[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 50.16.107.222. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Views 509
Citations 0
Letters
May 1, 2013

Falsification End Points for Observational Studies—Reply

Author Affiliations
 

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts (Dr Jena; jena@hcp.med.harvard.edu); and Medical Oncology Branch, National Cancer Institute, Bethesda, Maryland (Dr Prasad).

JAMA. 2013;309(17):1769-1771. doi:10.1001/jama.2013.3112

In Reply:Falsification hypotheses can help adjudicate whether observational associations are robust or whether they reflect selection bias among patients who receive an intervention. Dr Groenwold thoughtfully expands on a prerequisite to proper falsification analyses: the falsification hypothesis must test a putative mechanism of bias.

Consider, for example, the question posed by Groenwold of whether β-blocker therapy reduces perioperative cardiac risk. Even after adjusting for observed patient demographics and claims-based clinical characteristics, an estimated association between β-blocker therapy and cardiac risk may still be confounded by unobserved patient and physician characteristics, including unmeasured socioeconomic characteristics.

First Page Preview View Large
First page PDF preview
First page PDF preview
×