Toolkit for Weighting and Analysis of Nonequivalent Groups: A Tutorial on the TWANG Shiny App for Two Treatments

Griffin, Beth Ann; Sánchez, Ricardo Gil; Cefalu, Matthew; Stelzner, Chuck; Ayer, Lynsay; Coffman, Donna L.; Vegetabile, Brian G.; Pane, Joseph D.; Burgette, Lane F.; McCaffrey, Daniel F.

doi:10.7249/tla570-2

Cited by 28 publications

(36 citation statements)

References 6 publications

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“…To identify the association between the CKD groups and the duration of PPI administration, we used two-stage analysis. First, we calculated the weight variable for adjusting for age and sex for each group [ 14 ]. Second, a generalized linear model with inverse-probability weighting was used to demonstrate the relationship between CKD groups and duration of PPI use, and the p-value was estimated by the likelihood ratio test [ 15 , 16 ].…”

Section: Methodsmentioning

confidence: 99%

Chronic kidney disease (CKD) patients are exposed to more proton pump inhibitor (PPI)s compared to non-CKD patients

Lee

et al. 2018

PLoS ONE

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BackgroundProton pump inhibitor use is associated with incident chronic kidney disease, chronic kidney disease progression and end-stage renal disease. However, the extent of proton pump inhibitor prescriptions to chronic kidney disease patients is still unclear.MethodIn a retrospective study, we enrolled patients (>18 years old) who received proton pump inhibitor in the out-patient setting from 2014 through 2015. All data was obtained from electronical medical records of Soonchunhyang Medical Center. The prescription patterns and characteristics of proton pump inhibitors were analyzed according to individual estimated glomerular filtration rate of the patients.ResultDuring the study period 178,228 patients visited the out-patient clinic. Proton pump inhibitors were prescribed to 9,109 (5.11%) patients. In our sample, 50% were females and 9.8% were chronic kidney disease (eGFR<60mL/min/1.73 m2) patients. Among the patients with chronic kidney disease, 730 (8.0%) were categorized as stage 3 or 4 and 166 (1.8%) were categorized as stage 5 or end-stage renal disease. The prevalence of proton pump inhibitors prescription among chronic kidney disease patients was higher than in the non-chronic kidney disease group (p<0.001). Median duration of usage was 120 [interquartile range 63–273] days in the stage 3–4 group, 106 [56–266] days in the stage 5-end-stage renal disease group and 90 [56–176] days in the non-chronic kidney disease group. Patients in stage 3–4 group were prescribed longer duration of proton pump inhibitors than the non-chronic kidney disease group even after adjusting for age and sex (p<0.001). The main departments of medicine which prescribed proton pump inhibitors for the stage 3–4 group were gastroenterology (40.0%), cardiology (29.6%), nephrology (9.5%) and neurology (4.8%). Compared to the non-chronic kidney disease group, the stage 3–4 and stage 5-end-stage renal disease group were taking larger number of drugs simultaneously (6.90±4.17 vs4.54±2.43; p<0.001, 5.64±2.87 vs 4.54±2.34; p<0.001, respectively).ConclusionChronic kidney disease patients are taking proton pump inhibitors for a much longer duration compared to non-chronic kidney disease patients. Physicians should pay careful attention when prescribing proton pump inhibitors to high risk groups.

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Section: Methodsmentioning

confidence: 99%

Chronic kidney disease (CKD) patients are exposed to more proton pump inhibitor (PPI)s compared to non-CKD patients

Lee

et al. 2018

PLoS ONE

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“…The propensity of seeing a GP within 2 weeks was calculated using the Toolkit for Weighting and Analysis of Non-equivalent Groups (TWANG) 20 within R version 6.0 21 using the variables outlined in Table S1. Two models were investigated: Model 1, an inverse probability of treatment (IPT) model that used propensity weights to control for the differences in those who saw a GP; and Model 2, a doubly robust IPT model that also used propensity weights but further directly controlled for the influence of covariates on hospitalisation outcomes.…”

Section: Statistical Analysesmentioning

confidence: 99%

General practitioner follow-up after hospitalisation in Central and Eastern Sydney, Australia: access and impact on health services

et al. 2020

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Objectives. General practitioner (GP) follow-up after a hospital admission is an important indicator of integrated care. We examined the characteristics of patients who saw a GP within 2 weeks of hospital discharge in the Central and Eastern Sydney (CES) region, Australia, and the relationship between GP follow-up and subsequent hospitalisation. Methods. This data linkage study used a cohort of 10 240 people from the 45 and Up Study who resided in CES and experienced an overnight hospitalisation in the 5 years following recruitment (2007-14). Characteristics of participants who saw a GP within 2 weeks of discharge were compared with those who did not using generalised linear models. Time to subsequent hospitalisation was compared for the two groups using Cox proportional hazards regression models stratified by prior frequency of GP use. Results. Within 2 weeks of discharge, 64.3% participants saw a GP. Seeing a GP within 2 weeks of discharge was associated with lower rates of rehospitalisation for infrequent GP users (i.e. ,8 visits in year before the index hospitalisation; hazard ratio (HR) 0.83; 95% confidence interval (CI) 0.70-0.97) but not frequent GP users (i.e. 8 plus visits; HR 1.02; 95% CI 0.90-1.17). Conclusion. The effect of seeing a GP on subsequent hospitalisation was protective but differed depending on patient care needs. What is known about the topic? There is general consensus among healthcare providers that primary care is a significant source of ongoing health care provision. What does this paper add? This study explored the relationship between GP follow-up after an uncomplicated hospitalisation and its effect on rehospitalisation.

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“…The propensity scores to assess the effects of radiation on the OS and the OS by surgical type by node stage were both performed only on patients with pN+ and matched by factors that were significant in the MVA for OS (age, sex, race, tumor location, histology, facility type, facility location, insurance status, income, urban/rural location, type of surgical resection, N stage, and tumor size). The Toolkit for Weighting and Analysis of Non-equivalent Groups (TWANG) macro was run in SAS to create the propensity scores for this pathologically node-positive group (13).…”

Section: Methodsmentioning

confidence: 99%

The Incidence of Node-Positive Non-small-Cell Lung Cancer Undergoing Sublobar Resection and the Role of Radiation in Its Management

et al. 2020

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Purpose: To identify the incidence, preoperative risk factors, and prognosis associated with pathologically positive lymph node (pN+) in patients undergoing a sub-lobar resection (SLR). Methods: This is a retrospective study using the National Cancer Database (NCDB) from 2004 to 2014 analyzing SLR excluding those with any preoperative chemotherapy and/or radiation, follow-up <3 months, stage IV disease, or >1 tumor nodule. Multivariable modeling (MVA) was used to determine factors associated with overall survival (OS). Propensity score matching (PSM) was used to determine preoperative risk factors for pN+ in patients having at least one node examined to assess radiation's effect on OS in those patients with pN+ and to determine whether SLR was associated with inferior OS as compared to lobectomy for each nodal stage. Results: A total of 40,202 patients underwent SLR, but only 58.3% had one lymph node examined. Then, 2,615 individuals had pN+ which decreased progressively from 15.1% in 2004 to 8.9% in 2014 (N1, from 6.3 to 3.0%, and N2, from 8.4 to 5.9%). A lower risk of pN+ was noted for squamous cell carcinomas, bronchioloalveolar adenocarcinoma (BAC), adenocarcinomas, and right upper lobe locations. In the pN+ group, OS was worse without chemotherapy or radiation. Radiation was associated with a strong trend for OS in the entire pN+ group (p = 0.0647) which was largely due to the effects on those having N2 disease (p = 0.009) or R1 resections (p = 0.03), but not N1 involvement (p = 0.87). PSM noted that SLR was associated with an inferior OS as compared to lobectomy by nodal stage in the overall patient population and even for those with tumors <2 cm. Varlotto et al. Incidence and Outcomes of SLRs With Positive Nodes Conclusion: pN+ incidence in SLRs has decreased over time. SLR was associated with inferior OS as compared to lobectomy by nodal stage. Radiation appears to improve the OS in patients undergoing SLR with pN+, especially in those with N2 nodal involvement and/or positive margins.

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Toolkit for Weighting and Analysis of Nonequivalent Groups: A Tutorial on the TWANG Shiny App for Two Treatments

Cited by 28 publications

References 6 publications

Chronic kidney disease (CKD) patients are exposed to more proton pump inhibitor (PPI)s compared to non-CKD patients

Chronic kidney disease (CKD) patients are exposed to more proton pump inhibitor (PPI)s compared to non-CKD patients

General practitioner follow-up after hospitalisation in Central and Eastern Sydney, Australia: access and impact on health services

The Incidence of Node-Positive Non-small-Cell Lung Cancer Undergoing Sublobar Resection and the Role of Radiation in Its Management

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