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Physicians' prescribing preferences were a potential instrument for patients' actual prescriptions of antidepressants.

Davies NM, Gunnell D, Thomas KH, Metcalfe C, Windmeijer F, Martin RM - J Clin Epidemiol (2013)

Bottom Line: Prior prescriptions were strongly associated with actual prescriptions: physicians who previously prescribed TCAs were 14.9 percentage points (95% confidence interval [CI], 14.4, 15.4) more likely to prescribe TCAs, and those who previously prescribed paroxetine were 27.7 percentage points (95% CI, 26.7, 28.8) more likely to prescribe paroxetine, to their next patient.Physicians' previous prescriptions were less strongly associated with patients' baseline characteristics than actual prescriptions.The main instrumental variable assumptions held, suggesting that physicians' prescribing preferences are valid instruments for evaluating the short-term effects of antidepressants.

View Article: PubMed Central - PubMed

Affiliation: School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK; Medical Research Council Centre for Causal Analysis in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, UK. Electronic address: neil.davies@bristol.ac.uk.

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Directed acyclic graph of outcomes Y, prescriptions X, instrumental variable the unmeasured physician prescribing preference U*, surrogate instrument physicians' prior prescriptions Z, and unmeasured confounders U.
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fig1: Directed acyclic graph of outcomes Y, prescriptions X, instrumental variable the unmeasured physician prescribing preference U*, surrogate instrument physicians' prior prescriptions Z, and unmeasured confounders U.

Mentions: The assumptions defining an instrumental variable are described in Box 1 and illustrated in Fig. 1.


Physicians' prescribing preferences were a potential instrument for patients' actual prescriptions of antidepressants.

Davies NM, Gunnell D, Thomas KH, Metcalfe C, Windmeijer F, Martin RM - J Clin Epidemiol (2013)

Directed acyclic graph of outcomes Y, prescriptions X, instrumental variable the unmeasured physician prescribing preference U*, surrogate instrument physicians' prior prescriptions Z, and unmeasured confounders U.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3824069&req=5

fig1: Directed acyclic graph of outcomes Y, prescriptions X, instrumental variable the unmeasured physician prescribing preference U*, surrogate instrument physicians' prior prescriptions Z, and unmeasured confounders U.
Mentions: The assumptions defining an instrumental variable are described in Box 1 and illustrated in Fig. 1.

Bottom Line: Prior prescriptions were strongly associated with actual prescriptions: physicians who previously prescribed TCAs were 14.9 percentage points (95% confidence interval [CI], 14.4, 15.4) more likely to prescribe TCAs, and those who previously prescribed paroxetine were 27.7 percentage points (95% CI, 26.7, 28.8) more likely to prescribe paroxetine, to their next patient.Physicians' previous prescriptions were less strongly associated with patients' baseline characteristics than actual prescriptions.The main instrumental variable assumptions held, suggesting that physicians' prescribing preferences are valid instruments for evaluating the short-term effects of antidepressants.

View Article: PubMed Central - PubMed

Affiliation: School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK; Medical Research Council Centre for Causal Analysis in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, UK. Electronic address: neil.davies@bristol.ac.uk.

Show MeSH
Related in: MedlinePlus