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Utilisation du score de propension et du score pronostique en pharmacoépidémiologie

Abstract : Pharmacoepidemiologic observational studies are often conducted to evaluate newly marketed drugs or drugs in competition with many alternatives. In such cohort studies, the exposure of interest is rare. To take into account confounding factors in such settings, some authors advise against the use of the propensity score in favor of the prognostic score, but this recommendation is not supported by any study especially focused on infrequent exposures and ignores the type of estimation provided by each prognostic score-based method.The first part of this work evaluates the use of propensity score-based methods to estimate the marginal effect of a rare exposure. The second part evaluates the performance of the prognostic score based methods already reported in the literature, compares them with the propensity score based methods, and introduces some new prognostic score-based methods intended to estimate conditional or marginal effects. The last part deals with variance estimators of the treatment effect. We present the opposite consequences of ignoring the estimation step of the propensity score and the prognostic score. We show some new variance estimators accounting for this step.
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David Hajage. Utilisation du score de propension et du score pronostique en pharmacoépidémiologie. Santé publique et épidémiologie. Université Sorbonne Paris Cité, 2017. Français. ⟨NNT : 2017USPCC175⟩. ⟨tel-02083652⟩

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