Navigation Links
BUSM researchers find no adjustment method fully resolves confounding by indication
Date:5/26/2009

(Boston) - Researchers at Boston University School of Medicine (BUSM) and Boston University School of Public Health have found that no adjustment method fully resolves confounding by indication in observational studies, meaning when the validity of a study is threatened by unmeasured confounding, it is not straightforward to determine which method of adjustment, if any, is most effective in obtaining a valid and precise estimate of effect. The study appears online in the Journal of Clinical Epidemiology.

According to researchers, conventional methods to adjust for confounding, such as restriction and multivariable regression, leave residual confounding because of unmeasured factors. Propensity scores (PS) and instrumental variable (IV) methods have become increasingly popular with the intent to address residual confounding by simulating a randomized environment.

Using data from the Breast Cancer Effectiveness in Older Women study, a collaboration of investigators from the National Cancer Institute-funded Cancer Research Network, the researchers compared methods used to reduce confounding to estimate incidence rates of breast cancer recurrence in older women who received adjuvant chemotherapy compared with women who did not.

The researchers examined women 65 years of age or older diagnosed with early stage breast cancer. For women classified as high risk for recurrence, 20 percent experienced a breast cancer recurrence. In the unrestricted cohort, receipt of adjuvant chemotherapy was associated with recurrence. The PS distributions among women who received chemotherapy among those who did not showed no substantial overlap. Using the IV method, recurrence yielded a protective estimate. However, imbalances of measured factors across levels of the IV suggested residual confounding.

"With minimal trial-based information available to inform clinical guidelines, which currently offer no guidance for treating older women with cancer, non-randomized studies are vitally important," said lead author Jaclyn Bosco, MPH, project director in the Section of Geriatrics at BUSM. "Non-randomized studies are only reliable when confounding by indication is handled adequately. When treatment with adjuvant chemotherapy among older patients is based on clinical judgment, controlling for prognostic factors alone leaves residual confounding by indication."

Researchers further stated that PS and IV analysis methods can be useful under specific situations, but neither method adequately controlled confounding by indication in this study.


'/>"/>

Contact: Michelle Roberts
michelle.roberts@bmc.org
617-638-8491
Boston University Medical Center
Source:Eurekalert

Related medicine news :

1. Researchers gain ground in efforts to fight parasite infection
2. Poor attention in kindergarten predicts lower high school test scores, UC Davis researchers find
3. NYU School of Medicine pathology researchers solve another mystery in B lymphocyte development
4. Mayo Clinic Researchers Examine the Psychological Impact of Child Abuse
5. Mayo Clinic researchers examine the psychological impact of child abuse
6. CSI: Mayo Clinic Researchers Find Television Shows Inaccurately Portray Violent Crime
7. Mayo Clinic Researchers Say Triple Drug Combination is Promising Option to Treat Metastatic HER2+ Breast Cancer
8. Two Targeted Therapies Likely Better Than One in Patients with Aggressive Lymphoma, Mayo Clinic Researchers Say
9. Mayo Clinic Researchers Say Agent Provides Treatment Option for Women with Hot Flashes
10. Drug That Targets Vasculature Growth Attacks Aggressive Thyroid Cancer, Mayo Clinic Researchers Report
11. BUSM researchers find gram-negative rods in two Philippine neonatal intensive care units
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... Battle Creek, Michigan (PRWEB) , ... June 26, 2016 , ... ... abuse, joined as sponsor of the 2016 Cereal Festival and World’s Longest Breakfast Table ... held in honor of the city’s history as home to some of the world’s ...
(Date:6/25/2016)... ... June 25, 2016 , ... Experts from ... at AcademyHealth’s Annual Research Meeting June 26-28, 2016, at the Hynes Convention Center ... care topics including advance care planning, healthcare costs and patient and family engagement. ...
(Date:6/25/2016)... ... June 25, 2016 , ... As a lifelong Southern Californian, Dr. Omkar Marathe ... from the David Geffen School of Medicine at UCLA. He trained in Internal Medicine ... his fellowship in hematology/oncology at the UCLA-Olive View-Cedars Sinai program where he had the ...
(Date:6/24/2016)... ... , ... Those who have experienced traumatic events may suffer from a complex ... as drug or alcohol abuse, as a coping mechanism. To avoid this pain and ... a traumatic event. , Trauma sufferers tend to feel a range of emotions, from ...
(Date:6/24/2016)... , ... June 24, 2016 , ... ... offering micro-osteoperforation for accelerated orthodontic treatment. Dr. Cheng has extensive experience with all ... brackets , AcceleDent, and accelerated osteogenic orthodontics. , Micro-osteoperforation is a revolutionary ...
Breaking Medicine News(10 mins):
(Date:6/26/2016)... 26, 2016 Story Highlights: ... models within the health care industry is causing providers ... , Deloitte offers a suite of solutions for ... impacting efficient cost optimization: labor resource analysis, revenue cycle ... facilitate better outcomes and better economics ...
(Date:6/24/2016)... 24, 2016 ... the addition of the " Global Markets for ... This report focuses on ... updated review, including its applications in various applications. The ... which includes three main industries: pharmaceutical and biotechnology, food ...
(Date:6/24/2016)... , June 24, 2016 Research and ... Market for Companion Diagnostic Tests" report to their offering. ... for Companion Diagnostics The World Market for ... personalized medicine diagnostics. Market analysis in the report includes the ... Market (In Vitro Diagnostic Kits) by Region (N. America, EU, ...
Breaking Medicine Technology: