{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T09:31:54Z","timestamp":1769679114834,"version":"3.49.0"},"reference-count":51,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>Methods for pharmacoepidemiologic studies of large\u2010scale data repositories are established. Although clinical cohorts of older adults often contain critical information to advance our understanding of medication risk and benefit, the methods best suited to manage medication data in these samples are sometimes unclear and their degree of validation unknown. We sought to provide researchers, in the context of a clinical cohort study of delirium in older adults, with guidance on the methodological tools to use data from clinical cohorts to better understand medication risk factors and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN<\/jats:title>\n                    <jats:p>Prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING<\/jats:title>\n                    <jats:p>The Successful Aging After Elective Surgery (SAGES) prospective cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PARTICIPANTS<\/jats:title>\n                    <jats:p>A total of 560 older adults (aged \u226570\u2009years) without dementia undergoing elective major surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MEASUREMENTS<\/jats:title>\n                    <jats:p>Using the SAGES clinical cohort, methods used to characterize medications were identified, reviewed, analyzed, and distinguished by appropriateness and degree of validation for characterizing pharmacoepidemiologic data in smaller clinical data sets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Medication coding is essential; the American Hospital Formulary System, most often used in the United States, is not preferred over others. Use of equivalent dosing scales (e.g., morphine equivalents) for a single medication class (e.g., opioids) is preferred over multiclass analgesic equivalency scales. Medication aggregation from the same class (e.g., benzodiazepines) is well established; the optimal prevalence breakout for aggregation remains unclear. Validated scale(s) to combine structurally dissimilar medications (e.g., anticholinergics) should be used with caution; a lack of consensus exists regarding the optimal scale. Directed acyclic graph(s) are an accepted method to conceptualize causative frameworks when identifying potential confounders. Modeling\u2010based strategies should be used with evidence\u2010based, a priori variable\u2010selection strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>As highlighted in the SAGES cohort, the methods used to classify and analyze medication data in clinically rich cohort studies vary in the rigor by which they have been developed and validated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.16844","type":"journal-article","created":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T15:39:51Z","timestamp":1601566791000},"page":"2921-2926","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Approaches to Optimize Medication Data Analysis in Clinical Cohort Studies"],"prefix":"10.1111","volume":"68","author":[{"given":"Matthew S.","family":"Duprey","sequence":"first","affiliation":[{"name":"Department of Pharmacy and Health Systems Sciences, Bouve College of Health Sciences Northeastern University  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John W.","family":"Devlin","sequence":"additional","affiliation":[{"name":"Department of Pharmacy and Health Systems Sciences, Bouve College of Health Sciences Northeastern University  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Becky A.","family":"Briesacher","sequence":"additional","affiliation":[{"name":"Department of Pharmacy and Health Systems Sciences, Bouve College of Health Sciences Northeastern University  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas G.","family":"Travison","sequence":"additional","affiliation":[{"name":"Aging Brain Center Marcus Institute for Aging Research, Hebrew SeniorLife  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John L.","family":"Griffith","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Bouve College of Health Sciences Northeastern University  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon K.","family":"Inouye","sequence":"additional","affiliation":[{"name":"Aging Brain Center Marcus Institute for Aging Research, Hebrew SeniorLife  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,10]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"BrownleeS GarberJ.Medication overload: America's other drug problem. Lown Institute 2019.https:\/\/lowninstitute.org\/reports\/medication-overload-americas-other-drug-problem\/. Accessed March 6 2020."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2017.01.002"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-014-0643-5"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15767"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2017.10.026"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-113-12-941"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2012.08.004"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0226868"},{"key":"e_1_2_6_10_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1002\/9781118949740.ch5","volume-title":"Classification systems for drugs and diseases. Drug Utilization Research","author":"R\u00f8nning M","year":"2016"},{"key":"e_1_2_6_11_1","unstructured":"American Hospial Formulary Service Pharmacologic\u2010Therapeutic Classification.American Society of Health System Pharmacists 2020.https:\/\/www.ahfsdruginformation.com\/ahfs-pharmacologic-therapeutic-classification\/. Acccessed August 30 2020."},{"key":"e_1_2_6_12_1","unstructured":"Anatomical Therapeutic Chemical (ATC) Classification.World Health Organization 2020.https:\/\/www.who.int\/medicines\/regulation\/medicines-safety\/toolkit_atc\/en\/. Accessed August 30 2020."},{"key":"e_1_2_6_13_1","unstructured":"National Drug Code Directory.The U.S. Food and Drug Administration 2020.https:\/\/www.fda.gov\/drugs\/drug-approvals-and-databases\/national-drug-code-directory. Acccessed August 30 2020."},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2013.04.016"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181b7fbbb"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14386"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2009.08.040"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gln043"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-200207001-00002"},{"key":"e_1_2_6_20_1","volume-title":"AHFS Clinical Drug Information"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/13607863.2019.1571015"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1994.03520190064036"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-13-142"},{"key":"e_1_2_6_24_1","first-page":"214","article-title":"Benzodiazepine pharmacology and central nervous system\u2010mediated effects","volume":"13","author":"Griffin CE","year":"2013","journal-title":"Ochsner J"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1300027"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1301646"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000001094"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(81)90994-6"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.1949"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.2217\/1745509X.4.3.311"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2011.03491.x"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/0091270006292126"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13647"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-018-00630-z"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.79.3.340"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.EDE.0000042804.12056.6C"},{"key":"e_1_2_6_37_1","first-page":"393","volume-title":"Methods in Social Epidemiology","author":"Glymour MM","year":"2006"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwaa185"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra052321"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-199819010-00004"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/bimj.201700067"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(99)00103-1"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tree.2003.11.004"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.51.6.1173"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glx030"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/WAD.0000000000000099"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2010.02926.x"},{"key":"e_1_2_6_48_1","first-page":"181","article-title":"How to avoid missing data and the problems they pose: design considerations","volume":"24","author":"Lin JY","year":"2012","journal-title":"Shanghai Arch Psychiatry"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-12-96"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-13-92"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13793"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.329"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.16844","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgs.16844","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.16844","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T19:07:12Z","timestamp":1762196832000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.16844"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10]]},"references-count":51,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1111\/jgs.16844"],"URL":"https:\/\/doi.org\/10.1111\/jgs.16844","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10]]},"assertion":[{"value":"2020-03-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}