Adjustment for Bias Using Propensity Scores: A Simulation Study of Receipt of Respiratory Syncytial Virus (RSV) Immunoprophylaxis to Prevent RSV Infection and Infant Outcomes

• Activity Number: 422
• Type: Contributed
• Date/Time: Tuesday, August 2, 2011 : 2:00 PM to 3:50 PM
• Sponsor: Section on Statistics in Epidemiology
• Author(s): Pingsheng Wu*+ and William D. Dupont and Gabriel Escobar and Tina Hartert and Eileen M. Walsh and Kecia Carroll and Sherian Li and Edwards Mitchel and Tebeb Gebretsadik and Jeff Horner and Patrick Arbogast
• Companies: Vanderbilt University School of Medicine and Vanderbilt University School of Medicine and Kaiser Permanente Northern California and Vanderbilt University School of Medicine and Kaiser Permanente Northern California and Vanderbilt University School of Medicine and Kaiser Permanente Northern California and Vanderbilt University School of Medicine and Vanderbilt University School of Medicine and Vanderbilt University School of Medicine and Vanderbilt University School of Medicine
• Keywords: Propensity score ; Bias adjustment

Abstract

Concern exists that physicians may prescribe respiratory syncytial virus (RSV) immunoprophylaxis to only selected infants within the established high-risk groups, resulting in bias in estimating the effect of RSV immunoprophylaxis on RSV-attributable morbidity. We conducted a retrospective cohort study of 1205 privately insured premature (<32 weeks) infants who were eligible for and in whom RSV immunoprophylaxis is recommended by the American Academy of Pediatrics. Seventy seven percent of infants who were eligible received at least one dose of RSV immunoprophylaxis, and 5% experienced a RSV related hospitalization. Simulation studies were conducted to compare the performance of four propensity score methods in reducing bias in receipt of RSV immunoprophylaxis: stratification on the propensity score, propensity score matching, inverse probability of treatment weighting using the propensity score, and covariate adjustment using the propensity score. Performance of the methods relative to the true underlying association was compared and reported for the motivated RSV immunoprophylaxis and morbidity research.