Conclusion about the association between valve surgery and mortality in an infective endocarditis cohort changed after adjusting for survivor bias

Journal of Clinical Epidemiology
Imad M TleyjehLarry M Baddour

Abstract

Survivor bias commonly weakens observational studies, even those published in premier journals. It occurs because patients who live longer are more likely to receive treatment than those who die early. We sought to quantify the effect of survivor bias on the association between valve surgery and mortality in infective endocarditis (IE). The study cohort included 546 IE patients. We compared the hazard ratios (HR) resulting from two propensity score analysis approaches that adjusted for survivor bias (time-dependent variable and matching on follow-up time) with those achieved using the same models but without that adjustment (time-fixed variable). In the total cohort, the HR of surgery in the time-dependent model was 1.9 (95% confidence interval [CI] = 1.1-3.2; P = 0.03) vs. 0.9 (95% CI = 0.5-1.4; P = 0.53) in the time-fixed model. In the propensity score-matched subset, the HR of surgery was 1.3 (95% CI = 0.5-3.1; P = 0.56) and 0.8 (95% CI = 0.4-1.7; P = 0.57) in the subset with and without matching on follow-up time, respectively. Adjusting for survivor bias changed the conclusion about the association between valve surgery and mortality in IE. Researchers should be aware of this bias when evaluating observational studies of t...Continue Reading

References

Apr 16, 1992·The New England Journal of Medicine·N M GrahamJ P Phair
Jul 1, 1992·The Journal of Infectious Diseases·G F LempS R Hernandez
May 16, 1991·The New England Journal of Medicine·R D MooreR E Chaisson
Jun 1, 1996·Annals of Internal Medicine·M J Glesby, D R Hoover
Feb 12, 1998·Annals of Internal Medicine·D B Rubin
Jun 3, 1999·Annual Review of Public Health·L D Fisher, D Y Lin
Apr 19, 2000·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·J S LiG R Corey
Jan 29, 2002·Lancet·David A Grimes, Kenneth F Schulz
Dec 25, 2003·JAMA : the Journal of the American Medical Association·Holenarasipur R VikramVincent J Quagliarello
Sep 11, 2004·Journal of Clinical Epidemiology·Carl van WalravenGeorge A Wells
Nov 18, 2005·American Heart Journal·Andrew WangUNKNOWN International Collaboration on Endocarditis Investigators
Nov 18, 2005·American Heart Journal·Christopher H CabellUNKNOWN International Collaboration on Endocarditis Merged Database (ICE-MD) Study Group Investigators
Nov 15, 2006·Journal of Evaluation in Clinical Practice·Peter C AustinJack V Tu
Jan 6, 2007·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Olcay AksoyChristopher H Cabell
Jan 18, 2007·JAMA : the Journal of the American Medical Association·Ralph B D'Agostino, Ralph B D'Agostino

❮ Previous
Next ❯

Citations

May 24, 2011·Vascular Health and Risk Management·Stuart J HeadA Pieter Kappetein
Mar 8, 2016·Infectious Diseases·Abdelghani El RafeiLarry M Baddour
Feb 4, 2010·Journal of Clinical Epidemiology·Peter C Austin, Robert W Platt
Feb 4, 2010·Journal of Clinical Epidemiology·Peter C Austin, Robert W Platt
Apr 27, 2016·The Journal of Thoracic and Cardiovascular Surgery·Anelechi C Anyanwu
Oct 26, 2016·La Presse médicale·François Delahaye
Sep 17, 2015·Circulation·Larry M BaddourUNKNOWN American Heart Association Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular
Oct 9, 2020·The Journal of Antimicrobial Chemotherapy·Zakariya KashourImad M Tleyjeh
Nov 18, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Imad M Tleyjeh
Jan 13, 2021·Journal of General Internal Medicine·Imad M Tleyjeh, Tarek Kashour
Nov 9, 2020·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·Imad M TleyjehTarek Kashour
Feb 21, 2021·International Journal of Antimicrobial Agents·Prof Imad M Tleyjeh, Haytham Tlayjeh
Oct 4, 2020·Journal of Infection and Public Health·Haytham TlayjehImad M Tleyjeh

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.