propensity scores in the presence of effect modification a case study using the comparison of mortality on hemodialysis versus peritoneal dialysis倾向分数的效果修改案例研究使用的死亡率比较血液透析和腹膜透析.pdfVIP

Liem et al. Emerging Themes in Epidemiology 2010, 7:1 EMERGING THEMES /content/7/1/1 IN EPIDEMIOLOGY ANALY TIC PE RSPECT IVE Open Access Analytic perspective Propensity scores in the presence of effect modification: A case study using the comparison of mortality on hemodialysis versus peritoneal dialysis 1,2 3 1,4 5 6 Ylian S Liem* , John B Wong , MG Myriam Hunink , Frank Th de Charro and Wolfgang C Winkelmayer Abstract Purpose: To control for confounding bias from non-random treatment assignment in observational data, both traditional multivariable models and more recently propensity score approaches have been applied. Our aim was to compare a propensity score-stratified model with a traditional multivariable-adjusted model, specifically in estimating survival of hemodialysis (HD) versus peritoneal dialysis (PD) patients. Methods: Using the Dutch End-Stage Renal Disease Registry, we constructed a propensity score, predicting PD assignment from age, gender, primary renal disease, center of dialysis, and year of first renal replacement therapy. We developed two Cox proportional hazards regression models to estimate survival on PD relative to HD, a propensity score-stratified model stratifying on the propensity score and a multivariable-adjusted model, and tested several interaction terms in both models. Results: The propensity score performed well: it showed a reasonab le fit, had a good c-statistic, calibrated well and balanced the covariates. The main-effects multivariable-adjusted model and the propensity score-stratified univariable Cox m