Evidence map›Paper›PMID 37609668›Full record

ArticlePharmacoepidemiology and drug safety2024

Combining Super Learner with high-dimensional propensity score to improve confounding adjustment: A real-world application in chronic lymphocytic leukemia.

Neil Dhopeshwarkar, Wei Yang, Sean Hennessy, Joanna M Rhodes, Adam Cuker, Charles E Leonard

Abstract read
In one paragraph

Article in Pharmacoepidemiology and drug safety, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  2. Article
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

6 authors.

Neil DhopeshwarkarCenter for Real-World Effectiveness and Safety of Therapeutics and the Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0001-6305-256X
Wei YangCenter for Real-World Effectiveness and Safety of Therapeutics and the Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Sean HennessyCenter for Real-World Effectiveness and Safety of Therapeutics and the Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Joanna M RhodesDivision of Hematology/Medical Oncology, Department of Medicine, Northwell Health, New Hyde Park, New York, USA.
Adam CukerDepartment of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Charles E LeonardCenter for Real-World Effectiveness and Safety of Therapeutics and the Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Funding

Clinical Pharmacoepidemiology Training ProgramT32GM075766 · NIGMS · UNIVERSITY OF PENNSYLVANIA · PI Sean Hennessy, Charles Edward Leonard · 2006 to 2026
$8.4M
Clinical Importance of Drug-Drug InteractionsR01AG025152 · NIA · UNIVERSITY OF PENNSYLVANIA · PI HENNESSY, SEAN, LI, LANG · 2006 to 2021
$8.1M
Drug interactions involving psychoactive drugsR01AG060975 · NIA · UNIVERSITY OF PENNSYLVANIA · PI Charles Edward Leonard · 2019 to 2026
$3.9M
Major Bleeding with Ibrutinib in Chronic Lymphocytic LeukemiaF32HL154519 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI DHOPESHWARKAR, NEIL · 2020 to 2020
$74k
NHLBI NIH HHS F32 HL154519NIA NIH HHS R01 AG025152NIA NIH HHS R01 AG060975NIGMS NIH HHS T32 GM075766
6 · The paper itself

Abstract

purposeHigh-dimensional propensity score (hdPS) is a semiautomated method that leverages a vast number of covariates available in healthcare databases to improve confounding adjustment. A novel combined Super Learner (SL)-hdPS approach was proposed to assist with selecting the number of covariates for propensity score inclusion, and was found in plasmode simulation studies to improve bias reduction and precision compared to hdPS alone. However, the approach has not been examined in the applied setting.

methodsWe compared SL-hdPS's performance with that of several hdPS models, each with prespecified covariates and a different number of empirically-identified covariates, using a cohort study comparing real-world bleeding rates between ibrutinib- and bendamustine-rituximab (BR)-treated individuals with chronic lymphocytic leukemia in Optum's de-identified Clinformatics® Data Mart commercial claims database (2013-2020). We used inverse probability of treatment weighting for confounding adjustment and Cox proportional hazards regression to estimate hazard ratios (HRs) for bleeding outcomes. Parameters of interest included prespecified and empirically-identified covariate balance (absolute standardized difference [ASD] thresholds of <0.10 and <0.05) and outcome HR precision (95% confidence intervals).

resultsWe identified 2423 ibrutinib- and 1102 BR-treated individuals. Including >200 empirically-identified covariates in the hdPS model compromised covariate balance at both ASD thresholds. SL-hdPS balanced more covariates than all individual hdPS models at both ASD thresholds. The bleeding HR 95% confidence intervals were generally narrower with SL-hdPS than with individual hdPS models.

conclusionIn a real-world application, hdPS was sensitive to the number of covariates included, while use of SL for covariate selection resulted in improved covariate balance and possibly improved precision.

Indexed as

Leukemia, Lymphocytic, Chronic, B-CellCohort StudiesComputer SimulationHumansPropensity ScoreProportional Hazards Modelsbleedingchronic lymphocytic leukemiaconfoundinghigh-dimensional propensity scoreobservational studypharmacoepidemiologySuper Learner

Identifiers

PMID37609668
PMCPMC10841179

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.