Methods Projects

We review some methodological challenges facing drug safety networks such as CNODES and Sentinel.

We illustrate the confounding that can occur due to drug formulary restrictions using the example of fluticasone/salmeterol combination therapy, whose use is restricted in the province of Quebec, Canada. We found that formulary restrictions can result in substantial and unexpected confounding and should be considered during the design and analysis of pharmacoepidemiologic studies.

Patients with type 2 diabetes using incretin-based drugs to lower their blood sugar levels do not have an increased risk of heart failure, compared to those using combinations of other oral antidiabetic drugs.

Likelihood ratio meta-analysis (LRMA) provides an alternative technique for comparing alternative hypotheses, and the results of a LRMA can be presented in a format that is familiar to meta-analytic audience. We explain the LRMA method and illustrate its application to an existing meta-analysis of observation studies on the association between high potency statins and acute kidney injury.

We examine the standard propensity score and high-dimensional propensity score methods to identify which provides the best adjustment for confounding by indication. To demonstrate and compare the performance of each, we use both methods to assess the risk of diabetes among statin users in Quebec, Canada.

The use of incretin-based drugs, therapies prescribed for the treatment of type 2 diabetes, is not associated with an increased risk of pancreatic cancer, when compared with sulfonylureas.