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Performance of the disease risk score in a cohort study with policy-induced selection bias

Tadrous M, Mamdani MM, Juurlink DN, Krahn MD, Levesque LE, Cadarette SM. J Comp Eff Res. 2015; 4(6):607-14. Epub 2015 Nov 3.


Aim — To examine the performance of the disease risk score (DRS) in a cohort study with evidence of policy-induced selection bias.

Methods — We examined two cohorts of new users of bisphosphonates. Estimates for 1-year hip fracture rates between agents using DRS, exposure propensity scores and traditional multivariable analysis were compared.

Results — The results for the cohort with no evidence of policy-induced selection bias showed little variation across analyses (-4.1 to 2.0%). Analysis of the cohort with evidence of policy-induced selection bias showed greater variation (-13.5 to 8.1%), with the greatest difference seen with DRS analyses.

Conclusion — Our findings suggest that caution may be warranted when using DRS methods in cohort studies with policy-induced selection bias, further research is needed.

Keywords: Data evaluation Osteoporosis

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