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Cited by 264

The DOI matches its Crossref record; 115 of the 115 references it cites were found in a registry or an index.

Bias in Observational Studies of Prevalent Users: Lessons for Comparative Effectiveness Research From a Meta-Analysis of Statins

Open access
Danaei, Goodarz, Tavakkoli, Mohammad, Hernán, Miguel A.·2012·American Journal of Epidemiology

Abstract

Randomized clinical trials (RCTs) are usually the preferred strategy with which to generate evidence of comparative effectiveness, but conducting an RCT is not always feasible. Though observational studies and RCTs often provide comparable estimates, the questioning of observational analyses has recently intensified because of randomized-observational discrepancies regarding the effect of postmenopausal hormone replacement therapy on coronary heart disease. Reanalyses of observational data that excluded prevalent users of hormone replacement therapy led to attenuated discrepancies, which begs the question of whether exclusion of prevalent users should be generally recommended. In the current study, the authors evaluated the effect of excluding prevalent users of statins in a meta-analysis of observational studies of persons with cardiovascular disease. The pooled, multivariate-adjusted mortality hazard ratio for statin use was 0.77 (95% confidence interval (CI): 0.65, 0.91) in 4 studies that compared incident users with nonusers, 0.70 (95% CI: 0.64, 0.78) in 13 studies that compared a combination of prevalent and incident users with nonusers, and 0.54 (95% CI: 0.45, 0.66) in 13 studies that compared prevalent users with nonusers. The corresponding hazard ratio from 18 RCTs was 0.84 (95% CI: 0.77, 0.91). It appears that the greater the proportion of prevalent statin users in observational studies, the larger the discrepancy between observational and randomized estimates.

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Metadata

Authors
Danaei, G., Tavakkoli, M., & Hernán, M. A.
Venue
American Journal of Epidemiology
Published
2012-01-05
Volume
175
Issue
4
Pages
250-262
ISSN
  • 0002-9262 (ISSN-L)
  • 1476-6256
OpenAlex
W2125241858
Cited by
264
References
115
FWCI
3.07
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Bias in Observational Studies of Prevalent Users: Lessons for Comparative Effectiveness Research From a Meta-Analysis of Statins. https://app.cochat.ai/papers/10.1093/aje/kwr301
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Danaei, G., Tavakkoli, M., & Hernán, M. A. (2012). Bias in Observational Studies of Prevalent Users: Lessons for Comparative Effectiveness Research From a Meta-Analysis of Statins. American Journal of Epidemiology. https://doi.org/10.1093/aje/kwr301

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