Management

I. Cisapride Article:
a. Used Managed care claims database:
b. Dear Doctor letters didn’t seem to work well and Pharmacists dispensing CI’d drugs with
it
c. Don’t know if Pharmacist made an effort not to dispense or not. They aren’t looking at
Pharmacist documentation sort of thing
d. Doesn’t fit into a study design
II. FQ
a. Case control study in men from 10yr time frame
b. Eliminated hereditary PN (confounder) and diabetics
c. Parallel followed through time
d. Density sampling: Controls can become cases
e. Use Finasteride as control
f. Good to look at hospitalizations
III. COPD
a. Comparative study (RCT won’t be as real worldy or as big for this question)
b. Retrospective cohort study
c. Composite outcomes allow you to have more events (find differences unlikely due to
chance)
d. Propensity score matching: based on pt characteristics, how likely are they able to get
one treatment compared to another – can match people up to be similar and then one
gets treatment and one doesn’t
e. Logistic regression: multivariate analysis: look at potential confounders; if outcome is
yes/no, you use this specific form of multivariate analysis
f. Results: differences bigger before propensity score matching; after matching, they are
more similar at baseline.
g. Hazard ratio is like relative risk
h. People with asthma did better with steroid
i. If on LABA, adding steroid didn’t really help