Case Study: Cardio Toxicity Flashcards Preview

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Flashcards in Case Study: Cardio Toxicity Deck (10):
1

Hypotheses

Adjuvant CHEMO associated with an increased risk of cardiotoxicity in elderly BC patients
-Adjuvant RT is associated with an increased risk of cardiotoxicity in elderly BC patients
-Adujuvant CHEMO and RT synergistically interact to produce an increased risk of cardiotoxicity

2

Study Period

12 months before index date (BC diagnosis), 6 months treatment, then post treatment, then censor after 10 years from pre-treatment

3

Study Cohort

Started with 152,200 patients
Some excluded (largest exclusions were: Diagnosed prior to 1992, HMO membership, Missing Medicare coverage)
Ended with 31,748

4

Exposure measurement

Surgery (mastectomy, BCS)
RT (LSRT)
CHEMO

5

Outcomes

Heart Disease and Survival

6

Confounders

Age, Race, Year of cohort study, Marital status, geography, hormonal status, comorbidities

7

Required sample size

5500 exposed

8

Statistical Analyses

-Describe study cohort and subgroup (univariate and bivariate analyses)
-Evaluate propensity to receive treatment (Logistic regression)
-Determined odds of experiencing cardiac events (Logistic regression)
Determined rate of cardiac events (Cox proportional hazards model)
-Estimated cardiac-event free survival (Kaplan-Meier)

9

What is a Propensity study?

Attempts to estimate the effect of the treatment by accounting for covariates that predict receiving the treatment.

Also attempts to reduce bias due to confounding by variables that could be found in an estimate of the treatment effect obtained from simply comparing outcomes among units that received treatment versus those that did not

9

What is a Propensity study?

Attempts to estimate the effect of the treatment by accounting for covariates that predict receiving the treatment.

Also attempts to reduce bias due to confounding by variables that could be found in an estimate of the treatment effect obtained from simply comparing outcomes among units that received treatment versus those that did not