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Arch Iran Med. 2018;21(8): 368-375.
PMID: 30113859
Scopus ID: 85057043171
  Abstract View: 2997
  PDF Download: 1696

Research Methods

Comparative Effectiveness Study in Multiple Sclerosis Patients Using Instrumental Variable Analysis

Hamed Hosseini 1, Mohammad Ali Mansournia 1, Seyed Massood Nabavi 2, Ali Asghar Akhlaghi 3, Jaleh Gholami 4, Kazem Mohammad 1, Reza Majdzadeh 1,5*

1 Department of Epidemiology and Biostatistics, Public Health School, Tehran University of Medical Sciences, Tehran, Iran
2 Neurology Group, Department of Regenerative Biomedicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
3 Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
4 Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
5 Knowledge Utilization Research Centre (KURC), Tehran University of Medical Sciences, Tehran, Iran
*Corresponding Author: Email: rezamajd@tums.ac.ir

Abstract

Randomized clinical trials are considered the ideal source for generation of robust evidence for clinical and public health decision making. Estimation of treatment effect in observational studies is always subject to varying degrees of bias due to lack of random allocation, blindness, precise definition of intervention, as well as the existence of potential unknown and unmeasured confounding variables. Unlike other conventional methods, instrumental variable analysis (IVA), as a method for controlling confounding bias in non-randomized studies, attempts to estimate the treatment effect with the least bias even without knowing and measuring the potential confounders in the causal pathway. In this paper, after understanding the main concepts of this approach, it has been attempted to provide a method for analyzing and reporting the IVA for clinical researchers through a simplified example. The data used in this paper is derived from the clinical data of the follow-up of multiple sclerosis (MS) patients treated with two class of interferon.

Cite this article as: Hosseini H, Mansournia MA, Nabavi SM, Akhlaghi AA, Gholami J, Mohammad K, et al. Comparative effectiveness study in multiple sclerosis patients using instrumental variable analysis. Arch Iran Med. 2018;21(8):368–375
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Submitted: 28 Apr 2018
Accepted: 19 May 2018
ePublished: 01 Aug 2018
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