Two-Year Versus One-Year Head Start Program Impact: Addressing Selection Bias by Comparing Regression Modeling With Propensity Score Analysis

Purpose: To report a propensity score analysis comparing outcomes of the Supera interwoven nitinol stent to bare nitinol stents (BNS) in the femoropopliteal segment. Materials and Methods: A retrospective study was conducted utilizing data extracted from the Excellence in Peripheral Artery Disease (XLPAD) registry ( ClinicalTrials.gov identifier NCT01904851) on 871 patients (mean age 65.1 years; 713 men) who underwent femoropopliteal balloon angioplasty with either Supera stent implantation in 118 limbs or other contemporary BNS in 753 limbs between January 2006 and December 2016. All patients in both groups were matched for baseline demographic and clinical characteristics in a 1:1 propensity score matching using the nearest neighbor method to create the 118-patient matched BNS cohort. One-year outcomes included all-cause mortality, target vessel revascularization (TVR), and target limb revascularization (TLR). An additional core laboratory analysis was conducted to measure the deployed length of Supera stents. Results: In unmatched data, the Supera stent group had a numerically lower rate of TVR (7.6% vs 13.4%, p=0.08) and a significantly lower 1-year TLR rate (7.6% vs 16.2%, p=0.02) compared to the BNS group. Both groups had similar 1-year mortality (2.5% vs 2.7%, p=0.9). Kaplan-Meier analysis demonstrated that the Supera group had a significantly lower risk of TVR (p=0.02) and TLR (p=0.002) than the BNS group. After propensity matching, the 1-year TVR estimate was lower for Supera stents (7.6% vs 12.7%, p=0.08) and significantly lower for TLR (7.6% vs 13.6%, p=0.04) than the BNS group. There was no statistically significant association between Supera stent elongation (>10% of the labeled stent length) and 1-year risk of TLR (p=0.6). Conclusion: Supera stent usage in femoropopliteal intervention was associated with reduced risk of 1-year repeat target limb revascularization compared with BNS treatment in both unmatched and matched cohorts.

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Propensity score analysis with a time-dependent intervention is an acceptable although not an optimal analytical approach when treatment selection bias and survivor bias coexist

Journal of Clinical Epidemiology ◽

10.1016/j.jclinepi.2009.07.017 ◽

2010 ◽

Vol 63 (2) ◽

pp. 139-140 ◽

Cited By ~ 6

Author(s):

Imad M. Tleyjeh ◽

Hassan M.K. Ghomrawi ◽

James M. Steckelberg ◽

Victor M. Montori ◽

Tanya L. Hoskin ◽

...

Keyword(s):

Propensity Score ◽

Selection Bias ◽

Analytical Approach ◽

Propensity Score Analysis ◽

Treatment Selection ◽

Time Dependent ◽

Score Analysis ◽

Survivor Bias

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Abstract 12773: Dose-dependence of Beta-blocker Therapy on Subsequent Mortality in One Year Survivors After Myocardial Infarction

Circulation ◽

10.1161/circ.132.suppl_3.12773 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Jeffrey Goldberger

Keyword(s):

Myocardial Infarction ◽

Propensity Score ◽

Beta Blocker ◽

Propensity Score Analysis ◽

Dose Dependence ◽

Term Treatment ◽

Score Analysis ◽

Long Term Treatment ◽

One Year

Background: Beta-blocker (BB) therapy after acute myocardial infarction (MI) improves survival. The benefits of long term treatment remain debated. Methods: Of 7058 patients enrolled in the OBTAIN prospective multi-center registry of patients with acute MI, follow-up BB dosing information was available in 2822 patients who survived ≥1 year. BB dose was indexed to the target BB dose used in RCTs (when available), reported as %; only BBs studied in RCTs were included in this analysis. Dosage groups were No BB (n=302), ≤12.5% (n=557), 12.6-25% (n=848), 26-50% (n=687), and >50% (n=428) of target dose respectively. Vital status was obtained by chart review, Social Security Death Index, or direct contact. Adjustment for baseline differences among groups was achieved by propensity score analysis (predicted 1-year BB dose as control variable). Results: In the 5 groups, mean age was 62-64 years, with significant differences in gender, clinical, and MI characteristics. Mean ejection fractions were 47-50%. The figure shows Kaplan-Meier survival curves (unadjusted, p=0.06). Propensity score analysis showed an independent effect of BB dose on mortality (p=0.047). Compared to No BB, only the 12.6-25% dose group had a significant mortality reduction (HR 0.46, 95% CI 0.25-0.86, p=0.014). Conclusions: At one year after MI, continued BB therapy may be associated with lower mortality, but there appears to be a dose-dependence to this effect. Further studies are needed to optimize BB dosing strategies for long-term treatment after MI.

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Propensity score–weighted analysis of chemotherapy after PD-1 inhibitors versus chemotherapy alone in patients with non–small cell lung cancer (WJOG10217L)

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2019-000350 ◽

2020 ◽

Vol 8 (1) ◽

pp. e000350 ◽

Cited By ~ 4

Author(s):

Ryoji Kato ◽

Hidetoshi Hayashi ◽

Yasutaka Chiba ◽

Eriko Miyawaki ◽

Junichi Shimizu ◽

...

Keyword(s):

Lung Cancer ◽

Propensity Score ◽

Small Cell Lung Cancer ◽

Selection Bias ◽

Propensity Score Analysis ◽

Small Cell ◽

Control Cohort ◽

Small Cell Lung ◽

Score Analysis ◽

And Control

BackgroundStudies have suggested that chemotherapy after immune checkpoint inhibitors may confer an improved response for non–small cell lung cancer (NSCLC). However, potential selection bias in such studies has not been addressed. We therefore applied propensity score analysis to investigate the efficacy of chemotherapy after PD-1 inhibitor treatment (CAP) compared with chemotherapy alone.MethodsWe conducted a retrospective observational cohort study for patients treated at 47 institutions across Japan between April 1, 2014 and July 31, 2017. Eligible patients had advanced or recurrent NSCLC who have undergone chemotherapy. Patients subsequently treated with chemotherapy (docetaxel with or without ramucirumab, S-1 or pemetrexed) either after PD-1 inhibitor therapy (CAP cohort) or alone (control cohort) were included. The primary end point was objective response rate (ORR). Inverse probability weighting (IPW) was applied to adjust for potential confounding factors.ResultsA total of 1439 patients (243 and 1196 in the CAP and control cohorts, respectively) was available for unadjusted analysis. Several baseline characteristics—including age, histology,EGFRorALKgenetic alterations, and brain metastasis—differed significantly between the two cohorts. After adjustment for patient characteristics with the IPW method, ORR was 18.9% for the CAP cohort and 11.0% for the control cohort (ORR ratio 1.71; 95% CI 1.19 to 2.46; p=0.004). IPW-adjusted Kaplan-Meier curves showed that median progression-free survival (PFS) for the CAP and control cohorts was 2.8 and 2.7 months (IPW-adjusted HR 0.95; 95% CI 0.80 to 1.12; p=0.55), and median overall survival (OS) was 9.2 and 10.4 months (IPW-adjusted HR 1.05; 95% CI 0.86 to 1.28; p=0.63), respectively.ConclusionsAfter accounting for selection bias by propensity score analysis, CAP showed a significantly higher ORR compared with chemotherapy alone, with the primary end point of ORR being achieved. However, these results did not translate into a PFS or OS advantage, suggesting that prior administration of PD-1 inhibitors may result in a synergistic antitumor effect with subsequent chemotherapy, but that such an effect is transient. CAP therefore does not appear to achieve durable tumor control or confer a lasting survival benefit.

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One‐Year Recipient Morbidity of Liver Transplantation Using Pure Laparoscopic Versus Open Living Donor Right Hepatectomy: Propensity Score Analysis

Liver Transplantation ◽

10.1002/lt.25593 ◽

2019 ◽

Vol 25 (11) ◽

pp. 1642-1650 ◽

Cited By ~ 5

Author(s):

Jungchan Park ◽

Choon Hyuck David Kwon ◽

Gyu‐Seong Choi ◽

Suk‐Koo Lee ◽

Jong Man Kim ◽

...

Keyword(s):

Liver Transplantation ◽

Propensity Score ◽

Living Donor ◽

Propensity Score Analysis ◽

Right Hepatectomy ◽

Score Analysis ◽

One Year

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Safety and Efficacy of Embolic Protection Devices in Saphenous Vein Graft Interventions: A Propensity Score Analysis—Multicenter SVG PCI PROTECTA Study

Journal of Clinical Medicine ◽

10.3390/jcm9041198 ◽

2020 ◽

Vol 9 (4) ◽

pp. 1198

Author(s):

Wojciech Wańha ◽

Maksymilian Mielczarek ◽

Natasza Gilis-Malinowska ◽

Tomasz Roleder ◽

Marek Milewski ◽

...

Keyword(s):

Propensity Score ◽

Saphenous Vein ◽

Vein Graft ◽

Propensity Score Analysis ◽

Saphenous Vein Graft ◽

Embolic Protection ◽

Score Analysis ◽

Protection Devices ◽

One Year

Background: Evidence concerning the efficacy of the embolic protection devices (EPDs) in saphenous vein graft (SVG) percutaneous coronary intervention (PCI) is sparse. The study was designed to compare major cardiovascular events of all-comer population of SVG PCI with and without EPDs at one year of follow-up. Methods and results: A multi-center registry comparing PCI with and without EPDs in consecutive patients undergoing PCI of SVG. The group comprised 792 patients, among which 266 (33.6%) had myocardial infarction (MI). The primary composite endpoint was major adverse cardiac and cerebrovascular event (MACCE) defined as death, MI, target vessel revascularization (TVR), and stroke assessed at one year. After propensity score analysis, there were no differences in MACCE (21.9% vs. 23.9%; HR 0.91, 95% CI 0.57–1.45, p = 0.681, respectively) nor in secondary endpoints of death, MI, TVR, target lesion revascularization (TLR) and stroke at one year in EPDs PCI group vs. no-EPDs PCI group. Similarly, there were no differences between groups in the study endpoints at 30 days follow-up. Conclusions: There were no clinical benefit for routine use of EPDs during SVG PCI in short and long-term follow-up. Further studies are warranted to explore the effect of individual types of EPDs on clinical outcomes.

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