Propensity score matching and inverse probability of treatment weighting to address confounding by indication in comparative effectiveness research of oral anticoagulants

• Published in: Journal of comparative effectiveness research Vol. 9; no. 9; pp. 603 - 614
• Main Authors: Allan, Victoria, Ramagopalan, Sreeram V, Mardekian, Jack, Jenkins, Aaron, Li, Xiaoyan, Pan, Xianying, Luo, Xuemei
• Format: Journal Article
• Language: English
• Published: England Future Medicine Ltd 01.06.2020
• Subjects: Administration, Oral; Anticoagulants; Anticoagulants - administration & dosage; Anticoagulants - therapeutic use; atrial fibrillation; Atrial Fibrillation - drug therapy; Atrial Fibrillation - prevention & control; Bias; Cardiac arrhythmia; Case studies; Comparative Effectiveness Research; confounding by indication; Humans; inverse probability of treatment weighting; Medical prognosis; oral anticoagulants; Patients; Propensity Score; propensity score matching; Stroke; Stroke - drug therapy; Stroke - prevention & control; Systematic review; confounding by indication; comparative effectiveness research; atrial fibrillation; propensity score matching; inverse probability of treatment weighting; oral anticoagulants
• ISSN: 2042-6305; 2042-6313
• DOI: 10.2217/cer-2020-0013

After decades of warfarin being the only oral anticoagulant (OAC) widely available for stroke prevention in atrial fibrillation, four direct OACs (apixaban, dabigatran, edoxaban and rivaroxaban) were approved after demonstrating noninferior efficacy and safety versus warfarin in randomized controlled trials. Comparative effectiveness research of OACs based on real-world data provides complementary information to randomized controlled trials. Propensity score matching and inverse probability of treatment weighting are increasingly popular methods used to address confounding by indication potentially arising in comparative effectiveness research due to a lack of randomization in treatment assignment. This review describes the fundamentals of propensity score matching and inverse probability of treatment weighting, appraises differences between them and presents applied examples to elevate understanding of these methods within the atrial fibrillation field.