Your browser doesn't support javascript.
Evaluating sources of bias in observational studies of angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker use during COVID-19: beyond confounding.
Cohen, Jordana B; D'Agostino McGowan, Lucy; Jensen, Elizabeth T; Rigdon, Joseph; South, Andrew M.
  • Cohen JB; Renal-Electrolyte and Hypertension Division, Department of Medicine.
  • D'Agostino McGowan L; Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
  • Jensen ET; Department of Mathematics and Statistics, Wake Forest University.
  • Rigdon J; Department of Epidemiology and Prevention, Division of Public Health Sciences.
  • South AM; Department of Biostatistics and Data Science, Division of Public Health Sciences.
J Hypertens ; 39(4): 795-805, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1290201
ABSTRACT
Concerns over ACE inhibitor or ARB use to treat hypertension during COVID-19 remain unresolved. Although studies using more robust methodologies provided some clarity, sources of bias persist and it remains critical to quickly address this question. In this review, we discuss pernicious sources of bias using a causal model framework, including time-varying confounder, collider, information, and time-dependent bias, in the context of recently published studies. We discuss causal inference methodologies that can address these issues, including causal diagrams, time-to-event analyses, sensitivity analyses, and marginal structural modeling. We discuss effect modification and we propose a role for causal mediation analysis to estimate indirect effects via mediating factors, especially components of the renin--angiotensin system. Thorough knowledge of these sources of bias and the appropriate methodologies to address them is crucial when evaluating observational studies to inform patient management decisions regarding whether ACE inhibitors or ARBs are associated with greater risk from COVID-19.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Renin-Angiotensin System / Angiotensin-Converting Enzyme Inhibitors / Angiotensin Receptor Antagonists / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: J Hypertens Year: 2021 Document Type: Article

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Renin-Angiotensin System / Angiotensin-Converting Enzyme Inhibitors / Angiotensin Receptor Antagonists / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: J Hypertens Year: 2021 Document Type: Article