Benchmarking Observational Analyses Before Using Them to Address Questions Trials Do Not Answer: An Application to Coronary Thrombus Aspiration

Anthony A. Matthews, Issa J. Dahabreh, Ole Fröbert, Bertil Lindahl, Stefan James, Maria Feychting, Tomas Jernberg, Anita Berglund, Miguel A. Hernán

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

13 Citations (Scopus)
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Abstract

To increase confidence in the use of observational analyses when addressing effectiveness questions beyond those addressed by randomized trials, one can first benchmark the observational analyses against existing trial results. We used Swedish registry data to emulate a target trial similar to the Thrombus Aspiration in ST-Elevation Myocardial Infarction in Scandinavia (TASTE) randomized trial, which found no difference in the risk of death or myocardial infarction by 1 year with or without thrombus aspiration among individuals with ST-elevation myocardial infarction. We benchmarked the emulation against the trial at 1 year and then extended the emulation's follow-up to 3 years and estimated effects in subpopulations underrepresented in the trial. As in the TASTE trial, the observational analysis found no differences in risk of outcomes by 1 year between groups (risk difference = 0.7 (confidence interval, -0.7, 2.0) and -0.2 (confidence interval, -1.3, 1.0) for death and myocardial infarction, respectively), so benchmarking was considered successful. We additionally showed no difference in risk of death or myocardial infarction by 3 years, or within subpopulations by 1 year. Benchmarking against an index trial before using observational analyses to answer questions beyond those the trial could address allowed us to explore whether the observational data can be trusted to deliver valid estimates of treatment effects.

Original languageEnglish
JournalAmerican Journal of Epidemiology
Volume191
Issue9
Pages (from-to)1652-1665
Number of pages14
ISSN0002-9262
DOIs
Publication statusPublished - Sept 2022

Keywords

  • benchmarking
  • causal inference
  • observational analyses
  • randomized trial
  • target trial emulation
  • ST Elevation Myocardial Infarction/therapy
  • Humans
  • Benchmarking
  • Thrombectomy/methods
  • Treatment Outcome
  • Coronary Thrombosis/therapy
  • Myocardial Infarction
  • Percutaneous Coronary Intervention

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