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Confounding by indication: the case of calcium channel blockers
Author(s) -
Joffe Marshall M.
Publication year - 2000
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/(sici)1099-1557(200001/02)9:1<37::aid-pds471>3.0.co;2-u
Subject(s) - confounding , medicine , context (archaeology) , instrumental variable , pharmacoepidemiology , econometrics , pharmacology , medical prescription , paleontology , biology , economics
Purpose To review conceptual issues regarding confounding by indication in the context of studies of calcium channel blockers (CCBs). Methods Review of literature, with special attention to two articles in the current issue. Results Conflicting arguments about the presence of uncontrollable confounding by indication in studies of CCBs are reviewed and criticized. Studies with potential confounding by indication can benefit from appropriate analytic methods, including separating the effects of a drug taken at different times, sensitivity analysis for unmeasured confounders, and instrumental variables and G‐estimation. Conclusions Whether confounding by indication accounts for observed associations is often difficult to determine; this is the case in studies of CCBs. When confounding by indication is suspected, a variety of methods to deal with it may be useful. Copyright © 2000 John Wiley & Sons, Ltd.