Inverse probability of treatment weighting (Propensity score) using the military health system data repository and national death index

Joshua D. Mitchell, Brian F. Gage, Nicole Fergestrom, Eric Novak, Todd C. Villines

Research output: Contribution to journalReview article

Abstract

When randomized controlled trials are not feasible, retrospective studies using big data provide an efficient and cost-effective alternative, though they are at risk for treatment selection bias. Treatment selection bias occurs in a non-randomized study when treatment selection is based on pre-treatment characteristics that are also associated with the outcome. These pre-treatment characteristics, or confounders, can influence evaluation of a treatment's effect on the outcome. Propensity scores minimize this bias by balancing the known confounders between treatment groups. There are a few approaches to performing propensity score analyses, including stratifying by the propensity score, propensity matching, and inverse probability of treatment weighting (IPTW). Described here is the use of IPTW to balance baseline comorbidities in a cohort of patients within the US Military Health System Data Repository (MDR). The MDR is a relatively optimal data source, as it provides a contained cohort in which nearly complete information on inpatient and outpatient services is available for eligible beneficiaries. Outlined below is the use of the MDR supplemented with information from the national death index to provide robust mortality data. Also provided are suggestions for using administrative data. Finally, the protocol shares an SAS code for using IPTW to balance known confounders and plot the cumulative incidence function for the outcome of interest.

Original languageEnglish
Article numbere59825
JournalJournal of Visualized Experiments
Volume2020
Issue number155
DOIs
StatePublished - Jan 2019

Keywords

  • Bias
  • Big data
  • Confounding
  • Inverse probability of treatment weighting
  • Issue 155
  • Medicine
  • Military Health System Data Repository
  • National death index
  • Propensity score
  • Treatment selection

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