Abstract：
OBJECTIVE:Regression discontinuity (RD) is a quasi-experimental design that may provide valid estimates of treatment effects in case of continuous outcomes. We aimed to evaluate validity and precision in the RD design for dichotomous outcomes. STUDY DESIGN AND SETTING:We performed validation studies in three large randomized controlled trials (RCTs) (Corticosteroid Randomization After Significant Head injury [CRASH], the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries [GUSTO], and PROspective Study of Pravastatin in elderly individuals at risk of vascular disease [PROSPER]). To mimic the RD design, we selected patients above and below a cutoff (e.g., age 75 years) randomized to treatment and control, respectively. Adjusted logistic regression models using restricted cubic splines (RCS) and polynomials and local logistic regression models estimated the odds ratio (OR) for treatment, with 95% confidence intervals (CIs) to indicate precision. RESULTS:In CRASH, treatment increased mortality with OR 1.22 [95% CI 1.06-1.40] in the RCT. The RD estimates were 1.42 (0.94-2.16) and 1.13 (0.90-1.40) with RCS adjustment and local regression, respectively. In GUSTO, treatment reduced mortality (OR 0.83 [0.72-0.95]), with more extreme estimates in the RD analysis (OR 0.57 [0.35; 0.92] and 0.67 [0.51; 0.86]). In PROSPER, similar RCT and RD estimates were found, again with less precision in RD designs. CONCLUSION:We conclude that the RD design provides similar but substantially less precise treatment effect estimates compared with an RCT, with local regression being the preferred method of analysis.
journal_name
J Clin Epidemioljournal_title
Journal of clinical epidemiologyauthors
van Leeuwen N,Lingsma HF,Mooijaart SP,Nieboer D,Trompet S,Steyerberg EWdoi
10.1016/j.jclinepi.2018.02.015subject
Has Abstractpub_date
2018-06-01 00:00:00pages
70-79eissn
0895-4356issn
1878-5921pii
S0895-4356(17)30612-1journal_volume
98pub_type
杂志文章abstract：:The Indonesian Food and Drug Agency began to evaluate drug applications in the early 1970s through an Advisory Committee. This was in response to the perestroika-like policy applied to our drug industry; nowadays there are more than 300 drug companies formulating some 13,5600 drug products. During 1977-1988, 603 drugs...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(91)90111-l
更新日期：1991-01-01 00:00:00
abstract：:A key component in the evaluation of efficacy of a vaccine to protect against disease caused by an antigenically diverse infectious pathogen in a preventative vaccine trial is assessing how vaccine-induced protection depends on genotypic and phenotypic variations of the exposing pathogen. This assessment is made by co...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/s0895-4356(00)00258-4
更新日期：2001-01-01 00:00:00
abstract：OBJECTIVE:To evaluate the mechanisms of action in two successful geriatric clinical trials that tested multicomponent physical conditioning programs and to determine whether the pathways for overall benefit were through improvement in physical ability and/or self-confidence. STUDY DESIGN AND SETTING:PREHAB and DRIVER ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinepi.2006.04.009
更新日期：2007-01-01 00:00:00
abstract：:Our objective was to describe distortion in outcome studies due to "frailty bias" or differential susceptibility to adverse health outcomes due to frailties but attributed to other factors. We linked an administrative database to survey data (n = 5934) containing functional, condition, and outcome measures. The diseas...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(99)00056-6
更新日期：1999-08-01 00:00:00
abstract：OBJECTIVES:To assess the role of quality of work-life (QWL) research in a clinical research environment. STUDY DESIGN AND SETTING:A phenomenological qualitative research study was conducted. This research was conducted in a large Canadian ambulatory cancer treatment center that serves over 2.3 million people in Ontari...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2006.03.003
更新日期：2008-05-01 00:00:00
abstract：OBJECTIVE:The objective was to estimate the presence and extent to which potentially unnecessary and therefore maybe wasteful clinical trials regarding relevant interventions and outcomes in major clinical areas had been conducted. STUDY DESIGN AND SETTING:From current Cochrane collaboration systematic reviews in majo...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2016.11.003
更新日期：2017-02-01 00:00:00
abstract：OBJECTIVE:To test the theory of a U-shaped association between time from the first presentation of symptoms in primary care to the diagnosis (the diagnostic interval) and mortality after diagnosis of colorectal cancer (CRC). STUDY DESIGN AND SETTING:Three population-based studies in Denmark and the United Kingdom usin...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2011.12.006
更新日期：2012-06-01 00:00:00
abstract：:A summary performance measure comprised of a hierarchical balance task, a 4-meter walk, and five repetitive chair stands is increasingly being used as a predictor of independent living for older persons. The reliability and sensitivity to change of this summary performance measure have not been investigated, however. ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(02)00436-5
更新日期：2002-09-01 00:00:00
abstract：:This study reports the use of psychotropic drugs and pregnancy outcome in a prospective survey carried out in northern Finland in 1985-1986, consisting of 7933 pregnant women and their 8030 births. Of the mothers, 120 (1.5%) used psychotropic drugs during pregnancy and of them 26 (0.3% of the total) used these drugs b...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(96)00203-x
更新日期：1996-11-01 00:00:00
abstract：:This study investigates aspects of the reliability of the Maastricht criteria list for quality assessment in systematic reviews, and whether blinded reviewing is necessary to prevent review bias. We used the data set of 12 articles from a systematic review concerning the efficacy of balneotherapy in patients with arth...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(97)00297-7
更新日期：1998-04-01 00:00:00
abstract：OBJECTIVE:Graphical methods for generating explanatory hypotheses from limited categorical data are described and illustrated. STUDY DESIGN AND SETTING:Univariate, bivariate, multivariate, and multiplicative graphical methods were applied to clinical data regarding very ill older persons. The data to which these metho...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2011.06.007
更新日期：2012-02-01 00:00:00
abstract：OBJECTIVE:Clinical trials are unlikely to ever be launched for many comparative effectiveness research (CER) questions. Inferences from hypothetical randomized trials may however be emulated with marginal structural modeling (MSM) using observational data, but success in adjusting for time-dependent confounding and sel...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2013.01.016
更新日期：2013-08-01 00:00:00
abstract：OBJECTIVES:To evaluate how estimated treatment effects agree between nonrandomized studies using causal modeling with marginal structural models (MSM-studies) and randomized trials (RCTs). STUDY DESIGN:Meta-epidemiological study. SETTING:MSM-studies providing effect estimates on any healthcare outcome of any treatmen...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2019.10.012
更新日期：2020-02-01 00:00:00
abstract：OBJECTIVE:Cases and controls should be chosen from the same base population to reduce selection bias in case-control studies. For hospital cases, we examined how inferences drawn from a case-control study can differ by choice of hospital- vs. community-based controls. STUDY DESIGN AND SETTINGS:We used data from a case...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2009.11.006
更新日期：2010-08-01 00:00:00
abstract：OBJECTIVES:The objective of this study was to analyze adequacy of judgments about risk of bias (RoB) for blinding of participants and personnel (performance bias) in Cochrane systematic reviews of randomized controlled trials (RCTs). STUDY DESIGN AND SETTING:We extracted judgments and supporting comments for performan...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2019.05.012
更新日期：2019-09-01 00:00:00
abstract：OBJECTIVE:To determine the frequency of unpublished systematic reviews (SRs) and explore factors contributing to their occurrence. STUDY DESIGN AND SETTING:First or corresponding authors from a sample of SRs published in 2005 were asked to participate in a 26-item survey administered through the Internet, facsimile, a...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2008.09.014
更新日期：2009-06-01 00:00:00
abstract：OBJECTIVES:Elderly patients are inordinately affected by surgical site infections (SSIs). This study derived and internally validated a model that used routinely collected health administrative data to measure the probability of SSI in elderly patients within 30 days of surgery. STUDY DESIGN AND SETTING:All people exc...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2016.05.010
更新日期：2016-09-01 00:00:00
abstract：OBJECTIVE:Hospital mortality outcomes for acute myocardial infarction (AMI) patients are a focus of quality improvement programs conducted by government agencies. AMI mortality risk-adjustment models using administrative data typically adjust for baseline differences in mortality risk with a limited set of common and d...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2006.05.014
更新日期：2007-02-01 00:00:00
abstract：OBJECTIVES:It is difficult to compare the reliability of triage systems with the kappa statistic. In this article, a method for comparing triage systems was developed and applied to previously conducted triage reliability studies. STUDY DESIGN AND SETTING:From simulations with theoretical distributions, the minimum, n...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2010.01.012
更新日期：2010-11-01 00:00:00
abstract：OBJECTIVES:To evaluate the ability of population surveys to estimate the occurrence of maternal morbidities. STUDY DESIGN AND SETTING:A literature search was conducted using MEDLINE, EMBASE, POPLINE references from relevant papers and proceedings of scientific meetings. No restrictions were made regarding language, da...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2007.04.009
更新日期：2008-02-01 00:00:00
abstract：OBJECTIVE:We review the uses of electronic health care data algorithms, measures of their accuracy, and reasons for prioritizing one measure of accuracy over another. STUDY DESIGN AND SETTING:We use real studies to illustrate the variety of uses of automated health care data in epidemiologic and health services resear...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2011.09.002
更新日期：2012-03-01 00:00:00
abstract：OBJECTIVES:Disinvestment is critical for ensuring the long-term sustainability of health-care services. Key barriers to disinvestment are heterogeneity between research and clinical settings, absence of evidence of effectiveness of some health technologies, and exposure of patients and organizations to risks and poor o...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2013.08.014
更新日期：2014-02-01 00:00:00
abstract：:We investigated the relationship between antihypertensive drug treatment of hypertensives and their mean serum lipid concentrations in population based studies in Germany. Data from three surveys (Luebeck Blood Pressure Study (LBS) of 1984, MONICA Augsburg Survey I of 1984/85, MONICA Augsburg Survey II of 1989/90), ob...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(92)90204-z
更新日期：1992-12-01 00:00:00
abstract：:Cross-sectional data from the Epidemiology of Diabetes Complications Study were used to examine the relationships between waist to hip circumference ratio (WHR) and the presence of diabetes complications in IDDM adults ages 18-45 years (N = 586). Significantly higher WHRs were observed among both genders with prolifer...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(94)90291-7
更新日期：1994-05-01 00:00:00
abstract：OBJECTIVES:To identify key principles of graph construction and to review guidance on graph construction provided by medical journals. STUDY DESIGN AND SETTING:Review of a prevailing model of graph comprehension and survey of authors' instructions for all 120 core medical journals as indexed by PubMed. RESULTS:Graph ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2005.12.016
更新日期：2006-10-01 00:00:00
abstract：OBJECTIVE:Both randomized and observational studies commonly examine composite end points, but the literature on model development and criticism in this setting is limited. STUDY DESIGN AND SETTING:We examined approaches for evaluating heterogeneity in the effects of risk factors for different components of the end po...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2003.02.001
更新日期：2004-02-01 00:00:00
abstract：:This paper focuses on the appropriateness of outcome measures to evaluate trauma care. The preventable death rate (PDR), based on the study of deceased patients only, has been the traditional measure of the impact of trauma care on improving the survival of patients with severe trauma. Another measure frequently used ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(90)90125-9
更新日期：1990-01-01 00:00:00
abstract：OBJECTIVE:To address methodologic issues in searching for observational studies by presenting database search methods and results. STUDY DESIGN AND SETTING:Results of two literature searches for publications reporting on observational studies of alcohol consumption and the risk of breast cancer and large bowel cancer ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2005.03.004
更新日期：2005-09-01 00:00:00
abstract：:Numerous studies have shown that the symptoms of angina pectoris are more prevalent in women than men, than other manifestations of coronary heart disease, with the greatest discrepancies at younger ages. Variation in symptom reliability between genders could be a potential explanation for these differences. The Lipid...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(91)90009-x
更新日期：1991-01-01 00:00:00
abstract：:To examine the effect of cancer histopathology on the relationship between estrogen-replacement therapy (ERT) use and breast cancer risk, we performed a case-control study of 109 postmenopausal women 45 years or older with in situ or invasive breast cancer matched to 545 controls. When in situ and invasive tumors were...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(98)00116-4
更新日期：1998-12-01 00:00:00
