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Inverse probability weighting to estimate causal effect of a singular phase in a multiphase randomized clinical trial for multiple myeloma
Open accessAbstract
BACKGROUND: Randomization procedure in randomized controlled trials (RCTs) permits an unbiased estimation of causal effects. However, in clinical practice, differential compliance between arms may cause a strong violation of randomization balance and biased treatment effect among those who comply. We evaluated the effect of the consolidation phase on disease-free survival of patients with multiple myeloma in an RCT designed for another purpose, adjusting for potential selection bias due to different compliance to previous treatment phases. METHODS: We computed two propensity scores (PS) to model two different selection processes: the first to undergo autologous stem cell transplantation, the second to begin consolidation therapy. Combined stabilized inverse probability treatment weights were then introduced in the Cox model to estimate the causal effect of consolidation therapy miming an ad hoc RCT protocol. RESULTS: We found that the effect of consolidation therapy was restricted to the first 18 months of the phase (HR: 0.40, robust 95 % CI: 0.17-0.96), after which it disappeared. CONCLUSIONS: PS-based methods could be a complementary approach within an RCT context to evaluate the effect of the last phase of a complex therapeutic strategy, adjusting for potential selection bias caused by different compliance to the previous phases of the therapeutic scheme, in order to simulate an ad hoc randomization procedure. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01134484 May 28, 2010 (retrospectively registered) EudraCT: 2005-003723-39 December 17, 2008 (retrospectively registered).
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The study used stabilized inverse probability treatment weighting (sIPTW) to balance characteristics between SSRI/SNRI and psychotherapy groups.
“Fourth, we balanced the characteristics between patients receiving SSRIs/SNRIs and those receiving psychotherapy using the stabilized inverse probability treatment weighting (sIPTW) approach, which preserves the sample size of the original data and avoids underestimating the variance compared to IPTW [25].”
From Association between first-line antidepressant use and risk of dementia in older adults: a retrospective cohort study (2023) · cites this paper as [25]
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A structural approach to selection bias
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Lauffenburger, J. C., Ghazinouri, R., Jan, S., Makanji, S., Ferro, C. A., Lewey, J., Wittbrodt, E., Lee, J., Haff, N., Fontanet, C. P., et al. (2019) · PLOS ONE · doi:10.1371/journal.pone.0214754 · Cited by 50
Wang, G. H.-M., Chen, W.-H., Chang, S.-H., Zhang, T., Shao, H., Guo, J., & Lo-Ciganic, W.-H. (2023) · BMC Geriatrics · doi:10.1186/s12877-023-04475-z · Cited by 13
Metadata
- Authors
- Pezzi, A., Cavo, M., Biggeri, A., Zamagni, E., & Nanni, O.
- Affiliations
- IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola (IT)
- Istituto per lo Studio e la Prevenzione Oncologica (IT)
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IT)
- Corresponding author
- Nanni, Oriana
- Venue
- BMC Medical Research Methodology
- Published
- 2016-11-09
- Volume
- 16
- Issue
- 1
- Pages
- 150-150
- ISSN
- 1471-2288 (ISSN-L)
- PMC
- PMC5103416
- OpenAlex
- W2554111497
- Cited by
- 41
- References
- 1
- Citations by year
- 2026: 7 · 2025: 8 · 2023: 6 · 2022: 7 · 2021: 5 · 2020: 3 · 2019: 3 · 2018: 1 · 2017: 1
- FWCI
- 1.39
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Medical Research Methodology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Florence Research (University of Florence) (submittedVersion, cc-by)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Padua Research Archive (University of Padova) (submittedVersion, cc-by)
- Topics
- Physical Sciences › Mathematics › Statistics and Probability › Advanced Causal Inference Techniques
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Keywords
- inverse probability weighting, multiple myeloma, consolidation therapy, autologous stem cell transplantation, medication adherence, selection bias, propensity score, disease-free survival, causal effect estimation, time-varying treatment effects
- MeSH terms
- Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Multiple Myeloma, Research Design, Time Factors, Proportional Hazards Models, Randomized Controlled Trials as Topic, Outcome Assessment, Health Care, Clinical Trials, Phase III as Topic, Kaplan-Meier Estimate, Young Adult, Propensity Score
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