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Handling missing data in propensity score estimation in comparative effectiveness evaluations: a systematic review.

ABSTRACT: AIM:Even though systematic reviews have examined how aspects of propensity score methods are used, none has reviewed how the challenge of missing data is addressed with these methods. This review therefore describes how missing data are addressed with propensity score methods in observational comparative effectiveness studies. METHODS:Published articles on observational comparative effectiveness studies were extracted from MEDLINE and EMBASE databases. RESULTS:Our search yielded 167 eligible articles. Majority of these studies (114; 68%) conducted complete case analysis with only 53 of them stating this in the methods. Only 16 articles reported use of multiple imputation. CONCLUSION:Few researchers use correct methods for handling missing data or reported missing data methodology which may lead to reporting biased findings.

SUBMITTER: Malla L

PROVIDER: S-EPMC6478118 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Handling missing data in propensity score estimation in comparative effectiveness evaluations: a systematic review.

Malla Lucas L Perera-Salazar Rafael R McFadden Emily E Ogero Morris M Stepniewska Kasia K English Mike M

Journal of comparative effectiveness research 20171005 3

<h4>Aim</h4>Even though systematic reviews have examined how aspects of propensity score methods are used, none has reviewed how the challenge of missing data is addressed with these methods. This review therefore describes how missing data are addressed with propensity score methods in observational comparative effectiveness studies.<h4>Methods</h4>Published articles on observational comparative effectiveness studies were extracted from MEDLINE and EMBASE databases.<h4>Results</h4>Our search yi ...[more]

PMID: 28980833

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Project description:BackgroundChanneling occurs when a medication and its potential comparators are selectively prescribed based on differences in underlying patient characteristics. Drug safety advisories can provide new information regarding the relative safety or effectiveness of a drug product which might increase selective prescribing. In particular, when reported adverse effects vary among drugs within a therapeutic class, clinicians may channel patients toward or away from a drug based on the patient's underlying risk for an adverse outcome. If channeling is not identified and appropriately managed it might lead to confounding in observational comparative effectiveness studies.ObjectiveTo demonstrate channeling among new users of second generation antipsychotics following a Food and Drug Administration safety advisory and to evaluate the impact of channeling on cardiovascular risk estimates over time.Data sourceFlorida Medicaid data from 2001-2006.Study designRetrospective cohort of adults initiating second generation antipsychotics. We used propensity scores to match olanzapine initiators with other second generation antipsychotic initiators. To evaluate channeling away from olanzapine following an FDA safety advisory, we estimated calendar time-specific propensity scores. We compare the performance of these calendar time-specific propensity scores with conventionally-estimated propensity scores on estimates of cardiovascular risk.Principal findingsIncreased channeling away from olanzapine was evident for some, but not all, cardiovascular risk factors and corresponded with the timing of the FDA advisory. Covariate balance was optimized within period and across all periods when using the calendar time-specific propensity score. Hazard ratio estimates for cardiovascular outcomes did not differ across models (Conventional PS: 0.97, 95%CI: 0.81-3.18 versus calendar time-specific PS: 0.93, 95%CI: 0.77-3.04).ConclusionsChanges in channeling over time was evident for several covariates but had limited impact on cardiovascular risk estimates, possibly due to unmeasured confounding. Although calendar time-specific propensity scores appear to improve covariate balance, the impact on comparative effectiveness results is limited in this setting.

Dataset Information

Handling missing data in propensity score estimation in comparative effectiveness evaluations: a systematic review.

Publications

Handling missing data in propensity score estimation in comparative effectiveness evaluations: a systematic review.

Similar Datasets

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