Electronic medical records can be used to emulate target trials of sustained treatment strategies.

ABSTRACT: OBJECTIVE:To emulate three target trials: single treatment vs. no treatment, joint treatment vs. no treatment, and head-to-head comparison of two treatments, we explain how to estimate the observational analogs of intention-to-treat and per-protocol effects, using hazard ratios and survival curves. For per-protocol effects, we describe two methods for adherence adjustment via inverse-probability weighting. STUDY DESIGN AND SETTING:Prospective observational study using electronic medical records of individuals aged 55-84 with coronary heart disease from >500 practices in the United Kingdom between 2000 and 2010. RESULTS:The intention-to-treat mortality hazard ratio (95% confidence interval) was 0.90 (0.84, 0.97) for statins vs. no treatment, 0.88 (0.73, 1.06) for statins plus antihypertensi

SUBMITTER: Danaei G 

PROVIDER: S-EPMC5847447 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature