Evidence map›Paper›PMID 23296544›Full record

ArticlePharmacoepidemiology and drug safety2013

Calendar time-specific propensity scores and comparative effectiveness research for stage III colon cancer chemotherapy.

Christina DeFilippo Mack, Robert J Glynn, M Alan Brookhart, William R Carpenter, Anne Marie Meyer, Robert S Sandler, Til Stürmer

Abstract readComparative Study
In one paragraph

Article in Pharmacoepidemiology and drug safety, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed.

  1. Article
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  10. Integrase Strand Transfer Inhibitors Are Associated With Incident Diabetes Mellitus in People With Human Immunodeficiency Virus.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022
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  11. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Christina DeFilippo MackDepartment of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. cdmack@unc.edu
Robert J Glynn
M Alan Brookhart
William R Carpenter
Anne Marie Meyer
Robert S Sandler
Til Stürmer

Funding

DIGESTIVE DISEASES EPIDEMIOLOGY TRAINING PROGRAMT32DK007634 · NIDDK · UNIV OF NORTH CAROLINA CHAPEL HILL · PI ROBERT S. SANDLER · 1990 to 2026
$7.4M
Training ProgramU54CA153602 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI GODLEY, PAUL A. · 2010 to 2015
$5.4M
Risk Factors for Asymptomatic DiverticulosisR01DK094738 · NIDDK · UNIV OF NORTH CAROLINA CHAPEL HILL · PI KEKU, TEMITOPE O., SANDLER, ROBERT S. · 2012 to 2022
$4.8M
RISK FACTORS FOR COLON ADENOMASR01CA044684 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI SANDLER, ROBERT S. · 1988 to 2010
$4.6M
NC Colorectal Cancer Care Outcomes Research StudyU01CA093326 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI SANDLER, ROBERT S. · 2001 to 2008
$4.3M
Implementing Systemic Interventions to Close the Discovery-Delivery GapR01CA124402 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI WEINER, BRYAN J. · 2007 to 2012
$2.8M
Propensity Scores and Preventive Drug Use in the ElderlyR01AG023178 · NIA · UNIV OF NORTH CAROLINA CHAPEL HILL · PI STURMER, TIL · 2005 to 2014
$2.7M
Intestinal Microbiota, Diet and Risk of Colorectal AdenomasR01CA136887 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI KEKU, TEMITOPE O., SANDLER, ROBERT S. · 2009 to 2013
$1.5M
NCI NIH HHS HHSN261200800726PNCI NIH HHS R01 CA044684NCI NIH HHS R01 CA124402NCI NIH HHS R01 CA136887NCI NIH HHS U01 CA093326NCI NIH HHS U54 CA153602NIA NIH HHS R01 AG023178NIDDK NIH HHS R01 DK094738NIDDK NIH HHS T32 DK007634PHS HHS T32KD07634
6 · The paper itself

Abstract

purposeNonexperimental studies of treatment effectiveness provide an important complement to randomized trials by including heterogeneous populations. Propensity scores (PSs) are common in these studies but may not adequately capture changes in channeling experienced by innovative treatments. We use calendar time-specific (CTS) PSs to examine the effect of oxaliplatin during dissemination from off-label to widespread use.

methodsStage III colon cancer patients aged 65+ years initiating chemotherapy between 2003 and 2006 were examined using cancer registry data linked with Medicare claims. Two PS approaches for receipt of oxaliplatin versus 5-flourouricil were constructed using logistic models with key components of age, sex, substage, grade, census-level income, and comorbidities: (i) a conventional, year-adjusted PS and (ii) a CTS PS constructed and matched separately within 1-year intervals, then combined. We compared PS-matched hazard ratios (HRs) for mortality using Cox models.

resultsOxaliplatin use increased significantly; 8% (n = 86) of patients received it in the first time period versus 52% (n = 386) in the last. Channeling by comorbidities, income, and age appeared to change over time. The CTS PS improved covariate balance within calendar time strata and yielded an attenuated estimated benefit of oxaliplatin (HR = 0.75) compared with the conventional PS (HR = 0.69).

conclusionIn settings where prescribing patterns have changed and calendar time acts as a confounder, a CTS PS can characterize changes in treatment choices and estimating separate PSs within specific calendar time periods may result in enhanced confounding control. To increase validity of comparative effectiveness research, researchers should carefully consider drug lifecycles and effects of innovative treatment dissemination over time.

Indexed as

AgedAged, 80 and overAntimetabolites, AntineoplasticAntineoplastic AgentsColonic NeoplasmsComparative Effectiveness ResearchFemaleFluorouracilHumansLogistic ModelsMaleMedicareNeoplasm StagingOrganoplatinum CompoundsOxaliplatinPropensity ScoreAntimetabolites, AntineoplasticAntineoplastic AgentsFluorouracilOrganoplatinum CompoundsOxaliplatincolon cancercomparative effectiveness researchepidemiologic methodsoxaliplatinpharmacoepidemiologypropensity scores

Identifiers

PMID23296544
PMCPMC3659185

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.