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Instrumental Variable Analyses in Pharmacoepidemiology: What Target Trials Do We Emulate?
1Department of Epidemiology, Erasmus MC, P. O. Box 2040, 3000 CA Rotterdam, The Netherlands.
Instrumental variable (IV) methods help estimate treatment effects from observational data by emulating target trials. Recent advancements refine IV analysis validity and address tradeoffs in emulating trial designs.
Area of Science:
- Epidemiology
- Biostatistics
- Pharmacoepidemiology
Background:
- Estimating treatment effects using observational data requires emulating a target trial.
- Unmeasured confounding can necessitate instrumental variable (IV) methods.
Purpose of the Study:
- To review methodological advancements in evaluating IV analysis validity.
- To contextualize these advancements within feasible target trial protocols.
Main Methods:
- Review of recent methodological developments in instrumental variable analysis.
- Focus on sensitivity analyses, falsification strategies, and problem identification.
- Contextualization within target trial emulation frameworks.
Main Results:
- Increased development and application of tools for assessing IV analysis validity.
- Identification of previously overlooked issues in pharmacoepidemiology.
- Insights reveal restrictions and tradeoffs in emulating target trials with classical IV analysis.
Conclusions:
- Classical IV methods, viewed through the lens of target trials, highlight recent methodological importance.
- Tradeoffs in target trial definition are sometimes unavoidable but can be managed.
- Sensitivity analyses and discourse frameworks aid in interpreting IV and non-IV results from emulated trials.
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