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Using propensity scores to estimate effects of treatment initiation decisions: State of the science

Webster-Clark, M; Stürmer, T; Wang, T; Man, K; Marinac-Dabic, D; Rothman, KJ; Ellis, AR; ... Glynn, RJ; + view all (2021) Using propensity scores to estimate effects of treatment initiation decisions: State of the science. Statistics in Medicine , 40 (7) pp. 1718-1735. 10.1002/sim.8866. Green open access

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Abstract

Confounding can cause substantial bias in nonexperimental studies that aim to estimate causal effects. Propensity score methods allow researchers to reduce bias from measured confounding by summarizing the distributions of many measured confounders in a single score based on the probability of receiving treatment. This score can then be used to mitigate imbalances in the distributions of these measured confounders between those who received the treatment of interest and those in the comparator population, resulting in less biased treatment effect estimates. This methodology was formalized by Rosenbaum and Rubin in 1983 and, since then, has been used increasingly often across a wide variety of scientific disciplines. In this review article, we provide an overview of propensity scores in the context of real‐world evidence generation with a focus on their use in the setting of single treatment decisions, that is, choosing between two therapeutic options. We describe five aspects of propensity score analysis: alignment with the potential outcomes framework, implications for study design, estimation procedures, implementation options, and reporting. We add context to these concepts by highlighting how the types of comparator used, the implementation method, and balance assessment techniques have changed over time. Finally, we discuss evolving applications of propensity scores.

Type: Article
Title: Using propensity scores to estimate effects of treatment initiation decisions: State of the science
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/sim.8866
Publisher version: https://doi.org/10.1002/sim.8866
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: comparative effectiveness research, propensity scores, real-world data, real-world evidence, review
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy
URI: https://discovery.ucl.ac.uk/id/eprint/10118533
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