Project ECHO Revisited: Propensity Score Analysis And HCV Treatment Outcomes

Kimberly Page,1,2 Fares Qeadan,1,2 Clifford Qualls,2 Karla Thornton,1 Sanjeev Arora1 1Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA; 2Clinical and Translational Science Center, University of New Mexico Health Sciences Center, Albuquerque, NM,...

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Autores principales:	Page K, Qeadan F, Qualls C, Thornton K, Arora S
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	propensity scoring ECHO hepatitis C virus treatment Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/3f4cf4f2ad994be5b536262d7aa5f9b1
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spelling	oai:doaj.org-article:3f4cf4f2ad994be5b536262d7aa5f9b12021-12-02T11:41:58ZProject ECHO Revisited: Propensity Score Analysis And HCV Treatment Outcomes1179-1535https://doaj.org/article/3f4cf4f2ad994be5b536262d7aa5f9b12019-10-01T00:00:00Zhttps://www.dovepress.com/project-echo-revisited-propensity-score-analysis-and-hcv-treatment-out-peer-reviewed-article-HMERhttps://doaj.org/toc/1179-1535Kimberly Page,1,2 Fares Qeadan,1,2 Clifford Qualls,2 Karla Thornton,1 Sanjeev Arora1 1Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA; 2Clinical and Translational Science Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USACorrespondence: Kimberly PageDepartment of Internal Medicine, University of New Mexico Health Sciences Center, MSC10 5550, 1 University of New Mexico, Albuquerque, NM 98131, USATel +1505-272-2520Email Pagek@salud.unm.eduAbstract: Propensity score analysis is a statistical approach to reduce bias often present in non-randomized observational studies. In this paper we use this method to re-analyze data from a study that assessed whether patients receiving HCV treatment from providers in Project ECHO had different clinical outcomes than patients treated by specialists from an academic medical center (UNM HCV clinic) but in which treatment assignment was not randomized. We modeled the best estimated probability of treatment assignment, and then assess differences overall SVR and SVR in patients with genotype 1 infection by treatment arm using Stabilized Inverse Probability of Treatment Weights (SIPTW). Results show that after adjustment for SIPTW, HCV treatment outcomes were significantly better for the ECHO patients compared to the UNM HCV clinic patients. Higher proportions of patients treated by primary care providers achieved SVR and SVR with genotype 1 compared to those treated at UNM HCV clinic with 15.1% and 16.3% absolute differences, respectively. These results indicate that previously published results (showing no differences) were biased, and resulted in an underestimation of the treatment effect of ECHO on HCV treatment.Keywords: propensity scoring, ECHO, hepatitis C virus, treatmentPage KQeadan FQualls CThornton KArora SDove Medical Pressarticlepropensity scoringECHOhepatitis C virustreatmentDiseases of the digestive system. GastroenterologyRC799-869ENHepatic Medicine: Evidence and Research, Vol Volume 11, Pp 149-152 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	propensity scoring ECHO hepatitis C virus treatment Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	propensity scoring ECHO hepatitis C virus treatment Diseases of the digestive system. Gastroenterology RC799-869 Page K Qeadan F Qualls C Thornton K Arora S Project ECHO Revisited: Propensity Score Analysis And HCV Treatment Outcomes
description	Kimberly Page,1,2 Fares Qeadan,1,2 Clifford Qualls,2 Karla Thornton,1 Sanjeev Arora1 1Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA; 2Clinical and Translational Science Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USACorrespondence: Kimberly PageDepartment of Internal Medicine, University of New Mexico Health Sciences Center, MSC10 5550, 1 University of New Mexico, Albuquerque, NM 98131, USATel +1505-272-2520Email Pagek@salud.unm.eduAbstract: Propensity score analysis is a statistical approach to reduce bias often present in non-randomized observational studies. In this paper we use this method to re-analyze data from a study that assessed whether patients receiving HCV treatment from providers in Project ECHO had different clinical outcomes than patients treated by specialists from an academic medical center (UNM HCV clinic) but in which treatment assignment was not randomized. We modeled the best estimated probability of treatment assignment, and then assess differences overall SVR and SVR in patients with genotype 1 infection by treatment arm using Stabilized Inverse Probability of Treatment Weights (SIPTW). Results show that after adjustment for SIPTW, HCV treatment outcomes were significantly better for the ECHO patients compared to the UNM HCV clinic patients. Higher proportions of patients treated by primary care providers achieved SVR and SVR with genotype 1 compared to those treated at UNM HCV clinic with 15.1% and 16.3% absolute differences, respectively. These results indicate that previously published results (showing no differences) were biased, and resulted in an underestimation of the treatment effect of ECHO on HCV treatment.Keywords: propensity scoring, ECHO, hepatitis C virus, treatment
format	article
author	Page K Qeadan F Qualls C Thornton K Arora S
author_facet	Page K Qeadan F Qualls C Thornton K Arora S
author_sort	Page K
title	Project ECHO Revisited: Propensity Score Analysis And HCV Treatment Outcomes
title_short	Project ECHO Revisited: Propensity Score Analysis And HCV Treatment Outcomes
title_full	Project ECHO Revisited: Propensity Score Analysis And HCV Treatment Outcomes
title_fullStr	Project ECHO Revisited: Propensity Score Analysis And HCV Treatment Outcomes
title_full_unstemmed	Project ECHO Revisited: Propensity Score Analysis And HCV Treatment Outcomes
title_sort	project echo revisited: propensity score analysis and hcv treatment outcomes
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/3f4cf4f2ad994be5b536262d7aa5f9b1
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Project ECHO Revisited: Propensity Score Analysis And HCV Treatment Outcomes

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