Publicação
Propensity scores: an application in interventional cardiology
| Resumo: | Invasive techniques are essential in investigation and management of cardiac and vascular diseases, particularly obstructive coronary artery disease. These invasive techniques can be performed for diagnostic or interventional purposes, and the access to the target arteries can be done through the femoral or the radial artery. The transradial approach may be clinically preferable, namely because its use has been associated with fewer peri-procedural complications, like bleeding. Despite the advantages over transfemoral approach, concerns have risen on the potential for transradial approach to increase the incidence of peri-procedural neurological complications, like Stroke or Transient Ischemic Attack (TIA) (Jurga et al., 2011). The aim of this work is to access the association between the risk of peri-procedural Stroke/TIA and the transradial or the transfemoral approaches. A propensity score analysis was performed in a sample of 16 710 patients included in a single prospective registry between January of 2006 and November of 2012. Various PS methods like matching, genetic matching, stratification and inverse probability of treatment weighting were used to estimate the Average Treatment Effect for the Treated (ATT) and the Average Treatment Effect (ATE). To find the best possible matching, PS estimates were fitted from a GAMs and from logistic regressions. A logistic regression (LR) was performed too in order to identify all the factors associated to the occurrence of peri-procedural Stroke/TIA and estimate the Odds Ratios. To handle the low number of events and the subsequent separation problem, a Firth’s logistic regression correction was run. Both Propensity Score analysis and regression methods reached the same conclusions. The use of Transradial or Transfemoral Approach does not impact the occurrence of peri-procedural Stroke/TIA. So the clinically preferential use of Transradial can be performed without concerns relative to this technique. Regarding the methodology, GAM PS estimates provide better matchings when there are variables non-linear related with the treatment assignment logit, but genetic matching can overcome these differences by matching individually on these variables through the Generalized Mahalanobis Distance. |
|---|---|
| Autores principais: | Ferreira, Luís António Garcez Duarte da Costa |
| Assunto: | Propensity score Modelos aditivos generalizados Matching genético Estratificação Inverse probability of treatment weighting Trabalhos de projecto de mestrado - 2016 |
| Ano: | 2016 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| _version_ | 1866811603461079040 |
|---|---|
| author | Ferreira, Luís António Garcez Duarte da Costa |
| author_facet | Ferreira, Luís António Garcez Duarte da Costa |
| author_role | author |
| contributor_name_str_mv | Nunes, Maria Helena Mouriño Silva, 1969- Silva, Ana Luísa Trigoso Papoila da, 1958- Repositório Científico de Acesso Aberto da ULisboa |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Ferreira, Luís António Garcez Duarte da Costa\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | Nunes, Maria Helena Mouriño Silva, 1969- Silva, Ana Luísa Trigoso Papoila da, 1958- Repositório Científico de Acesso Aberto da ULisboa |
| datacite.creators.creator.creatorName.fl_str_mv | Ferreira, Luís António Garcez Duarte da Costa |
| datacite.date.Accepted.fl_str_mv | 2016-01-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2017-01-03T10:51:57Z |
| datacite.date.embargoed.fl_str_mv | 2017-01-03T10:51:57Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | Propensity score Modelos aditivos generalizados Matching genético Estratificação Inverse probability of treatment weighting Trabalhos de projecto de mestrado - 2016 |
| datacite.titles.title.fl_str_mv | Propensity scores: an application in interventional cardiology |
| dc.contributor.none.fl_str_mv | Nunes, Maria Helena Mouriño Silva, 1969- Silva, Ana Luísa Trigoso Papoila da, 1958- Repositório Científico de Acesso Aberto da ULisboa |
| dc.creator.none.fl_str_mv | Ferreira, Luís António Garcez Duarte da Costa |
| dc.date.Accepted.fl_str_mv | 2016-01-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2017-01-03T10:51:57Z |
| dc.date.embargoed.fl_str_mv | 2017-01-03T10:51:57Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10451/25649 |
| dc.language.none.fl_str_mv | eng |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.subject.none.fl_str_mv | Propensity score Modelos aditivos generalizados Matching genético Estratificação Inverse probability of treatment weighting Trabalhos de projecto de mestrado - 2016 |
| dc.title.fl_str_mv | Propensity scores: an application in interventional cardiology |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_bdcc |
| description | Invasive techniques are essential in investigation and management of cardiac and vascular diseases, particularly obstructive coronary artery disease. These invasive techniques can be performed for diagnostic or interventional purposes, and the access to the target arteries can be done through the femoral or the radial artery. The transradial approach may be clinically preferable, namely because its use has been associated with fewer peri-procedural complications, like bleeding. Despite the advantages over transfemoral approach, concerns have risen on the potential for transradial approach to increase the incidence of peri-procedural neurological complications, like Stroke or Transient Ischemic Attack (TIA) (Jurga et al., 2011). The aim of this work is to access the association between the risk of peri-procedural Stroke/TIA and the transradial or the transfemoral approaches. A propensity score analysis was performed in a sample of 16 710 patients included in a single prospective registry between January of 2006 and November of 2012. Various PS methods like matching, genetic matching, stratification and inverse probability of treatment weighting were used to estimate the Average Treatment Effect for the Treated (ATT) and the Average Treatment Effect (ATE). To find the best possible matching, PS estimates were fitted from a GAMs and from logistic regressions. A logistic regression (LR) was performed too in order to identify all the factors associated to the occurrence of peri-procedural Stroke/TIA and estimate the Odds Ratios. To handle the low number of events and the subsequent separation problem, a Firth’s logistic regression correction was run. Both Propensity Score analysis and regression methods reached the same conclusions. The use of Transradial or Transfemoral Approach does not impact the occurrence of peri-procedural Stroke/TIA. So the clinically preferential use of Transradial can be performed without concerns relative to this technique. Regarding the methodology, GAM PS estimates provide better matchings when there are variables non-linear related with the treatment assignment logit, but genetic matching can overcome these differences by matching individually on these variables through the Generalized Mahalanobis Distance. |
| dirty | 0 |
| eu_rights_str_mv | openAccess |
| format | masterThesis |
| fulltext.url.fl_str_mv | https://repositorio.ulisboa.pt/bitstreams/34c4f11c-9e8f-4401-92d2-80ab98a63228/download |
| id | ul_06ba41cf7633488feb4e3e22b0d97e80 |
| identifier.url.fl_str_mv | http://hdl.handle.net/10451/25649 |
| instacron_str | ul |
| institution | Universidade de Lisboa |
| instname_str | Universidade de Lisboa |
| language | eng |
| network_acronym_str | ul |
| network_name_str | Repositório da Universidade de Lisboa |
| oai_identifier_str | oai:repositorio.ulisboa.pt:10451/25649 |
| organization_str_mv | urn:organizationAcronym:ul |
| person_str_mv | Ferreira, Luís António Garcez Duarte da Costa |
| publishDate | 2016 |
| reponame_str | Repositório da Universidade de Lisboa |
| repository_id_str | urn:repositoryAcronym:ul |
| service_str_mv | urn:repositoryAcronym:ul |
| spelling | engpt_PTInvasive techniques are essential in investigation and management of cardiac and vascular diseases, particularly obstructive coronary artery disease. These invasive techniques can be performed for diagnostic or interventional purposes, and the access to the target arteries can be done through the femoral or the radial artery. The transradial approach may be clinically preferable, namely because its use has been associated with fewer peri-procedural complications, like bleeding. Despite the advantages over transfemoral approach, concerns have risen on the potential for transradial approach to increase the incidence of peri-procedural neurological complications, like Stroke or Transient Ischemic Attack (TIA) (Jurga et al., 2011). The aim of this work is to access the association between the risk of peri-procedural Stroke/TIA and the transradial or the transfemoral approaches. A propensity score analysis was performed in a sample of 16 710 patients included in a single prospective registry between January of 2006 and November of 2012. Various PS methods like matching, genetic matching, stratification and inverse probability of treatment weighting were used to estimate the Average Treatment Effect for the Treated (ATT) and the Average Treatment Effect (ATE). To find the best possible matching, PS estimates were fitted from a GAMs and from logistic regressions. A logistic regression (LR) was performed too in order to identify all the factors associated to the occurrence of peri-procedural Stroke/TIA and estimate the Odds Ratios. To handle the low number of events and the subsequent separation problem, a Firth’s logistic regression correction was run. Both Propensity Score analysis and regression methods reached the same conclusions. The use of Transradial or Transfemoral Approach does not impact the occurrence of peri-procedural Stroke/TIA. So the clinically preferential use of Transradial can be performed without concerns relative to this technique. Regarding the methodology, GAM PS estimates provide better matchings when there are variables non-linear related with the treatment assignment logit, but genetic matching can overcome these differences by matching individually on these variables through the Generalized Mahalanobis Distance.application/pdfpt_PTPropensity scores: an application in interventional cardiologyFerreira, Luís António Garcez Duarte da CostaNunes, Maria Helena Mouriño Silva, 1969-Silva, Ana Luísa Trigoso Papoila da, 1958-HostingInstitutionOrganizationalRepositório Científico de Acesso Aberto da ULisboae-mailmailto:repositorio@reitoria.ulisboa.ptrepositorio@reitoria.ulisboa.ptURNurn:tid:2016230482017-01-03T10:51:57Z201620162016-01-01T00:00:00ZHandlehttp://hdl.handle.net/10451/25649http://purl.org/coar/access_right/c_abf2open accessPropensity scoreModelos aditivos generalizadosMatching genéticoEstratificaçãoInverse probability of treatment weightingTrabalhos de projecto de mestrado - 20162270965 bytesliteraturehttp://purl.org/coar/resource_type/c_bdccmaster thesishttp://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://repositorio.ulisboa.pt/bitstreams/34c4f11c-9e8f-4401-92d2-80ab98a63228/download |
| spellingShingle | Propensity scores: an application in interventional cardiology Ferreira, Luís António Garcez Duarte da Costa Propensity score Modelos aditivos generalizados Matching genético Estratificação Inverse probability of treatment weighting Trabalhos de projecto de mestrado - 2016 |
| status | SINGLETON |
| subject.fl_str_mv | Propensity score Modelos aditivos generalizados Matching genético Estratificação Inverse probability of treatment weighting Trabalhos de projecto de mestrado - 2016 |
| title | Propensity scores: an application in interventional cardiology |
| title_full | Propensity scores: an application in interventional cardiology |
| title_fullStr | Propensity scores: an application in interventional cardiology |
| title_full_unstemmed | Propensity scores: an application in interventional cardiology |
| title_short | Propensity scores: an application in interventional cardiology |
| title_sort | Propensity scores: an application in interventional cardiology |
| topic | Propensity score Modelos aditivos generalizados Matching genético Estratificação Inverse probability of treatment weighting Trabalhos de projecto de mestrado - 2016 |
| topic_facet | Propensity score Modelos aditivos generalizados Matching genético Estratificação Inverse probability of treatment weighting Trabalhos de projecto de mestrado - 2016 |
| url | http://hdl.handle.net/10451/25649 |
| visible | 1 |