Sex differences in the impact of acute stroke treatment in a population-based study: a sex-specific propensity score approach
被引:1
作者:
Lisabeth, Lynda D.
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机构:
Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA
Univ Michigan, Stroke Program, Ann Arbor, MI 48109 USAUniv Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA
Lisabeth, Lynda D.
[1
,2
]
Baek, Jonggyu
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机构:
Univ Michigan, Sch Publ Hlth, Dept Biostat, Ann Arbor, MI 48109 USAUniv Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA
Baek, Jonggyu
[3
]
Morgenstern, Lewis B.
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机构:
Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA
Univ Michigan, Stroke Program, Ann Arbor, MI 48109 USAUniv Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA
Morgenstern, Lewis B.
[1
,2
]
Reeves, Mathew J.
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机构:
Michigan State Univ, Dept Epidemiol, E Lansing, MI 48824 USAUniv Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA
Reeves, Mathew J.
[4
]
Brown, Devin L.
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机构:
Univ Michigan, Stroke Program, Ann Arbor, MI 48109 USAUniv Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA
Brown, Devin L.
[2
]
Zahuranec, Darin B.
论文数: 0引用数: 0
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机构:
Univ Michigan, Stroke Program, Ann Arbor, MI 48109 USAUniv Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA
Zahuranec, Darin B.
[2
]
Smith, Melinda A.
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机构:
Univ Michigan, Stroke Program, Ann Arbor, MI 48109 USAUniv Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA
Smith, Melinda A.
[2
]
Sanchez, Brisa N.
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机构:
Univ Michigan, Sch Publ Hlth, Dept Biostat, Ann Arbor, MI 48109 USAUniv Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA
Sanchez, Brisa N.
[3
]
机构:
[1] Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA
[2] Univ Michigan, Stroke Program, Ann Arbor, MI 48109 USA
[3] Univ Michigan, Sch Publ Hlth, Dept Biostat, Ann Arbor, MI 48109 USA
[4] Michigan State Univ, Dept Epidemiol, E Lansing, MI 48824 USA
Stroke;
Sex factors;
Therapeutics;
TISSUE-PLASMINOGEN ACTIVATOR;
ACUTE ISCHEMIC-STROKE;
BRAIN ATTACK SURVEILLANCE;
CHRISTI BASIC PROJECT;
VARIABLE SELECTION;
URIC-ACID;
TRIAL;
SCALE;
D O I:
10.1016/j.annepidem.2017.07.006
中图分类号:
R1 [预防医学、卫生学];
学科分类号:
1004 ;
120402 ;
摘要:
Purpose: We investigated whether sex modifies the association of acute stroke treatment on functional outcome using propensity score (PS) methods to minimize confounding and to explore the differential effects of confounders by sex. Methods: We included tissue plasminogen activator (tPA) treated (n = 84) and nontreated ischemic stroke cases (n = 143) from a population-based stroke study (2008-2013). The PS model that estimated the probability of receiving tPA included interactions between sex and treatment predictors. The outcome model included sex, tPA, and their interaction. In addition, sex-specific PS values were included as a continuous covariate and modeled using splines. We compared the results with conventional methods of statistical adjustment. Results: Conventional methods of adjustment suggested that women receive greater benefit from tPA than men. After taking into consideration that the influence of confounders, specifically age and stroke severity, differed by sex, we found no sex difference in the tPA-functional outcome association (P =.94). Conclusions: Using PS methods that considered confounding of the sex x treatment interaction, we did not find that the association of tPA with functional outcome differed for women and men. Our findings may have implications for the methodologic approaches used to address confounding in studies that seek to compare stroke treatment effects by sex. (C) 2017 Elsevier Inc. All rights reserved.
机构:
Cornell Univ, Dept Biol Stat & Computat Biol, Ithaca, NY 14853 USA
Cornell Univ, Dept Stat Sci, Ithaca, NY 14853 USACornell Univ, Dept Biol Stat & Computat Biol, Ithaca, NY 14853 USA
Bien, Jacob
Taylor, Jonathan
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Stanford Univ, Dept Stat, Stanford, CA 94305 USACornell Univ, Dept Biol Stat & Computat Biol, Ithaca, NY 14853 USA
Taylor, Jonathan
Tibshirani, Robert
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h-index: 0
机构:
Stanford Univ, Dept Stat, Stanford, CA 94305 USA
Stanford Univ, Dept Hlth Res & Policy, Stanford, CA 94305 USACornell Univ, Dept Biol Stat & Computat Biol, Ithaca, NY 14853 USA
机构:
Univ Michigan, Sch Med, Dept Neurol, Ann Arbor, MI 48109 USA
VA Ctr Clin Management & Res, Ann Arbor, MI USAUniv Michigan, Sch Med, Dept Neurol, Ann Arbor, MI 48109 USA
Burke, James F.
Sussman, Jeremy B.
论文数: 0引用数: 0
h-index: 0
机构:
VA Ctr Clin Management & Res, Ann Arbor, MI USA
Univ Michigan, Sch Med, Dept Internal Med, Ann Arbor, MI 48109 USAUniv Michigan, Sch Med, Dept Neurol, Ann Arbor, MI 48109 USA
Sussman, Jeremy B.
Kent, David M.
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机构:
Tufts Univ, Sch Med, Dept Internal Med, Boston, MA 02111 USA
Tufts Univ, Sch Med, Tufts Med Ctr, Predict Analyt & Comparat Effectiveness Ctr, Boston, MA USAUniv Michigan, Sch Med, Dept Neurol, Ann Arbor, MI 48109 USA
Kent, David M.
Hayward, Rodney A.
论文数: 0引用数: 0
h-index: 0
机构:
VA Ctr Clin Management & Res, Ann Arbor, MI USA
Univ Michigan, Sch Med, Dept Internal Med, Ann Arbor, MI 48109 USAUniv Michigan, Sch Med, Dept Neurol, Ann Arbor, MI 48109 USA
机构:
Cornell Univ, Dept Biol Stat & Computat Biol, Ithaca, NY 14853 USA
Cornell Univ, Dept Stat Sci, Ithaca, NY 14853 USACornell Univ, Dept Biol Stat & Computat Biol, Ithaca, NY 14853 USA
Bien, Jacob
Taylor, Jonathan
论文数: 0引用数: 0
h-index: 0
机构:
Stanford Univ, Dept Stat, Stanford, CA 94305 USACornell Univ, Dept Biol Stat & Computat Biol, Ithaca, NY 14853 USA
Taylor, Jonathan
Tibshirani, Robert
论文数: 0引用数: 0
h-index: 0
机构:
Stanford Univ, Dept Stat, Stanford, CA 94305 USA
Stanford Univ, Dept Hlth Res & Policy, Stanford, CA 94305 USACornell Univ, Dept Biol Stat & Computat Biol, Ithaca, NY 14853 USA
机构:
Univ Michigan, Sch Med, Dept Neurol, Ann Arbor, MI 48109 USA
VA Ctr Clin Management & Res, Ann Arbor, MI USAUniv Michigan, Sch Med, Dept Neurol, Ann Arbor, MI 48109 USA
Burke, James F.
Sussman, Jeremy B.
论文数: 0引用数: 0
h-index: 0
机构:
VA Ctr Clin Management & Res, Ann Arbor, MI USA
Univ Michigan, Sch Med, Dept Internal Med, Ann Arbor, MI 48109 USAUniv Michigan, Sch Med, Dept Neurol, Ann Arbor, MI 48109 USA
Sussman, Jeremy B.
Kent, David M.
论文数: 0引用数: 0
h-index: 0
机构:
Tufts Univ, Sch Med, Dept Internal Med, Boston, MA 02111 USA
Tufts Univ, Sch Med, Tufts Med Ctr, Predict Analyt & Comparat Effectiveness Ctr, Boston, MA USAUniv Michigan, Sch Med, Dept Neurol, Ann Arbor, MI 48109 USA
Kent, David M.
Hayward, Rodney A.
论文数: 0引用数: 0
h-index: 0
机构:
VA Ctr Clin Management & Res, Ann Arbor, MI USA
Univ Michigan, Sch Med, Dept Internal Med, Ann Arbor, MI 48109 USAUniv Michigan, Sch Med, Dept Neurol, Ann Arbor, MI 48109 USA