NDT Advance Access originally published online on April 6, 2004
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Nephrol Dial Transplant (2004) 19: 1671-1673
Nephrol Dial Transplant Vol. 19 No. 7 © ERA-EDTA 2004; all rights reserved
Editorial Comment
Propensity scores: help or hype?
1 Division of Pharmacoepidemiology and Pharmacoeconomics, and 2 Division of Aging Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
Correspondence and offprint requests to: Wolfgang C. Winkelmayer, MD, ScD, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Email: wolfgang@post.harvard.edu
Keywords: bias; epidemiology; ESRD; late referral; nephrologist; propensity scores
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Introduction |
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In this issue of Nephrology Dialysis Transplantation, Kazmi et al. report an evaluation of the association between late nephrologist referral and mortality in a cohort of incident renal replacement therapy (RRT) patients [1]. After multivariable adjustment, they found that patients who reported having first been seen by a nephrologist <4 months prior to RRT had a nearly 50% higher risk of 1 year mortality compared to those patients who had their first nephrologist referral earlier in relation to their first RRT [hazards ratio (HR) 1.44; 95% confidence interval (CI): 1.15–1.80]. In addition to standard multivariable regression adjustment, the authors used propensity score (PS) analysis to control for confounding and argued that this approach was a more robust method to balance covariates, and that it helped in their study to overcome confounding and selection bias compared with the traditional approach. However, after
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What is the propensity score? |
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The uses of propensity scores |
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The issue of confounding: multivariable model adjustment vs propensity scores |
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Limitations and pitfalls |
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The indications for use of propensity scores |
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