinical factors may predict RSE in children with convulsive seizures.

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Section: Discussionmentioning

confidence: 99%

Early Clinical Variables Associated With Refractory Convulsive Status Epilepticus in Children

Peariso,

Arya,

Glauser

et al. 2023

Neurology

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“…Most of the Greedy matching methods such as nearest neighbor, reduces sample size to half, whereas the IPTW and optimal full matching retain the entire dataset, which was valuable for our study where race and ethnicity samples were smaller. We used the Olmos & Bovindassmy procedure (2015) 25 to perform PSW in R. We first created a selection model to estimate the propensity scores. The selection model, a logistic regression model, was used to estimate the selection bias on the model, where we included demographic variables that are often associated with the development of incident cognitive impairment.…”

Section: Methodsmentioning

confidence: 99%

Racial and ethnic differences in neuropsychiatric symptoms and progression to incident cognitive impairment among community‐dwelling participants

Babulal

Zhu

Trani

2023

Alzheimer's & Dementia

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INTRODUCTIONNeuropsychiatric symptoms (NPS) are a risk factor for dementia; however, their prevalence and severity among ethnoracial groups are poorly understood.METHODSWe used data from the National Alzheimer's Coordinating Center (NACC) (n = 6958; ≥50 years old). Cognitively normal participants at baseline, without any NPS or dementia diagnosis, had at least one follow‐up. Survival analyses assessed the hazard ratio for 12 NPS models and progression to cognitive impairment. Propensity score weighting (PSW) matched participants on age, sex, education, and race/ethnicity.RESULTSAll 12 NPS were significantly associated with progression to cognitive impairment. In the PSW models, compared to whites, Black/African Americans were more likely to progress to cognitive impairment across all 12 NPS models, followed by Hispanic, and then Asian participants.DISCUSSIONPSW minimized selection bias to provide robust risk estimates. There is a higher risk of progressing to cognitive impairment for ethnoracial groups with NPS. Tailored screening of NPS and cognitive impairment should incorporate patient and caregiver reports.

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“…Median OS and TTNTD were estimated via the Kaplan-Meier method 8 and compared using log-rank tests 9 . To account for differences between treatment sequencing groups, a Cox proportional hazards model 10 stratified by propensity score deciles 11,12 was used for the primary comparative effectiveness analyses. Propensity scores for treatment sequence arms were constructed based on random forest out-of-bag predictions 13 for all patients using baseline ECOG PS, smoking status, age at metastatic diagnosis, sex, albumin, and CA 19-9.…”

Section: Methodsmentioning

confidence: 99%

Survival Outcomes Based on Sequence of Therapy Using FOLFIRINOX and Nab-Paclitaxel + Gemcitabine in Metastatic Pancreatic Ductal Adenocarcinoma

Baron

Wang²,

Nevala-Plagemann

et al. 2021

Pancreas

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Objectives: Optimal sequence of therapy for patients with metastatic pancreatic ductal adenocarcinoma is unknown. Combination chemotherapy with fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) and nabpaclitaxel + gemcitabine (nab-p/gem) are standard first-line (1L) therapies. They have never been prospectively compared. We retrospectively compared overall survival (OS) of patients treated with 1L nab-p/gem and second-line (2L) FOLFIRINOX with those treated with the reverse sequence.Methods: Patients with metastatic pancreatic ductal adenocarcinoma treated with 1L FOLFIRINOX and 2L nab-p/gem or vice versa were identified using an electronic health record-derived real-world database. Using an intent-to-treat analysis, we compared OS from initiation of 1L therapy. A Cox model, stratified by deciles of propensity score, estimated the effect of treatment sequence on OS. Results:The study included 3027 patients. The median OS for 1L FOLFIRINOX versus nab-p/gem was 8.6 versus 6.1 months (hazard ratio, 0.77; 95% confidence interval, 0.70-0.84). The median OS for 1L FOLFIRINOX and 2L nab-p/gem versus 1L nab-p/gem and 2L FOLFIRINOX was 11.9 versus 11.5 months (hazard ratio, 0.97; 95% confidence interval, 0.79-1.18). Conclusions:In this analysis of real-world data, 1L FOLFIRINOX was associated with increased OS in propensity analysis. For patients who received both FOLFIRINOX and nab-p/gem, median OS was similar regardless of sequence.

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Propensity Scores: A Practical Introduction Using R

Cited by 94 publications

References 29 publications

Early Clinical Variables Associated With Refractory Convulsive Status Epilepticus in Children

Early Clinical Variables Associated With Refractory Convulsive Status Epilepticus in Children

Racial and ethnic differences in neuropsychiatric symptoms and progression to incident cognitive impairment among community‐dwelling participants

Survival Outcomes Based on Sequence of Therapy Using FOLFIRINOX and Nab-Paclitaxel + Gemcitabine in Metastatic Pancreatic Ductal Adenocarcinoma

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