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Published in: Clinical Orthopaedics and Related Research® 8/2015

01-08-2015 | In Brief

Statistics in Brief: An Introduction to the Use of Propensity Scores

Authors: Maria C. S. Inacio, PhD, Yuexin Chen, BS, Elizabeth W. Paxton, MA, Robert S. Namba, MD, Steven M. Kurtz, PhD, Guy Cafri, PhD, MStat

Published in: Clinical Orthopaedics and Related Research® | Issue 8/2015

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Excerpt

Randomized controlled trials (RCTs) are considered the gold standard of clinical research because randomization reduces the risk of extraneous factors influencing results of a study [2]. Nonetheless, high-quality, observational studies are at times more desirable than experimental studies (such as RCTs) owing to the their capacity to evaluate rare events, fewer ethical challenges with conducting the study, feasibility attributable to lower costs or infrastructure needs, and sometimes greater generalizability of the findings because of less-strict inclusion or exclusion criteria for patients and surgeons. Most orthopaedic studies are observational and retrospective [4, 7, 24]. …
Literature
1.
go back to reference Aaltonen KJ, Virkki LM, Jamsen E, Sokka T, Konttinen YT, Peltomaa R, Tuompo R, Yli-Kerttula T, Kortelainen S, Ahokas-Tuohinto P, Blom M, Nordstrom DC. Do biologic drugs affect the need for and outcome of joint replacements in patients with rheumatoid arthritis? A register-based study. Semin Arthritis Rheum. 2013;43:55–62.PubMedCrossRef Aaltonen KJ, Virkki LM, Jamsen E, Sokka T, Konttinen YT, Peltomaa R, Tuompo R, Yli-Kerttula T, Kortelainen S, Ahokas-Tuohinto P, Blom M, Nordstrom DC. Do biologic drugs affect the need for and outcome of joint replacements in patients with rheumatoid arthritis? A register-based study. Semin Arthritis Rheum. 2013;43:55–62.PubMedCrossRef
2.
go back to reference Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, Guyatt GH, Harbour RT, Haugh MC, Henry D, Hill S, Jaeschke R, Leng G, Liberati A, Magrini N, Mason J, Middleton P, Mrukowicz J, O’Connell D, Oxman AD, Phillips B, Schünemann HJ, Edejer T, Varonen H, Vist GE, Williams JW Jr, Zaza S; GRADE Working Group. Grading quality of evidence and strength of recommendations. BMJ. 2004; 328:1490.PubMedCrossRef Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, Guyatt GH, Harbour RT, Haugh MC, Henry D, Hill S, Jaeschke R, Leng G, Liberati A, Magrini N, Mason J, Middleton P, Mrukowicz J, O’Connell D, Oxman AD, Phillips B, Schünemann HJ, Edejer T, Varonen H, Vist GE, Williams JW Jr, Zaza S; GRADE Working Group. Grading quality of evidence and strength of recommendations. BMJ. 2004; 328:1490.PubMedCrossRef
3.
go back to reference Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behav Res. 2011; 46:399–424.PubMedCentralPubMedCrossRef Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behav Res. 2011; 46:399–424.PubMedCentralPubMedCrossRef
4.
go back to reference Cunningham BP, Harmsen S, Kweon C, Patterson J, Waldrop R, McLaren A, McLemore R. Have levels of evidence improved the quality of orthopaedic research? Clin Orthop Relat Res. 2013;471:3679–3686.PubMedCentralPubMedCrossRef Cunningham BP, Harmsen S, Kweon C, Patterson J, Waldrop R, McLaren A, McLemore R. Have levels of evidence improved the quality of orthopaedic research? Clin Orthop Relat Res. 2013;471:3679–3686.PubMedCentralPubMedCrossRef
5.
go back to reference D’Agostino RB Jr. Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med. 1998; 17:2265–2281.PubMedCrossRef D’Agostino RB Jr. Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med. 1998; 17:2265–2281.PubMedCrossRef
6.
go back to reference Faries DE, Leon AC, Haro JM, Obenchain RL. Analysis of Observational Health Care Data Using SAS. Cary, NC: SAS Institute; 2010. Faries DE, Leon AC, Haro JM, Obenchain RL. Analysis of Observational Health Care Data Using SAS. Cary, NC: SAS Institute; 2010.
7.
go back to reference Hanzlik S, Mahabir RC, Baynosa RC, Khiabani KT. Levels of evidence in research published in The Journal of Bone and Joint Surgery (American Volume) over the last thirty years. J Bone Joint Surg Am. 2009; 91:425–428.PubMedCrossRef Hanzlik S, Mahabir RC, Baynosa RC, Khiabani KT. Levels of evidence in research published in The Journal of Bone and Joint Surgery (American Volume) over the last thirty years. J Bone Joint Surg Am. 2009; 91:425–428.PubMedCrossRef
8.
go back to reference Hellsten EK, Hanbidge MA, Manos AN, Lewis SJ, Massicotte EM, Fehlings MG, Coyte PC, Rampersaud YR. An economic evaluation of perioperative adverse events associated with spinal surgery. Spine J. 2013; 13:44–53.PubMedCrossRef Hellsten EK, Hanbidge MA, Manos AN, Lewis SJ, Massicotte EM, Fehlings MG, Coyte PC, Rampersaud YR. An economic evaluation of perioperative adverse events associated with spinal surgery. Spine J. 2013; 13:44–53.PubMedCrossRef
9.
go back to reference Hong G. Marginal mean weighting through stratification: Adjustment for selection bias in multilevel data. J Educ Behav Stat. 2010; 35:499–531.CrossRef Hong G. Marginal mean weighting through stratification: Adjustment for selection bias in multilevel data. J Educ Behav Stat. 2010; 35:499–531.CrossRef
10.
go back to reference Hong G. Marginal mean weighting through stratification: a generalized method for evaluating multivalued and multiple treatments with nonexperimental data. Psychol Methods. 2012; 17:44–60.PubMedCrossRef Hong G. Marginal mean weighting through stratification: a generalized method for evaluating multivalued and multiple treatments with nonexperimental data. Psychol Methods. 2012; 17:44–60.PubMedCrossRef
11.
go back to reference Imbens GW. Nonparametric estimation of average treatment effects under exogeneity: a review. Rev Econ Stat. 2004; 86:4–29.CrossRef Imbens GW. Nonparametric estimation of average treatment effects under exogeneity: a review. Rev Econ Stat. 2004; 86:4–29.CrossRef
12.
go back to reference Inacio MC, Cafri G, Paxton EW, Kurtz SM, Namba RS. Alternative bearings in total knee arthroplasty: risk of early revision compared to traditional bearings: an analysis of 62,177 primary cases. Acta Orthop. 2013; 84:145–152.PubMedCentralPubMedCrossRef Inacio MC, Cafri G, Paxton EW, Kurtz SM, Namba RS. Alternative bearings in total knee arthroplasty: risk of early revision compared to traditional bearings: an analysis of 62,177 primary cases. Acta Orthop. 2013; 84:145–152.PubMedCentralPubMedCrossRef
13.
go back to reference Lovald ST, Ong KL, Lau EC, Schmier JK, Bozic KJ, Kurtz SM. Mortality, cost, and downstream disease of total hip arthroplasty patients in the medicare population. J Arthroplasty. 2014;29:242–246.PubMedCrossRef Lovald ST, Ong KL, Lau EC, Schmier JK, Bozic KJ, Kurtz SM. Mortality, cost, and downstream disease of total hip arthroplasty patients in the medicare population. J Arthroplasty. 2014;29:242–246.PubMedCrossRef
14.
go back to reference Mandel S, Schilling J, Peterson E, Rao DS, Sanders W. A retrospective analysis of vertebral body fractures following epidural steroid injections. J Bone Joint Surg Am. 2013;95:961–964.PubMedCrossRef Mandel S, Schilling J, Peterson E, Rao DS, Sanders W. A retrospective analysis of vertebral body fractures following epidural steroid injections. J Bone Joint Surg Am. 2013;95:961–964.PubMedCrossRef
15.
go back to reference Margolis DJ, Gupta J, Hoffstad O, Papdopoulos M, Glick HA, Thom SR, Mitra N. Lack of effectiveness of hyperbaric oxygen therapy for the treatment of diabetic foot ulcer and the prevention of amputation: a cohort study. Diabetes Care. 2013; 36:1961–1966.PubMedCentralPubMedCrossRef Margolis DJ, Gupta J, Hoffstad O, Papdopoulos M, Glick HA, Thom SR, Mitra N. Lack of effectiveness of hyperbaric oxygen therapy for the treatment of diabetic foot ulcer and the prevention of amputation: a cohort study. Diabetes Care. 2013; 36:1961–1966.PubMedCentralPubMedCrossRef
16.
go back to reference Paus AC, Steen H, Roislien J, Mowinckel P, Teigland J. High mortality rate in rheumatoid arthritis with subluxation of the cervical spine: a cohort study of operated and nonoperated patients. Spine (Phila Pa 1976). 2008; 33:2278–2283. Paus AC, Steen H, Roislien J, Mowinckel P, Teigland J. High mortality rate in rheumatoid arthritis with subluxation of the cervical spine: a cohort study of operated and nonoperated patients. Spine (Phila Pa 1976). 2008; 33:2278–2283.
17.
go back to reference Petilon JM, Glassman SD, Dimar JR, Carreon LY. Clinical outcomes after lumbar fusion complicated by deep wound infection: a case-control study. Spine (Phila Pa 1976). 2012; 37:1370–1374. Petilon JM, Glassman SD, Dimar JR, Carreon LY. Clinical outcomes after lumbar fusion complicated by deep wound infection: a case-control study. Spine (Phila Pa 1976). 2012; 37:1370–1374.
18.
go back to reference Pugely AJ, Martin CT, Gao Y, Mendoza-Lattes S, Callaghan JJ. Differences in short-term complications between spinal and general anesthesia for primary total knee arthroplasty. J Bone Joint Surg Am. 2013; 95:193–199.PubMedCrossRef Pugely AJ, Martin CT, Gao Y, Mendoza-Lattes S, Callaghan JJ. Differences in short-term complications between spinal and general anesthesia for primary total knee arthroplasty. J Bone Joint Surg Am. 2013; 95:193–199.PubMedCrossRef
19.
go back to reference Pugely AJ, Martin CT, Gao Y, Mendoza-Lattes SA. Outpatient surgery reduces short-term complications in lumbar discectomy: an analysis of 4310 patients from the ACS-NSQIP database. Spine (Phila Pa 1976). 2013; 38:264–271. Pugely AJ, Martin CT, Gao Y, Mendoza-Lattes SA. Outpatient surgery reduces short-term complications in lumbar discectomy: an analysis of 4310 patients from the ACS-NSQIP database. Spine (Phila Pa 1976). 2013; 38:264–271.
20.
go back to reference Raphael IJ, Tischler EH, Huang R, Rothman RH, Hozack WJ, Parvizi J. Aspirin: an alternative for pulmonary embolism prophylaxis after arthroplasty? Clin Orthop Relat Res. 2014;472:482–488.PubMedCentralPubMedCrossRef Raphael IJ, Tischler EH, Huang R, Rothman RH, Hozack WJ, Parvizi J. Aspirin: an alternative for pulmonary embolism prophylaxis after arthroplasty? Clin Orthop Relat Res. 2014;472:482–488.PubMedCentralPubMedCrossRef
21.
go back to reference Rosenbaum PR, Rubin DB. The central role of the propensity score in observational studies for causal effects. Biometrika. 1983; 70:41–55.CrossRef Rosenbaum PR, Rubin DB. The central role of the propensity score in observational studies for causal effects. Biometrika. 1983; 70:41–55.CrossRef
22.
go back to reference Rubin DB. Using propensity scores to help design observational studies: Application to the tobacco litigation. Health Serv Outcomes Res Methodol. 2001; 2:169–188.CrossRef Rubin DB. Using propensity scores to help design observational studies: Application to the tobacco litigation. Health Serv Outcomes Res Methodol. 2001; 2:169–188.CrossRef
23.
go back to reference Rubin DB, Thomas N. Combining propensity score matching with additional adjustments for prognostic covariates. J Am Stat Assoc. 2000;95:573–585.CrossRef Rubin DB, Thomas N. Combining propensity score matching with additional adjustments for prognostic covariates. J Am Stat Assoc. 2000;95:573–585.CrossRef
24.
go back to reference Samuelsson K, Desai N, McNair E, van Eck CF, Petzold M, Fu FH, Bhandari M, Karlsson J. Level of evidence in anterior cruciate ligament reconstruction research: a systematic review. Am J Sports Med. 2012; 41:924–934.PubMedCrossRef Samuelsson K, Desai N, McNair E, van Eck CF, Petzold M, Fu FH, Bhandari M, Karlsson J. Level of evidence in anterior cruciate ligament reconstruction research: a systematic review. Am J Sports Med. 2012; 41:924–934.PubMedCrossRef
25.
go back to reference Seicean A, Seicean S, Alan N, Schiltz NK, Rosenbaum BP, Jones PK, Kattan MW, Neuhauser D, Weil RJ. Preoperative anemia and perioperative outcomes in patients who undergo elective spine surgery. Spine (Phila Pa 1976). 2013; 38:1331–1341. Seicean A, Seicean S, Alan N, Schiltz NK, Rosenbaum BP, Jones PK, Kattan MW, Neuhauser D, Weil RJ. Preoperative anemia and perioperative outcomes in patients who undergo elective spine surgery. Spine (Phila Pa 1976). 2013; 38:1331–1341.
26.
go back to reference Seicean A, Seicean S, Alan N, Schiltz NK, Rosenbaum BP, Jones PK, Neuhauser D, Kattan MW, Weil RJ. Effect of smoking on the perioperative outcomes of patients who undergo elective spine surgery. Spine (Phila Pa 1976). 2013; 38:1294–1302. Seicean A, Seicean S, Alan N, Schiltz NK, Rosenbaum BP, Jones PK, Neuhauser D, Kattan MW, Weil RJ. Effect of smoking on the perioperative outcomes of patients who undergo elective spine surgery. Spine (Phila Pa 1976). 2013; 38:1294–1302.
27.
go back to reference Shi HY, Chang JK, Chiu HC. Volume associations in total hip arthroplasty: a nationwide Taiwan population-based study. J Arthroplasty. 2013;28:1834–1838PubMedCrossRef Shi HY, Chang JK, Chiu HC. Volume associations in total hip arthroplasty: a nationwide Taiwan population-based study. J Arthroplasty. 2013;28:1834–1838PubMedCrossRef
29.
go back to reference Stuart EA, Marcus SM, Horvitz-Lennon MV, Gibbons RD, Normand SL. Using non-experimental data to estimate treatment effects. Psychiatr Ann. 2009; 39:41451.PubMedCentralPubMedCrossRef Stuart EA, Marcus SM, Horvitz-Lennon MV, Gibbons RD, Normand SL. Using non-experimental data to estimate treatment effects. Psychiatr Ann. 2009; 39:41451.PubMedCentralPubMedCrossRef
Metadata
Title
Statistics in Brief: An Introduction to the Use of Propensity Scores
Authors
Maria C. S. Inacio, PhD
Yuexin Chen, BS
Elizabeth W. Paxton, MA
Robert S. Namba, MD
Steven M. Kurtz, PhD
Guy Cafri, PhD, MStat
Publication date
01-08-2015
Publisher
Springer US
Published in
Clinical Orthopaedics and Related Research® / Issue 8/2015
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-015-4239-4

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