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Comment & Response
June 22, 2020

Chlorthalidone and Hydrochlorothiazide for Treatment of Patients With Hypertension—Reply

Author Affiliations
  • 1Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York
  • 2Medical Informatics Services, New York-Presbyterian Hospital, New York, New York
  • 3Observational Health Data Sciences and Informatics, New York, New York
  • 4Department of Medicine, Columbia University, New York, New York
  • 5Epidemiology Analytics, Janssen Research and Development, Titusville, New Jersey
JAMA Intern Med. Published online June 22, 2020. doi:10.1001/jamainternmed.2020.1736

In Reply We assessed chlorthalidone and hydrochlorothiazide in the treatment of hypertension by comparing the outcomes patients experience in real-world practice when their physicians prescribe them monotherapy.1 We acknowledge that our analysis with large-scale propensity adjustment2 and negative and positive control calibration3 cannot fully eliminate the possibility of residual confounding. The variables included in the analysis, however, are likely to be correlated with any unmeasured variables that might cause confounding. Moreover, physician factors, which were not directly controlled, would influence patient outcomes through correlation with patient-level characteristics associated with response or toxic effects, and would thereby be addressed by the propensity scoring methods.

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