{"id":2528,"date":"2021-11-02T00:00:00","date_gmt":"2021-11-02T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/importance-of-accounting-for-loss-to-follow-up-when-comparing-mortality-between-immigrants-and-long-term-residents-a-population-based-retrospective-cohort\/"},"modified":"2023-06-14T19:56:28","modified_gmt":"2023-06-14T23:56:28","slug":"importance-of-accounting-for-loss-to-follow-up-when-comparing-mortality-between-immigrants-and-long-term-residents-a-population-based-retrospective-cohort","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/importance-of-accounting-for-loss-to-follow-up-when-comparing-mortality-between-immigrants-and-long-term-residents-a-population-based-retrospective-cohort\/","title":{"rendered":"Importance of accounting for loss to follow-up when comparing mortality between immigrants and long-term residents: a population-based retrospective cohort"},"content":{"rendered":"<p><strong>Objectives <\/strong>&#x2014; To evaluate the association between immigration status and all-cause mortality in different disease cohorts, and the impact of loss to follow-up on the observed associations.<\/p>\n<p><strong>Design <\/strong>&#x2014; Population-based retrospective cohort study using linked administrative health data in Ontario, Canada.<\/p>\n<p><strong>Setting <\/strong>&#x2014; We followed adults with a first-ever diagnosis of ischaemic stroke, cancer or schizophrenia between 2002 and 2013 from index event to death, loss to follow-up, or end of follow-up in 2018.<\/p>\n<p><span class=\"bold\">Primary and Secondary Outcome Measures &#x2014;<\/span> Our outcomes of interest were all-cause mortality and loss to follow-up. For each disease cohort, we calculated adjusted HRs of death in immigrants compared with long-term residents, adjusting for demographic characteristics and comorbidities, with and without censoring for those who were lost to follow-up. We calculated the ratio of two the HRs and the respective CL using bootstrapping methods.<\/p>\n<p><strong>Results <\/strong>&#x2014; Immigrants were more likely to be lost to follow-up than long-term residents in all disease cohorts. Not accounting for this loss to follow-up overestimated the magnitude of the association between immigration status and mortality in those with ischaemic stroke (HR of death before vs after accounting for censoring: 0.78 vs 0.83, ratio=0.95; 95% CL 0.93 to 0.97), cancer (0.74 vs 0.78, ratio=0.96; 0.95 to 0.96), and schizophrenia (0.54 vs 0.56, ratio=0.97; 0.96 to 0.98).<\/p>\n<p><strong>Conclusions <\/strong>&#x2014; Immigrants to Canada have a survival advantage that varies by the disease studied. The magnitude of this advantage is modestly overestimated by not accounting for the higher loss to follow-up in immigrants.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Objectives &#x2014; To evaluate the association between immigration status and all-cause mortality in different disease cohorts, and the impact of loss to follow-up on the observed associations. Design &#x2014; Population-based retrospective cohort study using linked administrative health data in Ontario, Canada. Setting &#x2014; We followed adults with a first-ever diagnosis of ischaemic stroke, cancer or [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-2528","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Vyas MV, Fang J, Austin PC, Laupacis A, Cheung MC, Silver FL, Kapral MK. <em>BMJ Open<\/em>. 2021; 11(11):e046377. Epub 2021 Nov 2.","source_url":"https:\/\/bmjopen.bmj.com\/content\/11\/11\/e046377.long","ices_scientist":[1118,1385,1293,1193,1150,1375],"site":[6733],"research_program":[6742],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"4E6BE44E-10D5-4BB1-80DA-AE42203C609F","sitecore_item_name":"Importance-of-accounting-for-loss-to-follow-up-when-comparing-mortality-between-immigrants","sitecore_field_values":"{\n  \"Title\": \"Importance of accounting for loss to follow-up when comparing mortality between immigrants and long-term residents: a population-based retrospective cohort\",\n  \"Short title\": \"Importance of accounting for loss to\",\n  \"Summary\": \"This study aimed to evaluate the association between immigration status and all-cause mortality in different disease cohorts, and the impact of loss to follow-up on the observed associations.\",\n  \"Citation\": \"<p>Vyas MV, Fang J, Austin PC, Laupacis A, Cheung MC, Silver FL, Kapral MK. <em>BMJ Open<\/em>. 2021; 11(11):e046377. Epub 2021 Nov 2. DOI: <a href=\"https:\/\/doi.org\/10.1136\/bmjopen-2020-046377\" title=\"opens external link\">https:\/\/doi.org\/10.1136\/bmjopen-2020-046377<\/a><\/p>\",\n  \"Abstract\": \"<p><strong>Objectives <\/strong>&mdash; To evaluate the association between immigration status and all-cause mortality in different disease cohorts, and the impact of loss to follow-up on the observed associations.<\/p>n<p><strong>Design <\/strong>&mdash; Population-based retrospective cohort study using linked administrative health data in Ontario, Canada.<\/p>n<p><strong>Setting <\/strong>&mdash; We followed adults with a first-ever diagnosis of ischaemic stroke, cancer or schizophrenia between 2002 and 2013 from index event to death, loss to follow-up, or end of follow-up in 2018.<\/p>n<p><span class=\"bold\">Primary and Secondary Outcome Measures &mdash;<\/span> Our outcomes of interest were all-cause mortality and loss to follow-up. For each disease cohort, we calculated adjusted HRs of death in immigrants compared with long-term residents, adjusting for demographic characteristics and comorbidities, with and without censoring for those who were lost to follow-up. We calculated the ratio of two the HRs and the respective CL using bootstrapping methods.<\/p>n<p><strong>Results <\/strong>&mdash; Immigrants were more likely to be lost to follow-up than long-term residents in all disease cohorts. Not accounting for this loss to follow-up overestimated the magnitude of the association between immigration status and mortality in those with ischaemic stroke (HR of death before vs after accounting for censoring: 0.78 vs 0.83, ratio=0.95; 95% CL 0.93 to 0.97), cancer (0.74 vs 0.78, ratio=0.96; 0.95 to 0.96), and schizophrenia (0.54 vs 0.56, ratio=0.97; 0.96 to 0.98).<\/p>n<p><strong>Conclusions <\/strong>&mdash; Immigrants to Canada have a survival advantage that varies by the disease studied. The magnitude of this advantage is modestly overestimated by not accounting for the higher loss to follow-up in immigrants.<\/p>n<p><a href=\"https:\/\/bmjopen.bmj.com\/content\/11\/11\/e046377.long\" title=\"Opens external link\">View full text<\/a><\/p>\",\n  \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{A427077E-906B-463B-8DC1-8DB109670483}|{7D498E8B-5801-4F9E-AC41-11ED50F3C34E}|{83920C20-06BE-4C6B-9FA7-06B69A509A24}|{C61EC381-DBA1-4E07-8583-0E6F2F691360}|{85A20A85-A5DB-4EC9-A9C2-DDBB2DEDBF72}|{BA7F184D-0B54-4C38-827F-77223D5A2AC7}\",\n  \"Posted Date\": \"20211102T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2021\/November\/Importance-of-accounting-for-loss-to-follow-up-when-comparing-mortality-between-immigrants"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Importance of accounting for loss to follow-up when comparing mortality between immigrants and long-term residents: a population-based retrospective cohort<\/title>\n<meta name=\"description\" content=\"Objectives &#x2014; 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