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Real World Health Care Data Analysis

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"Real world health care data is common and growing in use with sources such as observational studies, patient registries, electronic medical record databases, insurance healthcare claims databases, as well as data from pragmatic trials. This data serves as the basis for the growing use of real world evidence in medical decision-making. However, the data itself is not evidence. Analytical methods must be used to turn real world data into valid and meaningful evidence. Real World Health Care Data Analysis: Causal Methods and Implementation Using SAS brings together best practices for causal comparative effectiveness analyses based on real world data in a single location and provides SAS code and examples to make the analyses relatively easy and efficient. The book focuses on analytic methods adjusted for time-independent confounding, which are useful when comparing the effect of different potential interventions on some outcome of interest when there is no randomization. These methods include: propensity score matching, stratification methods, weighting methods, regression methods, and approaches that combine and average across these methods methods for comparing two interventions as well as comparisons between three or more interventions algorithms for personalized medicine sensitivity analyses for unmeasured confounding"

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,Contents

Contents

About the Book

What Does This Book Cover?

Is This Book for You?

What Should You Know about the Examples?

Software Used to Develop the Book’s Content

Example Code and Data

Acknowledgments

We Want to Hear from You

About the Authors

Chapter 1: Introduction to Observational and Real World Evidence Research

1.1 Why This Book?

1.2 Definition and Types of Real World Data (RWD)

1.3 Experimental Versus Observational Research

1.4 Types of Real World Studies

1.4.1 Cross-sectional Studies

1.4.2 Retrospective or Case-control Studies

1.4.3 Prospective or Cohort Studies

1.5 Questions Addressed by Real World Studies

1.6 The Issues: Bias and Confounding

1.6.1 Selection Bias

1.6.2 Information Bias

,1.6.3 Confounding

1.7 Guidance for Real World Research

1.8 Best Practices for Real World Research

1.9 Contents of This Book

References

Chapter 2: Causal Inference and Comparative Effectiveness: A Foundation

2.1 Introduction

2.2 Causation

2.3 From R.A. Fisher to Modern Causal Inference Analyses

2.3.1 Fisher’s Randomized Experiment

2.3.2 Neyman’s Potential Outcome Notation

2.3.3 Rubin’s Causal Model

2.3.4 Pearl’s Causal Model

2.4 Estimands

2.5 Totality of Evidence: Replication, Exploratory, and Sensitivity Analyses

2.6 Summary

References

Chapter 3: Data Examples and Simulations

3.1 Introduction

3.2 The REFLECTIONS Study

3.3 The Lindner Study

3.4 Simulations

3.5 Analysis Data Set Examples

, 3.5.1 Simulated REFLECTIONS Data

3.5.2 Simulated PCI Data

3.6 Summary

References

Chapter 4: The Propensity Score

4.1 Introduction

4.2 Estimate Propensity Score

4.2.1 Selection of Covariates

4.2.2 Address Missing Covariates Values in Estimating Propensity Score

4.2.3 Selection of Propensity Score Estimation Model

4.2.4 The Criteria of “Good” Propensity Score Estimate

4.3 Example: Estimate Propensity Scores Using the Simulated REFLECTIONS Data

4.3.1 A Priori Logistic Model

4.3.2 Automatic Logistic Model Selection

4.3.3 Boosted CART Model

4.4 Summary

References

Chapter 5: Before You Analyze – Feasibility Assessment

5.1 Introduction

5.2 Best Practices for Assessing Feasibility: Common Support

5.2.1 Walker’s Preference Score and Clinical Equipoise

5.2.2 Standardized Differences in Means and Variance Ratios

5.2.3 Tipton’s Index

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