%0 Journal Article %1 Koller2008 %A Koller, Michael T %A Stijnen, Theo %A Steyerberg, Ewout W %A Lubsen, Jacobus %D 2008 %J Journal of clinical epidemiology %K Bias(Epidemiology) CauseofDeath ChronicDisease ClinicalTrialsasTopic ClinicalTrialsasTopic:statistics&numericald DataInterpretation Humans Meta-AnalysisasTopic OddsRatio ResearchDesign Statistical TreatmentOutcome RCT %N 4 %P 365-72 %R 10.1016/j.jclinepi.2007.05.009 %T Meta-analyses of chronic disease trials with competing causes of death may yield biased odds ratios. %U http://www.ncbi.nlm.nih.gov/pubmed/18313561 %V 61 %X OBJECTIVE: To study the odds ratio (OR) as measure of treatment effect in the context of mutually exclusive causes of death. STUDY DESIGN AND SETTING: As example we consider meta-analyses of randomized trials of implantable cardioverter defibrillator implantation (ICD). We compare the pooled OR to the pooled cause-specific hazard ratio (HR) for each of the mutually exclusive outcomes "sudden cardiac death" (SCD) and "death other than SCD." RESULTS: The pooled OR and cause-specific HR for the reduction of SCD are similar (0.43 and 0.44, respectively) for nine included trials. However, the OR erroneously presumes a potential trend toward an adverse effect of the ICD on "death other than arrhythmia" (OR 1.11 0.84-1.45), whereas such an effect is small with the cause-specific HR (HR 1.03 0.79-1.32). In general, it is shown that a spurious association of treatment with öther death" may be seen when a substantial number of death from the cause of interest is postponed. CONCLUSION: The OR should be used with caution to study effects of treatment on mutually exclusive causes of death. Practically this concern applies primarily to meta-analysis where the use of the cause-specific HR, whenever available, is recommended. %@ 0895-4356

@article{Koller2008, abstract = {OBJECTIVE: To study the odds ratio (OR) as measure of treatment effect in the context of mutually exclusive causes of death. STUDY DESIGN AND SETTING: As example we consider meta-analyses of randomized trials of implantable cardioverter defibrillator implantation (ICD). We compare the pooled OR to the pooled cause-specific hazard ratio (HR) for each of the mutually exclusive outcomes "sudden cardiac death" (SCD) and "death other than SCD." RESULTS: The pooled OR and cause-specific HR for the reduction of SCD are similar (0.43 and 0.44, respectively) for nine included trials. However, the OR erroneously presumes a potential trend toward an adverse effect of the ICD on "death other than arrhythmia" (OR 1.11 [0.84-1.45]), whereas such an effect is small with the cause-specific HR (HR 1.03 [0.79-1.32]). In general, it is shown that a spurious association of treatment with "other death" may be seen when a substantial number of death from the cause of interest is postponed. CONCLUSION: The OR should be used with caution to study effects of treatment on mutually exclusive causes of death. Practically this concern applies primarily to meta-analysis where the use of the cause-specific HR, whenever available, is recommended.}, added-at = {2023-02-03T11:44:35.000+0100}, author = {Koller, Michael T and Stijnen, Theo and Steyerberg, Ewout W and Lubsen, Jacobus}, biburl = {https://www.bibsonomy.org/bibtex/2ca384a4005171b657aab7fedfd24c588/jepcastel}, city = {Basel Institute for Clinical Epidemiology, University Hospital Basel, CH-4031 Basel, Switzerland. kollerm@uhbs.ch}, doi = {10.1016/j.jclinepi.2007.05.009}, interhash = {137c1f2aff701db8ed3b0b3ce3247711}, intrahash = {ca384a4005171b657aab7fedfd24c588}, isbn = {0895-4356}, issn = {0895-4356}, journal = {Journal of clinical epidemiology}, keywords = {Bias(Epidemiology) CauseofDeath ChronicDisease ClinicalTrialsasTopic ClinicalTrialsasTopic:statistics&numericald DataInterpretation Humans Meta-AnalysisasTopic OddsRatio ResearchDesign Statistical TreatmentOutcome RCT}, month = {4}, note = {4586<m:linebreak></m:linebreak>PUBM: Print-Electronic; JID: 8801383; 2006/05/23 [received]; 2007/05/08 [revised]; 2007/05/10 [accepted]; 2007/10/15 [aheadofprint]; ppublish;<m:linebreak></m:linebreak>Mesures d&#039;associació}, number = 4, pages = {365-72}, pmid = {18313561}, timestamp = {2023-05-04T08:59:38.000+0200}, title = {Meta-analyses of chronic disease trials with competing causes of death may yield biased odds ratios.}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18313561}, volume = 61, year = 2008 }