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Activity Number: 110
Type: Topic Contributed
Date/Time: Monday, August 4, 2014 : 8:30 AM to 10:20 AM
Sponsor: ENAR
Abstract #311277 View Presentation
Title: A Comparison of Confounding Adjustment Methods for Assessment of Asthma Controller Medication Effectiveness
Author(s): Lingling Li*+ and William Vollmer and Melissa G. Butler and Pingsheng Wu and Elyse O. Kharbanda and Ann Chen Wu
Companies: Harvard Pilgrim Health Care Institute and Kaiser Permanente and Kaiser Permanente and Vanderbilt University School of Medicine and HealthPartners Institute for Education and Research and Harvard Pilgrim Health Care Institute
Keywords: Confounding adjustment ; Propensity score ; high-dimensional propensity score ; comparative effectiveness ; asthma ; electronic healthcare database
Abstract:

We compared the impact of three confounding adjustment procedures: covariate-adjusted regression, propensity score regression, and high-dimensional propensity score regression to assess the effect of selected asthma controller medication use (leukotriene antagonists, LTRA, and inhaled corticosteroids, ICS) on four asthma-related adverse outcomes: emergency department visits, hospitalizations, oral corticosteroid use, and the composite outcome of the above. We used a cohort of 24,680 new users ages 4-17 years at the incident dispensing from the Population-Based Effectiveness in Asthma and Lung Diseases (PEAL) Network of five commercial health plans and TennCare, the Tennessee Medicaid program, during the period of January 1, 2004 to December 31, 2010.

The three methods yielded similar results, indicating that pediatric patients treated with LTRA were no more likely than those treated with ICS to experience adverse outcomes. We provide important observations on how to correctly apply the methods in observational data analysis and suggest statistical research areas that need more work to guide implementation.


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