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Activity Number: 81 - Contributed Poster Presentations: Section on Statistics in Epidemiology
Type: Contributed
Date/Time: Monday, August 3, 2020 : 10:00 AM to 2:00 PM
Sponsor: Section on Statistics in Epidemiology
Abstract #313620
Title: Estimating the Causal Effect of Surgical Treatment for Posterior Malleolus Fracture with Different Treatment Rules on Patient Reported Outcomes
Author(s): Nicholas Williams* and Oleksandr Savenkov and Bopha Chrea
Companies: Weill Cornell Medicine and Weill Cornell Medicine and Hospital for Special Surgery
Keywords: Causal inference; Targeted Maximum Likelihood Estimation; Treatment rules; Non-parametric; Personalized medicine
Abstract:

Posterior malleolus fractures are fractures of the posterior tibia at the ankle. Historical variation exists regarding when to surgically treat posterior malleolus fractures based on the size of the posterior articular surface involved. We studied the effect of surgically treating posterior malleolus fractures on one-year post-operation PROMIS (the Patient-Reported Outcomes Measurement Information System) using an observational cohort of 93 patients at the Hospital for Special Surgery. The effect of surgical treatment, under two different dynamic treatment regimes (all patients with >15% articular surface involved receive surgery and all patients with >25% of articular surface involved receive surgery), on physical function, pain interference, and pain intensity was evaluated using Cross-Validated Targeted Maximum Likelihood Estimation (CV-TMLE) with the lmtp R package. After adjusting for baseline confounders, no evidence was found of a differential effect of surgical treatment rules on self-reported physical function, pain intensity, or pain interference at one-year post-operation.


Authors who are presenting talks have a * after their name.

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