|
Activity Number:
|
248
|
|
Type:
|
Contributed
|
|
Date/Time:
|
Tuesday, July 31, 2007 : 8:30 AM to 10:20 AM
|
|
Sponsor:
|
IMS
|
| Abstract - #310103 |
|
Title:
|
Use of Marginal Structural Models To Estimate the Effect of Epoetin on Survival of Dialysis Patients
|
|
Author(s):
|
Yi Zhang*+ and Dennis Cotter and Mae Thamer and James Kaufman and Miguel A. Hernan
|
|
Companies:
|
Medical Technology and Practice Patterns Institute and Medical Technology and Practice Patterns Institute and Medical Technology and Practice Patterns Institute and Veterans Affairs Boston Healthcare Systems/Boston University School of Medicine and Harvard School of Public Health
|
|
Address:
|
4733 Bethesda Ave Suite 510, Bethesda, MD, 20814,
|
|
Keywords:
|
Causal inference ; marginal structural models ; mortality
|
|
Abstract:
|
Clinical trials have shown that dialysis patients targeted to higher hematocrit levels have an increased risk of mortality. Data from United States Renal Data System were used to identify 18,353 patients who initiated dialysis and epoetin treatment in 2001. The outcome of the study is death during the 12-month follow-up period. Main exposure of interest is the average epoetin dose in the most recent three months. We conducted analyses using marginal structural models to control for time-dependent confounding arising from the treatment and hematocrit outcome. Analyses did not demonstrate a survival benefit of higher epoetin doses, consistent with RCT findings. Given the wider confidence intervals at high epoetin doses, further studies are needed to confirm the statistical significance of these findings.
|
