{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T06:03:47Z","timestamp":1784613827578,"version":"3.55.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T00:00:00Z","timestamp":1713139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100002429","name":"Amgen Inc.","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002429","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Evidence on the comparative effectiveness of osteoporosis treatments is heterogeneous. This may be attributed to different populations and clinical practice, but also to differing methodologies ensuring comparability of treatment groups before treatment effect estimation and the amount of residual confounding by indication. This study assessed the comparability of denosumab vs oral bisphosphonate (OBP) groups using propensity score (PS) methods and negative control outcome (NCO) analysis. A total of 280\u2009288 women aged \u226550\u00a0yr initiating denosumab or OBP in 2011-2018 were included from the UK Clinical Practice Research Datalink (CPRD) and the Danish National Registries (DNR). Balance of observed covariates was assessed using absolute standardized mean difference (ASMD) before and after PS weighting, matching, and stratification, with ASMD &amp;gt;0.1 indicating imbalance. Residual confounding was assessed using NCOs with \u2265100 events. Hazard ratio (HR) and 95%CI between treatment and NCO were estimated using Cox models. Presence of residual confounding was evaluated with 2 approaches (1) &amp;gt;5% of NCOs with 95% CI excluding 1, (2) &amp;gt;5% of NCOs with an upper CI &amp;lt;0.75 or lower CI &amp;gt;1.3. The number of imbalanced covariates before adjustment (CPRD 22\/87; DNR 18\/83) decreased, with 2%\u201311% imbalance remaining after weighting, matching, or stratification. Using approach 1, residual confounding was present for all PS methods in both databases (\u22658% of NCOs), except for stratification in DNR (3.8%). Using approach 2, residual confounding was present in CPRD with PS matching (5.3%) and stratification (6.4%), but not with weighting (4.3%). Within DNR, no NCOs had HR estimates with upper or lower CI limits beyond the specified bounds indicating residual confounding for any PS method. Achievement of covariate balance and determination of residual bias were dependent upon several factors including the population under study, PS method, prevalence of NCO, and the threshold indicating residual confounding.<\/jats:p>","DOI":"10.1093\/jbmr\/zjae059","type":"journal-article","created":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T13:06:12Z","timestamp":1713186372000},"page":"844-854","source":"Crossref","is-referenced-by-count":3,"title":["Evaluating the comparability of osteoporosis treatments using propensity score and negative control outcome methods in UK and Denmark electronic health record databases"],"prefix":"10.1093","volume":"39","author":[{"given":"Eng Hooi","family":"Tan","sequence":"first","affiliation":[{"name":"Nuffield Department of Orthopaedics , Rheumatology and Musculoskeletal Sciences, , Oxford OX3 7LD , United Kingdom"},{"name":"Centre for Statistics in Medicine, University of Oxford , Rheumatology and Musculoskeletal Sciences, , Oxford OX3 7LD , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trishna","family":"Rathod-Mistry","sequence":"additional","affiliation":[{"name":"Nuffield Department of Orthopaedics , Rheumatology and Musculoskeletal Sciences, , Oxford OX3 7LD , United Kingdom"},{"name":"Centre for Statistics in Medicine, University of Oxford , Rheumatology and Musculoskeletal Sciences, , Oxford OX3 7LD , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria Y","family":"Strauss","sequence":"additional","affiliation":[{"name":"Nuffield Department of Orthopaedics , Rheumatology and Musculoskeletal Sciences, , Oxford OX3 7LD , United Kingdom"},{"name":"Centre for Statistics in Medicine, University of Oxford , Rheumatology and Musculoskeletal Sciences, , Oxford OX3 7LD , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"O\u2019Kelly","sequence":"additional","affiliation":[{"name":"Center for Observantional Research, Amgen Ltd , Uxbridge UB8 1DH , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Giorgianni","sequence":"additional","affiliation":[{"name":"Center for Observantional Research, Amgen Ltd , Uxbridge UB8 1DH , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Baxter","sequence":"additional","affiliation":[{"name":"Center for Observantional Research, Amgen Ltd , Uxbridge UB8 1DH , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa C","family":"Brunetti","sequence":"additional","affiliation":[{"name":"Center for Observantional Research, Amgen Ltd , Uxbridge UB8 1DH , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alma Becic","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University , Aarhus 8200 , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Ehrenstein","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University , Aarhus 8200 , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Prieto-Alhambra","sequence":"additional","affiliation":[{"name":"Nuffield Department of Orthopaedics , Rheumatology and Musculoskeletal Sciences, , Oxford OX3 7LD , United Kingdom"},{"name":"Centre for Statistics in Medicine, University of Oxford , Rheumatology and Musculoskeletal Sciences, , Oxford OX3 7LD , United Kingdom"},{"name":"Department of Medical Informatics, Erasmus University Medical Centre , Rotterdam 3015 GD , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,4,15]]},"reference":[{"issue":"1","key":"2024080610505739000_ref1","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1007\/s11657-022-01061-5","article-title":"UK clinical guideline for the prevention and treatment of osteoporosis","volume":"17","author":"Gregson","year":"2022","journal-title":"Arch Osteoporos"},{"issue":"11","key":"2024080610505739000_ref2","doi-asserted-by":"crossref","first-page":"951","DOI":"10.2165\/11589310-000000000-00000","article-title":"Denosumab for the prevention of osteoporotic fractures in post-menopausal women: a NICE single technology appraisal","volume":"29","author":"Scotland","year":"2011","journal-title":"Pharmacoeconomics"},{"key":"2024080610505739000_ref3","volume-title":"Bisphosphonates for Treating Osteoporosis","author":"National Institute for Health and Care 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