{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T18:43:36Z","timestamp":1773254616575,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T00:00:00Z","timestamp":1769299200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T00:00:00Z","timestamp":1769299200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Confounding is a key concern in observational studies using healthcare databases. The high\u2010dimensional propensity score (HDPS) algorithm is an approach for generating and prioritising proxy variables, leveraging all available information in a database to mitigate residual confounding. This study aims to implement HDPS approaches in a novel setting using primary and secondary data available from Hong Kong (HK).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using data from HK, we implemented HDPS in a cohort study investigating the use of different antihypertensive drug classes and incident dementia risk. The top 250 HDPS covariates were included in inverse probability of treatment weighting in addition to investigator\u2010specified variables. Diagnostics evaluated the performance of the HDPS. Sensitivity analyses included varying the number of HDPS covariates and removing potentially influential or inappropriate covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>434\u2009506 new\u2010users of antihypertensives were included. With a traditional PS approach, no evidence for an association was observed for each antihypertensive comparison. After HDPS implementation, the estimate for beta\u2010blockers shifted from no evidence (Hazard ratio (HR): 0.93, 95% confidence interval (CI): 0.86\u20131.02) to moderate evidence of a reduced hazard of incident dementia compared to angiotensin\u2010converting enzyme inhibitors (HR: 0.90, 95% CI: 0.82\u20130.98). A greater overall covariate balance between comparison groups was achieved after the inclusion of HDPS covariates and potential frailty markers were identified as influential.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We successfully implemented the HDPS in HK data, observing improved covariate balance across a wider set of potential confounders. HDPS also identified possible database\u2010specific frailty markers which could be considered more widely when specifying adjustment variables in this setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70326","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T05:54:32Z","timestamp":1769406872000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High\u2010Dimensional Propensity Scores for Mitigating Confounding: Implementation Using Primary and Secondary Care Data in Hong Kong"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4117-4504","authenticated-orcid":false,"given":"Edmund C. L.","family":"Cheung","sequence":"first","affiliation":[{"name":"Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Fan","sequence":"additional","affiliation":[{"name":"Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1513-8726","authenticated-orcid":false,"given":"Celine S. L.","family":"Chui","sequence":"additional","affiliation":[{"name":"School of Nursing, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"},{"name":"School of Public Health, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8618-7333","authenticated-orcid":false,"given":"Angel Y. S.","family":"Wong","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7194-2615","authenticated-orcid":false,"given":"John","family":"Tazare","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,25]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"f6409","article-title":"Making Inferences on Treatment Effects From Real World Data: Propensity Scores, Confounding by Indication, and Other Perils for the Unwary in Observational Research","volume":"347","author":"Freemantle N.","year":"2013","journal-title":"BMJ (Clinical Research Ed)"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0007022020"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.8866"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2011.568786"},{"key":"e_1_2_11_6_1","first-page":"l5657","article-title":"Alternative Approaches for Confounding Adjustment in Observational Studies Using Weighting Based on the Propensity Score: A Primer for Practitioners","volume":"367","author":"Desai R. J.","year":"2019","journal-title":"BMJ (Clinical Research ed)"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3181a663cc"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000886"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwt323"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-016-0119-1"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5412"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5566"},{"key":"e_1_2_11_13_1","unstructured":"S.Lendle \u201cHigh Dimensional Propensity Score Algorithm in R \u201d2017 https:\/\/github.com\/lendle\/hdps."},{"key":"e_1_2_11_14_1","unstructured":"D.Robert \u201cautoCovariateSelection: Automated Covariate Selection Using HDPS Algorithm \u201d2020 https:\/\/CRAN.R\u2010project.org\/package=autoCovariateSelection."},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3773"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(66)90062-2"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.1363"},{"key":"e_1_2_11_18_1","first-page":"h6926","article-title":"Cardiovascular Outcomes Associated With Use of Clarithromycin: Population Based Study","volume":"352","author":"Wong A. Y.","year":"2016","journal-title":"BMJ (Clinical Research ed)"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afaf121"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2024.3774"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2024.100927"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5121"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000581"},{"key":"e_1_2_11_24_1","unstructured":"N.Greifer \u201cWeightIt: Weighting for Covariate Balance in Observational Studies \u201d2023 https:\/\/CRAN.R\u2010project.org\/package=WeightIt."},{"key":"e_1_2_11_25_1","unstructured":"M.Fan \u201cHigh\u2010Dimensional Propensity Score (HDPS) \u201d2024 https:\/\/github.com\/Cainefm\/hdps."},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwr001"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S168687"},{"issue":"6","key":"e_1_2_11_28_1","first-page":"1426","article-title":"Frailty in Aging and the Search for the Optimal Biomarker: A Review","volume":"10","author":"Sep\u00falveda M.","year":"2022","journal-title":"Biomedicine"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-016-0485-3"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-017-0310-3"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01296-0"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws165"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwr364"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.2328"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glae178"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000787"}],"container-title":["Pharmacoepidemiology and Drug Safety"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pds.70326","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pds.70326","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pds.70326","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T01:11:48Z","timestamp":1773191508000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pds.70326"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,25]]},"references-count":35,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1002\/pds.70326"],"URL":"https:\/\/doi.org\/10.1002\/pds.70326","archive":["Portico"],"relation":{},"ISSN":["1053-8569","1099-1557"],"issn-type":[{"value":"1053-8569","type":"print"},{"value":"1099-1557","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,25]]},"assertion":[{"value":"2025-06-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70326"}}