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- Title
Influence of incomplete death information on cumulative risk estimates in US claims data.
- Authors
Barberio, Julie; Naimi, Ashley I; Patzer, Rachel E; Kim, Christopher; Hernandez, Rohini K; Brookhart, M Alan; Gilbertson, David; Bradbury, Brian D; Lash, Timothy L
- Abstract
Administrative claims databases often do not capture date or fact of death, so studies using these data may inappropriately treat death as a censoring event—equivalent to other withdrawal reasons—rather than a competing event. We examined 1-, 3-, and 5-year inverse-probability-of-treatment weighted cumulative risks of a composite cardiovascular outcome among 34 527 initiators of telmisartan (exposure) and ramipril (referent), who were aged ≥55 years, in Optum (United States) claims data from 2003 to 2020. Differences in cumulative risks of the cardiovascular endpoint due to censoring of death (cause-specific), as compared with treating death as a competing event (subdistribution), increased with greater follow-up time and older age, where event and mortality risks were higher. Among ramipril users, 5-year cause-specific and subdistribution cumulative risk estimates per 100, respectively, were 16.4 (95% CI, 15.3-17.5) and 16.2 (95% CI, 15.1-17.3) among ages 55-64 (difference = 0.2) and were 43.2 (95% CI, 41.3-45.2) and 39.7 (95% CI, 37.9-41.4) among ages ≥75 (difference = 3.6). Plasmode simulation results demonstrated the differences in cause-specific versus subdistribution cumulative risks to increase with increasing mortality rate. We suggest researchers consider the cohort's baseline mortality risk when deciding whether real-world data with incomplete death information can be used without concern. This article is part of a Special Collection on Pharmacoepidemiology.
- Subjects
UNITED States; CARDIOVASCULAR disease related mortality; MORTALITY risk factors; RISK assessment; CARDIOVASCULAR diseases; HEALTH insurance reimbursement; RESEARCH funding; TELMISARTAN; RAMIPRIL; AGE distribution; DESCRIPTIVE statistics; CARDIOVASCULAR diseases risk factors; LONGITUDINAL method; CONFIDENCE intervals
- Publication
American Journal of Epidemiology, 2024, Vol 193, Issue 9, p1281
- ISSN
0002-9262
- Publication type
Article
- DOI
10.1093/aje/kwae034