Strengthening Health Services Research Using Target Trial Emulation: An Application to Volume-Outcomes Studies.

ABSTRACT: The number of operations that surgeons have previously performed is associated with their patients' outcomes. However, this association may not be causal, because previous studies have often been cross-sectional and their analyses have not considered time-varying confounding or positivity violations. In this paper, using the example of surgeons who perform coronary artery bypass grafting, we describe (hypothetical) target trials for estimation of the causal effect of the surgeons' operative volumes on patient mortality. We then demonstrate how to emulate these target trials using data from US Medicare claims and provide effect estimates. Our target trial emulations suggest that interventions on physicians' volume of coronary artery bypass grafting operations have little effect on patient m

SUBMITTER: Madenci AL 

PROVIDER: S-EPMC8799904 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature