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Application of marginal structural models in pharmacoepidemiologic studies: a systematic review
Shibing Yang1, Charles B Eaton, Juan Lu
1Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, Richmond, VA, USA.
Pharmacoepidemiology and Drug Safety
|January 25, 2014
Summary
Inverse probability weighting (IPW) is increasingly used in pharmacoepidemiology to address time-varying confounding. However, reporting practices for this complex method are inconsistent, highlighting a need for standardized guidelines.
Area of Science:
- Epidemiology
- Biostatistics
- Pharmacology
Background:
- Time-varying confounding is a significant challenge in pharmacoepidemiologic studies.
- Marginal structural models (MSM) with inverse probability weighting (IPW) are advanced statistical methods to address this challenge.
- The application and reporting of IPW in published studies require systematic evaluation.
Purpose of the Study:
- To systematically review pharmacoepidemiologic studies published in 2012 that utilized inverse probability weighting (IPW) estimation of marginal structural models (MSM).
- To assess the methods used for estimating the effect of time-varying treatments in these studies.
- To identify common practices and potential areas for improvement in the application and reporting of IPW.
Main Methods:
- A systematic literature search was conducted using Web of Science and PubMed for studies published in 2012.
- Studies were screened for eligibility by at least two independent reviewers.
- Data extraction was performed by one reviewer and confirmed by a senior epidemiologist.
Main Results:
- Twenty pharmacoepidemiologic studies met the eligibility criteria.
- Reporting of the positivity assumption was often absent.
- While some studies used intention-to-treat or as-treated strategies, detailed reporting on treatment adherence and multiphase modeling was limited.
- Nearly half of the studies found substantial differences between IPW estimates and standard regression models.
Conclusions:
- The utilization of IPW for time-varying confounding in medical literature is growing.
- Current reporting standards for IPW application are variable and often suboptimal.
- Developing best practices for reporting complex epidemiological methods is recommended to enhance transparency and reproducibility.
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