The Extent and Magnitude of Bias in Case-Crossover Studies of Real-World Non-transient Medications Patterns: A Simulation Study with Real-World Examples.

ABSTRACT:

Introduction

A case-crossover study is a self-controlled design most appropriate for evaluating transient medication exposures. However, it has increasingly been used in studies of chronic medications and can cause bias in effect estimates that vary based on the pattern of medication use. The goal of this study was to evaluate the magnitude of this bias across different medication-use patterns.

Objective

To quantify the magnitude of the bias introduced by different medication patterns and evaluate different case-crossover approaches to mitigate the bias.

Methods

We conducted a simulation study evaluating the bias introduced by (1) seven common medication patterns separately, and (2) cohort with 15 different patterns combined. We evaluated each scenario under risk rati

SUBMITTER: Huang HC 

PROVIDER: S-EPMC12804240 | biostudies-literature | 2026 Jan

REPOSITORIES: biostudies-literature