A comparison of propensity score methods: a case-study estimating the effectiveness of post-AMI statin use.

Abstract:

:There is an increasing interest in the use of propensity score methods to estimate causal effects in observational studies. However, recent systematic reviews have demonstrated that propensity score methods are inconsistently used and frequently poorly applied in the medical literature. In this study, we compared the following propensity score methods for estimating the reduction in all-cause mortality due to statin therapy for patients hospitalized with acute myocardial infarction: propensity-score matching, stratification using the propensity score, covariate adjustment using the propensity score, and weighting using the propensity score. We used propensity score methods to estimate both adjusted treated effects and the absolute and relative risk reduction in all-cause mortality. We also examined the use of statistical hypothesis testing, standardized differences, box plots, non-parametric density estimates, and quantile-quantile plots to assess residual confounding that remained after stratification or matching on the propensity score. Estimates of the absolute reduction in 3-year mortality ranged from 2.1 to 4.5 per cent, while estimates of the relative risk reduction ranged from 13.3 to 17.0 per cent. Adjusted estimates of the reduction in the odds of 3-year death varied from 15 to 24 per cent across the different propensity score methods.

journal_name

Stat Med

journal_title

Statistics in medicine

authors

Austin PC,Mamdani MM

doi

10.1002/sim.2328

subject

Has Abstract

pub_date

2006-06-30 00:00:00

pages

2084-106

issue

12

eissn

0277-6715

issn

1097-0258

journal_volume

25

pub_type

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