Quantifying bias reduction with fixed-duration versus all-available covariate assessment periods

Pharmacoepidemiology and Drug Safety
John G ConnollyJoshua J Gagne

Abstract

Implementing a cohort study in longitudinal healthcare databases requires looking back over some covariate assessment period (CAP) preceding cohort entry to measure confounders. We used simulations to compare fixed-duration versus all-available CAPs for confounder adjustment in the presence of differences in available baseline time between exposure groups. We simulated cohorts of 10 000 patients with binary variables for a single confounder, exposure, and outcome. Baseline time was simulated based on the observed distribution in a claims-based comparison of statin users versus nonusers. We compared bias after measuring confounders using fixed-duration and all-available CAPs, both when exposure groups had similar and discrepant amounts of available baseline time. When the comparison groups had similar amounts of baseline time, an all-available CAP was less biased than a fixed-duration CAP. When baseline time differed between comparison groups, the preferable CAP approach depended on the direction of confounding and which exposure group had higher covariate sensitivity. These findings were consistent in direction across sensitivity analyses. In certain settings of differential available baseline time between exposure groups, the ...Continue Reading

References

May 3, 2005·Journal of Clinical Epidemiology·Sebastian Schneeweiss, Jerry Avorn
Mar 26, 2013·Pharmacoepidemiology and Drug Safety·Steven M BrunelliJohn D Seeger
Jun 19, 2015·Current Epidemiology Reports·Michele Jonsson Funk, Suzanne N Landi
Nov 27, 2015·Pharmacoepidemiology and Drug Safety·David T GilbertsonKenneth J Rothman
Apr 12, 2017·Pharmacoepidemiology and Drug Safety·Sonja S NakasianJessica M Franklin
Apr 15, 2018·Pharmacoepidemiology and Drug Safety·Mitchell M ConoverMichele Jonsson Funk

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Citations

Jul 20, 2019·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·John G ConnollyJoshua J Gagne
Oct 22, 2019·PLoS Medicine·Michael FralickAaron S Kesselheim
Aug 10, 2021·Health Services & Outcomes Research Methodology·Rebecca A HubbardJessica Chubak

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