Prior event rate ratio adjustment: numerical studies of a statistical method to address unrecognized confounding in observational studies

Pharmacoepidemiology and Drug Safety
Menggang YuRichard Tannen

Abstract

The purpose of this study was to evaluate a statistical method, prior event rate ratio (PERR) adjustment, and an alternative, PERR-ALT, both of which have the potential to overcome "unmeasured confounding," both analytically and via simulation. Formulae were derived for the target estimates of both PERR methods, which were compared with results from simulations to ensure their validity. In addition to the theoretical insights gained, relative biases of both PERR methods for estimating exposure effects were also investigated via simulation studies and compared empirically with electronic medical record database study results. Theoretical derivations closely matched simulated results. In simulation studies, both PERR methods significantly reduce bias from unmeasured confounding compared with the standard Cox model. When there is no interaction between unmeasured confounders and time intervals, the estimate from PERR-ALT is unbiased, whereas the estimate from PERR has well-controlled relative bias. When interactions exist, relative biases tend to increase but not greatly, especially when the exposure effect is relatively large in comparison with the interaction effects. When the event rate is low and the sample size is limited, PE...Continue Reading

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Citations

Nov 21, 2014·Pharmacoepidemiology and Drug Safety·Md Jamal UddinOlaf H Klungel
May 23, 2017·Gastroenterology·Michael F VaeziColin W Howden
Dec 17, 2014·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Sean Hennessy, Charles E Leonard
Feb 1, 2018·Pharmacoepidemiology and Drug Safety·Xiang ZhangGuido W Imbens
Apr 21, 2018·Journal of the American Geriatrics Society·Jan Zirk-SadowskiAlessandro Ble
May 11, 2012·Pharmacoepidemiology and Drug Safety·Sebastian SchneeweissScott R Smith
Dec 14, 2016·Learning Health Systems·Richard Tannen, Menggang Yu
Apr 20, 2016·International Journal of Clinical Pharmacy·Md Jamal UddinOlaf H Klungel
Jan 1, 2017·Journal of the Royal Statistical Society. Series C, Applied Statistics·Jaeun Choi, A James O'Malley
Mar 21, 2020·Journal of Clinical Epidemiology·Lauren R RodgersUNKNOWN MASTERMIND Consortium
Jun 26, 2021·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jongyeon KimBryan Lau

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