%0 Journal Article %1 Morant2004 %A Morant, S V %A Pettitt, D %A MacDonald, T M %A Burke, T A %A Goldstein, J L %D 2004 %J Pharmacoepidemiology and drug safety %K 80andover Adult AgeFactors Aged Anti-InflammatoryAgents CohortStudies CyclooxygenaseInhibitors CyclooxygenaseInhibitors:adverseeffects CyclooxygenaseInhibitors:therapeuticuse Databases DrugUtilizationReview Factual FamilyPractice FamilyPractice:statistics&numericaldata Female GastrointestinalHemorrhage GastrointestinalHemorrhage:chemicallyinduced GastrointestinalHemorrhage:epidemiology GreatBritain GreatBritain:epidemiology Humans Male MiddleAged Non-Steroidal Non-Steroidal:adverseeffects Non-Steroidal:therapeuticuse Osteoarthritis Osteoarthritis:drugtherapy Pharmacoepidemiology RegressionAnalysis RiskFactors SexFactors Thiazines Thiazines:adverseeffects Thiazines:therapeuticuse Thiazoles Thiazoles:adverseeffects Thiazoles:therapeuticuse %N 6 %P 345-53 %R 10.1002/pds.946 %T Application of a propensity score to adjust for channelling bias with NSAIDs. %U http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15170763 http://www.ncbi.nlm.nih.gov/pubmed/15170763 %V 13 %X PURPOSE: To compare the relative risks of upper GI haemorrhage (UGIH) in users of Newer versus Older, non-specific NSAIDs when adjusted for channelling bias by regression on individual covariates, a propensity score and both. METHODS: Cohort study of patients prescribed NSAIDs between June 1987 and January 2000. Exposure to Newer and Older non-specific NSAIDs was identified, and risk factors evaluated for each patient. Results of multiple covariate analyses and the propensity scoring technique to assess potential channelling bias in comparisons between Newer and Older non-specific NSAIDs were compared. RESULTS: This study included 7.1 thousand patient years (tpy) exposure to meloxicam, 1.6 tpy exposure to coxibs, and 628 tpy exposure to Older non-specific NSAIDs. Patients receiving Newer NSAIDs were older, more likely to have a history of GI symptoms, and at higher risk for GI complications. Adjusting for these risk factors reduced the relative risks of UGIH on meloxicam and coxibs versus Older non-specific NSAIDs to 0.84 (95%CI 0.60, 1.17) and 0.36 (0.14, 0.97) respectively. CONCLUSIONS: Channelling towards high GI risk patients occurred in the prescribing of Newer NSAIDs. Propensity scores highlighted the markedly different risk profiles of users of Newer and Older non-specific NSAID. Correcting for channelling bias, coxib exposure, but not meloxicam exposure, was associated with less UGIH than Older non-specific NSAID exposure. In the present study, corrections made by regression on a propensity score and on individual covariates were similar.

@article{Morant2004, abstract = {PURPOSE: To compare the relative risks of upper GI haemorrhage (UGIH) in users of Newer versus Older, non-specific NSAIDs when adjusted for channelling bias by regression on individual covariates, a propensity score and both. METHODS: Cohort study of patients prescribed NSAIDs between June 1987 and January 2000. Exposure to Newer and Older non-specific NSAIDs was identified, and risk factors evaluated for each patient. Results of multiple covariate analyses and the propensity scoring technique to assess potential channelling bias in comparisons between Newer and Older non-specific NSAIDs were compared. RESULTS: This study included 7.1 thousand patient years (tpy) exposure to meloxicam, 1.6 tpy exposure to coxibs, and 628 tpy exposure to Older non-specific NSAIDs. Patients receiving Newer NSAIDs were older, more likely to have a history of GI symptoms, and at higher risk for GI complications. Adjusting for these risk factors reduced the relative risks of UGIH on meloxicam and coxibs versus Older non-specific NSAIDs to 0.84 (95%CI 0.60, 1.17) and 0.36 (0.14, 0.97) respectively. CONCLUSIONS: Channelling towards high GI risk patients occurred in the prescribing of Newer NSAIDs. Propensity scores highlighted the markedly different risk profiles of users of Newer and Older non-specific NSAID. Correcting for channelling bias, coxib exposure, but not meloxicam exposure, was associated with less UGIH than Older non-specific NSAID exposure. In the present study, corrections made by regression on a propensity score and on individual covariates were similar.}, added-at = {2023-02-03T11:44:35.000+0100}, author = {Morant, S V and Pettitt, D and MacDonald, T M and Burke, T A and Goldstein, J L}, biburl = {https://www.bibsonomy.org/bibtex/2d74afbd6527e5518774968be00896ebb/jepcastel}, city = {Medicines Monitoring Unit, Department of Medicine & Therapeutics, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK. steve.morant@btinternet.com}, doi = {10.1002/pds.946}, interhash = {2bc542bae53d97c7f3f29356c80cfb5d}, intrahash = {d74afbd6527e5518774968be00896ebb}, issn = {1053-8569}, journal = {Pharmacoepidemiology and drug safety}, keywords = {80andover Adult AgeFactors Aged Anti-InflammatoryAgents CohortStudies CyclooxygenaseInhibitors CyclooxygenaseInhibitors:adverseeffects CyclooxygenaseInhibitors:therapeuticuse Databases DrugUtilizationReview Factual FamilyPractice FamilyPractice:statistics&numericaldata Female GastrointestinalHemorrhage GastrointestinalHemorrhage:chemicallyinduced GastrointestinalHemorrhage:epidemiology GreatBritain GreatBritain:epidemiology Humans Male MiddleAged Non-Steroidal Non-Steroidal:adverseeffects Non-Steroidal:therapeuticuse Osteoarthritis Osteoarthritis:drugtherapy Pharmacoepidemiology RegressionAnalysis RiskFactors SexFactors Thiazines Thiazines:adverseeffects Thiazines:therapeuticuse Thiazoles Thiazoles:adverseeffects Thiazoles:therapeuticuse}, month = {6}, note = {15170763; 1053-8569 Journal Article; ID: 83;}, number = 6, pages = {345-53}, pmid = {15170763}, timestamp = {2023-02-03T11:44:35.000+0100}, title = {Application of a propensity score to adjust for channelling bias with NSAIDs.}, url = {http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15170763 http://www.ncbi.nlm.nih.gov/pubmed/15170763}, volume = 13, year = 2004 }