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Statin Use and Risks for Death and Hospitalization in Chronic Heart Failure—Reply
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In Reply: Dr Suissa raises a question about immortal time bias in our intent-to-treat analysis. This bias is a result of incorrectly classifying the person-time before the first exposure to a medication as being "on therapy."1 However, our analysis was not performed in this manner. Follow-up started when each participant met the combination of criteria for heart failure and Adult Treatment Panel III criteria to receive cholesterol-lowering therapy, and this defined the participant's index date. After the index date, we structured our data in 2 ways for different analyses: intent-to-treat and time-varying exposure to statin therapy. In both data structures, person-time before the first-identified exposure to statins during follow-up was correctly classified as being "off therapy."
The primary difference between the intent-to-treat and time-varying classification to statin therapy is that in our intent-to-treat approach, the participants were considered "on therapy" once they were exposed during follow-up; in the latter, participants . . . [Full Text of this Article]
Alan S. Go, MD
alan.s.go@kp.org
Jingrong Yang, MA
Kaiser Permanente of Northern California
Oakland
Jerry H. Gurwitz, MD
Meyers Primary Care Institute
Worcester, Mass
RELATED LETTERS
Statin Use and Risks for Death and Hospitalization in Chronic Heart Failure
Samy Suissa
JAMA. 2007;297(10):1057.
EXTRACT
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Statin Use and Risks for Death and Hospitalization in Chronic Heart Failure
Wayne Gerard and Julia Gerard
JAMA. 2007;297(10):1057-1058.
EXTRACT
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RELATED ARTICLE
Statin Therapy and Risks for Death and Hospitalization in Chronic Heart Failure
Alan S. Go, Wendy Y. Lee, Jingrong Yang, Joan C. Lo, and Jerry H. Gurwitz
JAMA. 2006;296(17):2105-2111.
ABSTRACT
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