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1、NIHPublicAccessAuthorManuscriptJClinEpidemiol.Authormanuscript;availableinPMC2007May1.NIH-PAAuthorManuscriptPublishedinfinaleditedformas:NIH-PAAuthorManuscriptNIH-PAAuthorManuscriptJClinEpidemiol.2006May;59(5):437±447.Areviewoftheapplicationofpropensi
2、tyscoremethodsyieldedincreasinguse,advantagesinspecificsettings,butnotsubstantiallydifferentestimatescomparedwithconventionalmultivariablemethodsTilStürmer,MD,MPH1,2,ManishaJoshi,MS,MSW1,RobertJ.Glynn,PhD,ScD1,2,JerryAvorn,MD1,KennethJ.Rothman,DrPH1,3
3、,andSebastianSchneeweiss,MD,ScD11DivisionofPharmacoepidemiologyandPharmacoeconomics,BrighamandWomen’sHospital,HarvardMedicalSchool,Boston,MA,USA2DivisionofPreventiveMedicine,BrighamandWomen’sHospital,HarvardMedicalSchool,Boston,MA,USA3DepartmentofEpid
4、emiology,BostonUniversitySchoolofPublicHealthAbstractObjective—Propensityscoreanalysesattempttocontrolforconfoundinginnon-experimentalstudiesbyadjustingforthelikelihoodthatagivenpatientisexposed.Suchanalyseshavebeenproposedtoaddressconfoundingbyindica
5、tion,butthereislittleempiricalevidencethattheyachievebettercontrolthanconventionalmultivariateoutcomemodeling.Studydesignandmethods—UsingPubMedandScienceCitationIndex,weassessedtheuseofpropensityscoresovertimeandcriticallyevaluatedstudiespublishedthro
6、ugh2003.Results—Useofpropensityscoresincreasedfromatotalof8papersbefore1998to71in2003.Mostofthe177publishedstudiesabstractedassessedmedications(N=60)orsurgicalinterventions(N=51),mainlyincardiologyandcardiacsurgery(N=90).WhetherPSmethodsorconventional
7、outcomemodelswereusedtocontrolforconfoundinghadlittleeffectonresultsinthosestudiesinwhichsuchcomparisonwaspossible.Only9outof69studies(13%)hadaneffectestimatethatdifferedbymorethan20%fromthatobtainedwithaconventionaloutcomemodelinallPSanalysespresente
8、d.Conclusions—Publicationofresultsbasedonpropensityscoremethodshasincreaseddramatically,butthereislittleevidencethatthesemethodsyieldsubstantiallydifferentestimatescomparedwithconventionalmultivariablemethods.Keywordspropensityscore;epidemiolo
