Fahmida Homayra, Benjamin Enns, Jeong Eun Min, Megan Kurz, Paxton Bach, Julie Bruneau, Sander Greenland, Paul Gustafson, Mohammad Ehsanul Karim, P Todd Korthuis, Thomas Loughin, Malcolm MacLure, Lawrence McCandless, Robert William Platt, Kevin Schnepel, Hitoshi Shigeoka, Uwe Siebert, Eugenia Socias, Evan Wood, Bohdan Nosyk
BACKGROUND: Instrumental variable (IV) analysis provides an alternative set of identification assumptions in the presence of uncontrolled confounding when attempting to estimate causal effects. Our objective was to evaluate the suitability of measures of prescriber preference and calendar time as potential IVs to evaluate the comparative effectiveness of buprenorphine/naloxone versus methadone for treatment of opioid use disorder (OUD). METHODS: Using linked population-level health administrative data, we constructed five IVs: prescribing preference at the individual, facility, and region levels (continuous and categorical variables), calendar time, and a binary prescriber's preference IV in analyzing the treatment assignment-treatment discontinuation association using both incident-user and prevalent-new-user designs...
March 1, 2024: Epidemiology