Robert J Glynn

..Use of propensity scores will not correct biases from unmeasured confounders, but can aid in understanding determinants of drug use and lead to improved estimates of drug effects in some settings...

..However, whether the absolute risk reduction among such individuals justifies wide application of statin therapy in primary prevention is a controversial issue with broad policy and public health implications...

..Observational studies have yielded variable estimates of the effect of statin therapy on the risk of venous thromboembolism, and evidence from randomized trials is lacking...

..We addressed, using the JUPITER trial cohort, whether this association remains when LDL-cholesterol concentrations are reduced to the very low ranges with high-dose statin treatment...

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..To test whether supplementation with alternate-day vitamin E or daily vitamin C affects the incidence of age-related cataract in a large cohort of men...

..The goal of restricting study populations is to make patients more homogeneous regarding potential confounding factors and treatment effects and thereby achieve less biased effect estimates...

..Objective: The aim of this study was to compare the effects of 2 recent cost-sharing policies on emergency hospitalizations due to chronic obstructive pulmonary disease, asthma, or emphysema (CAE), and on physician visits...

..The coverage gap remains the subject of Congressional debate; evidence regarding its impact on cardiovascular drug use and health outcomes is needed...

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..To test whether supplementation with alternate-day vitamin E or daily vitamin C affects the incidence of the diagnosis of age-related macular degeneration (AMD) in a large-scale randomized trial of male physicians...

..No previous trial in men at usual risk has examined vitamin C alone in the prevention of cancer...

..8 mmol/L (<70 mg/dL). However, the benefit of lowering both LDL cholesterol and hsCRP after the start of statin therapy is controversial. We prospectively tested this hypothesis...

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..The aim of this study was to evaluate the effect of statin treatment in primary prevention of cardiovascular events in different race/ethnic groups...

..Observational studies have not provided evidence regarding associations of multivitamin use with total and site-specific cancer incidence or mortality...

..There is substantial concern regarding the potential cardiovascular adverse effects of selective coxibs and nonselective NSAIDs, but many patients with arthritis experience important clinical benefits from these agents...

..Removing patient out-of-pocket drug costs may increase adherence, improve clinical outcomes, and even reduce overall health costs for high-risk patients. The existing data are inadequate to assess whether this strategy is effective...

..We sought to assess the relationship between increasing use of cardiovascular medications and trends in long-term prognosis after myocardial infarction (MI) in the elderly...

..To test whether beta carotene supplementation affects the incidence of age-related maculopathy (ARM) in a large-scale randomized trial...

..We analyzed sex-specific outcomes in the Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) and synthesized the results with prior trials...

..The influence of systolic and diastolic blood pressure (BP) on incident atrial fibrillation (AF) is not well studied among initially healthy, middle-aged women...

..We sought to evaluate and rank the performance of comorbidity scores across selected U.S. and Canadian elderly populations using health care utilization databases...

..1% vs 94.6%, P <.001). CONCLUSIONS: In this study, we observed high positive predictive values for a Medicare claims-based diagnosis of AMI and a diagnosis based on structured hospital record review...

..The aim of the present study was to assess the relationship of six previously characterized gene variants in the renin-angiotensin system and the NOS3 gene with blood pressure progression and incident hypertension...

..However, there is relatively little information about the comparative safety of opioids. Therefore, we sought to compare the safety of opioids commonly used for nonmalignant pain...

..One can compare the impact of risk factors on different types of cataract with methods of competing risk survival analysis that account for tied events...

..In the future, this new model may be used to identify individuals at increased risk of mortality...

..Generalized method of moments estimation produced substantially the same results as the 2-stage logistic method. Few substantive differences among the methods were observed, despite their reliance on distinct assumptions...

..However, few long-term trials have evaluated men at initially low risk of cardiovascular disease, and no previous trial in men has examined vitamin C alone in the prevention of cardiovascular disease...

..We analyzed the impact on health plan spending of a switch in public drug insurance from full coverage to a prescription copayment (copay), and then to income-based deductibles plus coinsurance (IBD)...

..A substantial proportion of incident CHD may be attributed to excess weight...

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..We prospectively examined whether socioeconomic status (SES) predicts incident type II diabetes (diabetes), a cardiovascular risk equivalent and burgeoning public health epidemic among women...

..Our objective was to examine the incidence of AMD in a trial of combined folic acid, pyridoxine hydrochloride (vitamin B(6)), and cyanocobalamin (vitamin B(12)) therapy...

..Although studies of specific populations have suggested that hsCRP is a reliable longitudinal marker, it is unclear how strongly hsCRP tracks in individuals after a single increased concentration...

..The aim of this study was to examine the association between socioeconomic status, blood pressure (BP) progression, and incident hypertension...

..Evaluations of drug cost-sharing policies within the same population are needed for a fair comparison of different options...

..Randomized data on statins for primary prevention in older persons are limited, and the relative hazard of cardiovascular disease associated with an elevated cholesterol level weakens with advancing age...

..Adherence to medications that are prescribed after myocardial infarction is poor. Eliminating out-of-pocket costs may increase adherence and improve outcomes...

..To test whether alternate-day low-dose aspirin affects incidence of age-related macular degeneration (AMD) in a large-scale randomized trial of women...

..Highly prevalent, noncardiovascular conditions appear to deter use of antihypertensives in elderly with hypertension...

..Nonexperimental studies of drug effects in large automated databases can provide timely assessment of real-life drug use, but are prone to confounding by variables that are not contained in these databases and thus cannot be controlled...

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..The safety of alternative analgesics is unclear. We examined the comparative safety of nonselective NSAIDs (nsNSAIDs), selective cyclooxygenase 2 inhibitors (coxibs), and opioids...

..However, trial data directly addressing whether this recommendation defines a patient population in which statin therapy is effective have not previously been published...

..Observational studies have shown inconsistent associations between regular multivitamin use and CVD, with no long-term clinical trials of multivitamin use...

..To examine whether intake of ω-3 fatty acids and fish affects incidence of age-related macular degeneration (AMD) in women...

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..To test whether alternate day vitamin E affects the incidence of age-related macular degeneration (AMD) in a large-scale randomized trial of women...

..Here, we develop and test an algorithm that empirically identifies candidate covariates, prioritizes covariates, and integrates them into a propensity-score-based confounder adjustment model...

..However, linkage between cancer registry and claims data including pharmacy-dispensing information is not always available. We examined the accuracy of claims-based definitions of incident cancers and their date of diagnosis...

..We show how to assess the impact of confounding by factors not measured in Medicare claims data in a study of the association between selective COX2 inhibitors and acute myocardial infarction (MI)...

..Early albuminuria probably reflects vascular endothelial dysfunction, which may be mediated in part by chronic inflammation...

..CHD and stroke have broadly comparable risk factor profiles that differ widely from the profile for VTE...

..To compare cardiovascular risk among women with high normal blood pressure (130-9/85-9 mm Hg) against those with normal blood pressure (120-9/75-84 mm Hg) and those with baseline hypertension...

..Health state preferences can be a crucial component of cost-effectiveness analyses, but off-the-shelf health state utilities specifically for older people are not available...

..In conclusion, as the absolute risk increased with increasing hs-CRP, the absolute risk reduction associated with rosuvastatin within JUPITER was also greatest among those with the greatest entry hs-CRP levels...

..Increasing validity based on PS trimming may be a unique advantage of PS's over conventional outcome models...

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..To develop and validate a single numerical comorbidity score for predicting short- and long-term mortality, by combining conditions in the Charlson and Elixhauser measures...

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..To investigate whether high-sensitivity C-reactive protein (hsCRP) and other biomarkers of inflammation predict age-related macular degeneration (AMD)...

..We evaluated the efficacy of statin therapy in primary prevention among individuals with moderate chronic kidney disease (CKD)...

..Such trials are frequently embedded in health care systems with available automated records, which can be used to enhance the design of the trial...

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..Short-term aspirin therapy can lower the risk for venous thromboembolism (VTE) in high-risk patients, but whether the long-term use of low-dose aspirin reduces risk in healthy adults is uncertain...

..Such analyses have been proposed to address confounding by indication, but there is little empirical evidence that they achieve better control than conventional multivariate outcome modeling...

..We also present comparisons between the clustered Wilcoxon test and each of the signed rank tests and mixed model approaches and show dramatic differences in power in favor of the clustered Wilcoxon test for some designs...

..In the presence of effect-measure modification, different analytic approaches produce different summary estimates...

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..Both randomized and observational studies commonly examine composite end points, but the literature on model development and criticism in this setting is limited...

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..In this article, we present large-sample theory and simulation results for this test procedure and apply it to diabetic retinopathy data from type I diabetics in the Sorbinil Retinopathy Trial...

..80. CONCLUSIONS: We conclude that in epidemiologic studies of the elderly, a modified diagnosis-based score using empirically derived weights provides improved adjustment for comorbidity and enhances the validity of findings...

..The rules are not complicated and may be applied in a straightforward manner. Discontinuing follow-up would save time and possibly resources, and adjusting for the nonresponse in the analysis would reduce the impact of nonresponse bias...

..A statistical method is presented for attributing explained variation in patient care to different levels of aggregation in a multilevel model with the aim of prioritizing and targeting quality improvement interventions...

..Researchers need to be clear about the population for which an overall treatment estimate is most suitable...

..This extends previous work by Rosner and Willett for obtaining point and interval estimates of measurement error corrected Pearson correlations...

..These simulation studies and other analytical results suggest that standard model-building tools designed to create good predictive models of the exposure will not always lead to optimal PS models, particularly in small studies...

..A simulation study suggests that the method performs well. Results highlight the advantage of multiple imputation that data imputed under one model can be analysed under several alternative models...