A comparison of propensity score methods: A case-study estimating the effectiveness of post-AMI statin use
A comparison of propensity score methods: A case-study estimating the effectiveness of post-AMI statin use
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DOI：
10.1002/sim.2328
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发表时间：
2006-06-30
影响因子：
2
通讯作者：
Mamdani, MM
中科院分区：
文献类型：
--
作者：
Austin, PC;Mamdani, MM
在观察性研究中，人们对使用倾向评分方法来估计因果效应越来越感兴趣。然而，最近的系统综述表明，倾向评分方法在医学文献中使用不一致，并且经常应用不良。在这项研究中，我们比较了以下倾向评分方法来估计急性心肌梗死住院患者他汀类药物治疗导致的全因死亡率的降低：倾向评分匹配，使用倾向评分分层，使用倾向评分协变量调整，以及使用倾向评分加权。我们使用倾向评分方法来估计调整后的治疗效果以及全因死亡率的绝对和相对风险降低。我们还检查了统计假设检验、标准化差异、箱形图、非参数密度估计和分位数-分位数图的使用，以评估分层或倾向评分匹配后遗留的残留混淆。3年死亡率绝对降低的估计值从2.1%到4.5%不等，而相对风险降低的估计值从13.3%到17.0%不等。在不同的倾向评分方法中，3年死亡几率降低的调整估计值从15%到24%不等。版权所有(c) 2005 John Wiley & Sons, Ltd。
There is an increasing interest in the use of propensity score methods to estimate causal effects in observational studies. However, recent systematic reviews have demonstrated that propensity score methods are inconsistently used and frequently poorly applied in the medical literature. In this study, we compared the following propensity score methods for estimating the reduction in all-cause mortality due to statin therapy for patients hospitalized with acute myocardial infarction: propensity-score matching, stratification using the propensity score, covariate adjustment using the propensity score, and weighting using the propensity score. We used propensity score methods to estimate both adjusted treated effects and the absolute and relative risk reduction in all-cause mortality. We also examined the use of statistical hypothesis testing, standardized differences, box plots, non-parametric density estimates, and quantile-quantile plots to assess residual confounding that remained after stratification or matching on the propensity score. Estimates of the absolute reduction in 3-year mortality ranged from 2.1 to 4.5 per cent, while estimates of the relative risk reduction ranged from 13.3 to 17.0 per cent. Adjusted estimates of the reduction in the odds of 3-year death varied from 15 to 24 per cent across the different propensity score methods. Copyright (c) 2005 John Wiley & Sons, Ltd.