long-acting paliperiodone palmitate (PP). The case presented compares the effectiveness of two antipsychotic treatment strategies: oral second-generation antipsychotics (SGAs) vs. This paper demonstrates how to use exploratory spatial data analysis (ESDA) and spatial statistical methods to investigate and control for these potential biases. Root, Elisabeth Dowling Thomas, Deborah S K Campagna, Elizabeth J Morrato, Elaine HĪrea-level variation in treatment and outcomes may be a potential source of confounding bias in observational comparative effectiveness studies. PMID:19285103Īdjusting for geographic variation in observational comparative effectiveness studies: a case study of antipsychotics using state Medicaid data. The relationship between risk factor scores and mortality was stronger for CHD than stroke. Conclusions Weak associations between CHD and stroke mortality and strong associations between CHD and stroke risk scores suggest geographic variation in risk factors may not underlie geographic variations in stroke and CHD mortality. There was a stronger (p < 0.0001) association between state-level FCRS and state-level CHD mortality (r = 0.28, p = 0.18), than between FSRS and stroke mortality (r = 0.12, p = 0.56). Results There was no relationship between CHD and stroke mortality rates (r = 0.04 p = 0.78), but there was between CHD and stroke risk scores at the individual (r = 0.68 p < 0.0001) and state (r = 0.64, p < 0.0001) level. In an ecologic analysis, the age-adjusted, race-sex weighted, average state-level risk factor levels were compared to state-level mortality rates. Vital statistics provided age-adjusted CHD and stroke mortality rates. Methods Framingham CHD Risk Score (FCRS) and Stroke Risk Score (FSRS) were calculated for 25,770 stroke-free and 22,247 CHD-free participants from the REasons for Geographic And Racial Differences in Stroke cohort. Purpose Geographic variation in risk factors may underlie geographic disparities in coronary heart disease (CHD) and stroke mortality. Howard, George Cushman, Mary Prineas, Ronald J. Advancing the Hypothesis that Geographic Variations in Risk Factors Contribute Relatively Little to Observed Geographic Variations in Heart Disease and Stroke Mortality
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