Cain, Lauren E., Saag, Michael S., Petersen, Maya, May, Margaret T., Ingle, Suzanne M., Logan, Roger, Robins, James M., Abgrall, Sophie, Shepherd, Bryan E., Deeks, Steven G., Gill, M. John, Touloumi, Giota, Vourli, Georgia, Dabis, Francois, Vandenhende, Marie-Anne, Reiss, Peter, van Sighem, Ard, Samji, Hasina ORCID: 0000-0002-4555-7609, Hogg, Robert S., Rybniker, Jan, Sabin, Caroline A., Jose, Sophie, del Amo, Julia, Moreno, Santiago ORCID: 0000-0002-2843-1094, Rodriguez, Benigno, Cozzi-Lepri, Alessandro, Boswell, Stephen L., Stephan, Christoph, Perez-Hoyos, Santiago ORCID: 0000-0001-9797-4917, Jarrin, Inma, Guest, Jodie L., Monforte, Antonella D'Arminio, Antinori, Andrea ORCID: 0000-0003-2121-4684, Moore, Richard, Campbell, Colin N. J., Casabona, Jordi, Meyer, Laurence, Seng, Remonie, Phillips, Andrew N., Bucher, Heiner C., Egger, Matthias ORCID: 0000-0001-7462-5132, Mugavero, Michael J., Haubrich, Richard, Geng, Elvin H., Olson, Ashley, Eron, Joseph J., Napravnik, Sonia, Kitahata, Mari M., Van Rompaey, Stephen E., Teira, Ramon, Justice, Amy C., Tate, Janet P., Costagliola, Dominique ORCID: 0000-0003-0765-0869, Sterne, Jonathan A. C. and Hernan, Miguel A. (2016). Using observational data to emulate a randomized trial of dynamic treatment-switching strategies: an application to antiretroviral therapy. Int. J. Epidemiol., 45 (6). S. 2038 - 2050. OXFORD: OXFORD UNIV PRESS. ISSN 1464-3685

Full text not available from this repository.

Abstract

Background: When a clinical treatment fails or shows suboptimal results, the question of when to switch to another treatment arises. Treatment switching strategies are often dynamic because the time of switching depends on the evolution of an individual's time-varying covariates. Dynamic strategies can be directly compared in randomized trials. For example, HIV-infected individuals receiving antiretroviral therapy could be randomized to switching therapy within 90 days of HIV-1 RNA crossing above a threshold of either 400 copies/ml (tight-control strategy) or 1000 copies/ml (loose-control strategy). Methods: We review an approach to emulate a randomized trial of dynamic switching strategies using observational data from the Antiretroviral Therapy Cohort Collaboration, the Centers for AIDS Research Network of Integrated Clinical Systems and the HIV-CAUSAL Collaboration. We estimated the comparative effect of tight-control vs. loose-control strategies on death and AIDS or death via inverse-probability weighting. Results: Of 43 803 individuals who initiated an eligible antiretroviral therapy regimen in 2002 or later, 2001 met the baseline inclusion criteria for the mortality analysis and 1641 for the AIDS or death analysis. There were 21 deaths and 33 AIDS or death events in the tight-control group, and 28 deaths and 41 AIDS or death events in the loose-control group. Compared with tight control, the adjusted hazard ratios (95% confidence interval) for loose control were 1.10 (0.73, 1.66) for death, and 1.04 (0.86, 1.27) for AIDS or death. Conclusions: Although our effective sample sizes were small and our estimates imprecise, the described methodological approach can serve as an example for future analyses.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Cain, Lauren E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Saag, Michael S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Petersen, MayaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
May, Margaret T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ingle, Suzanne M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Logan, RogerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Robins, James M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Abgrall, SophieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Shepherd, Bryan E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Deeks, Steven G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gill, M. JohnUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Touloumi, GiotaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vourli, GeorgiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dabis, FrancoisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vandenhende, Marie-AnneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reiss, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van Sighem, ArdUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Samji, HasinaUNSPECIFIEDorcid.org/0000-0002-4555-7609UNSPECIFIED
Hogg, Robert S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rybniker, JanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sabin, Caroline A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jose, SophieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
del Amo, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Moreno, SantiagoUNSPECIFIEDorcid.org/0000-0002-2843-1094UNSPECIFIED
Rodriguez, BenignoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cozzi-Lepri, AlessandroUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boswell, Stephen L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stephan, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Perez-Hoyos, SantiagoUNSPECIFIEDorcid.org/0000-0001-9797-4917UNSPECIFIED
Jarrin, InmaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Guest, Jodie L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Monforte, Antonella D'ArminioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Antinori, AndreaUNSPECIFIEDorcid.org/0000-0003-2121-4684UNSPECIFIED
Moore, RichardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Campbell, Colin N. J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Casabona, JordiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meyer, LaurenceUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Seng, RemonieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Phillips, Andrew N.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bucher, Heiner C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Egger, MatthiasUNSPECIFIEDorcid.org/0000-0001-7462-5132UNSPECIFIED
Mugavero, Michael J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haubrich, RichardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Geng, Elvin H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Olson, AshleyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eron, Joseph J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Napravnik, SoniaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kitahata, Mari M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Van Rompaey, Stephen E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Teira, RamonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Justice, Amy C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tate, Janet P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Costagliola, DominiqueUNSPECIFIEDorcid.org/0000-0003-0765-0869UNSPECIFIED
Sterne, Jonathan A. C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hernan, Miguel A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-254851
DOI: 10.1093/ije/dyv295
Journal or Publication Title: Int. J. Epidemiol.
Volume: 45
Number: 6
Page Range: S. 2038 - 2050
Date: 2016
Publisher: OXFORD UNIV PRESS
Place of Publication: OXFORD
ISSN: 1464-3685
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
COHORT PROFILE; PREVENTION; MORTALITY; FAILURE; REGIMES; CANCER; ARTMultiple languages
Public, Environmental & Occupational HealthMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/25485

Downloads

Downloads per month over past year

Altmetric

Export

Actions (login required)

View Item View Item