Using Registry Data to Construct a Comparison Group for Programmatic Effectiveness Evaluation
Using Registry Data to Construct a Comparison Group for Programmatic Effectiveness Evaluation
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DOI：
10.1093/aje/kwy103
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发表时间：
2018-09-01
影响因子：
5
通讯作者：
Nash, Denis
中科院分区：
文献类型：
--
作者：
Robertson, McKaylee M.;Waldron, Levi;Nash, Denis
许多非随机干预依赖于前后设计来评估有效性。这种设计不能解释可能产生结果的干预之外的事件。我们描述了一种构建基于监测注册表的比较组的方法，该方法允许在控制感兴趣结果的长期趋势的同时估计干预的有效性。利用基于人群的纽约市人类免疫缺陷病毒监测登记处的数据，我们为2009年12月至2013年3月参加纽约市人类免疫缺陷病毒护理协调计划（CCP）的人员创建了一个同期对照组。纳入注册为基础（非CCP）的对照组需要满足CCP的资格标准。为了控制结果的长期趋势，我们在非CCP、基于注册的对照组中随机分配一个假入组日期，使假入组日期的分布与CCP入组日期的分布相匹配。然后，我们将CCP患者与非CCP患者在CCP入组倾向、入组日期和基线病毒载量方面进行匹配。基于注册表的对照组估计值相对于项目有效性的前后估计值有所减弱。这些方法广泛适用于观察性干预有效性研究和监测登记条件下的规划评估。
Many nonrandomized interventions rely upon a pre-post design to evaluate effectiveness. Such designs cannot account for events external to the intervention that may produce the outcome. We describe a method to construct a surveillance registry-based comparison group, which allows for estimating the effectiveness of the intervention while controlling for secular trends in the outcome of interest. Using data from the population-based, human immunodeficiency virus Surveillance Registry in New York City, we created a contemporaneous comparison group for persons enrolled in the New York City human immunodeficiency virus Care Coordination Program (CCP) from December 2009 to March 2013. Inclusion in the Registry-based (non-CCP) comparison group required meeting CCP eligibility criteria. To control for secular trends in the outcome, we randomly assigned persons in the non-CCP, Registry-based comparison group a pseudoenrollment date such that the distribution of pseudoenrollment dates matched the distribution of enrollment dates among CCP enrollees. We then matched CCP to non-CCP persons on propensity for enrollment in the CCP, enrollment dates, and baseline viral load. Registry-based comparison group estimates were attenuated relative to pre-post estimates of program effectiveness. These methods have broad applicability for observational intervention effectiveness studies and programmatic evaluations for conditions with surveillance registries.