Skip to Main content Skip to Navigation
Theses

Stratégies palliatives à la non-randomisation en santé mentale : score de propension et techniques d’ajustement apparentées. Méthodologie appliquée à la prise en compte des facteurs de confusion dans le cas de la schizophrénie

Abstract : Objective : To evaluate control methods for measured or unmeasured confusion bias, in observational situation of psychotic or schizophrenic patients. Methods : Propensity score method (for measured confusion bias) and analyses of sensibility (for unmeasured confusion bias) were applied in the field of psychiatric epidemiology, specifically in schizophrenia. In first, the question of residual bias was underlined by the results of a transversal study. The exposition at a contextual parameter (prison) was studied in link with psychotic disorders (DSM IV), with a classic control method.Second, to lead to an unbiased estimation of treatment effect, we compared a classic control method with a method based on propensity score. These approach were applied to a cohort of French schizophrenic patients where we studied the event (relapse) by the treatment exposition (polypharmacy or not).Third, we developed a synthesis on modelisation of uncertainty and non-measured confusion bias. Theories and methods were described, and then applied on results of previous studies. Results : The transversal study, with non-demonstrated results still then, allow us to reach the question of control quality in the case of exposition to a parameter in observational situation. The cohort study permit to compare a classic control method and propensity score (PS). We highlighted different results according to some control method. Stratification method on PS seemed to be the best method to predict relapse according to treatment exposition. Non-measured bias control methods were then described. And a combination of probabilistic methods was applied to the previous studies. Conclusion : In the case of observational studies, the objective was to study, to describe and to apply modelisation methods to take in account differences at baseline, potentially source of confusion bias. This research is at the crossroads of methodology, biostatistics and epidemiology.
Document type :
Theses
Complete list of metadatas

Cited literature [187 references]  Display  Hide  Download

https://tel.archives-ouvertes.fr/tel-00934619
Contributor : Abes Star :  Contact
Submitted on : Wednesday, January 22, 2014 - 12:52:08 PM
Last modification on : Wednesday, October 14, 2020 - 3:57:11 AM
Long-term archiving on: : Thursday, April 24, 2014 - 11:01:23 AM

File

VD_SARLON_EMMANUELLE_09012014....
Version validated by the jury (STAR)

Identifiers

  • HAL Id : tel-00934619, version 1

Collections

Citation

Emmanuelle Sarlon. Stratégies palliatives à la non-randomisation en santé mentale : score de propension et techniques d’ajustement apparentées. Méthodologie appliquée à la prise en compte des facteurs de confusion dans le cas de la schizophrénie. Médecine humaine et pathologie. Université Paris Sud - Paris XI, 2014. Français. ⟨NNT : 2013PA11T103⟩. ⟨tel-00934619⟩

Share

Metrics

Record views

1002

Files downloads

2311