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Simultaneously assessing intended and unintended treatment effects of multiple treatment options: a pragmatic “matrix design”
Author(s) -
Rassen Jeremy A.,
Solomon Daniel H.,
Glynn Robert J.,
Schneeweiss Sebastian
Publication year - 2011
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/pds.2121
Subject(s) - medicine , intensive care medicine , unintended consequences , pharmacoepidemiology , risk analysis (engineering) , pharmacology , epistemology , philosophy , medical prescription
Purpose A key aspect of comparative effectiveness research is the assessment of competing treatment options and multiple outcomes rather than a single treatment option and a single benefit or harm. In this commentary, we describe a methodological framework that supports the simultaneous examination of a “matrix” of treatments and outcomes in non‐randomized data. Methods We outline the methodological challenges to a matrix‐type study (matrix design). We consider propensity score matching with multiple treatment groups, statistical analysis, and choice of association measure when evaluating multiple outcomes. We also discuss multiple testing, use of high‐dimensional propensity scores for covariate balancing in light of multiple outcomes, and suitability of available software. Conclusion The matrix design study methods facilitate examination of the comparative benefits and harms of competing treatment choices, and also provides the input required for calculating the numbers needed to treat and for a broader benefit/harm assessment that weighs endpoints of varying severity. Copyright © 2011 John Wiley & Sons, Ltd.