An evaluation of three statistical estimation methods for assessing health policy effects on prescription drug claims
| Autor: | David M. Thompson, Manish Mittal, Kevin C. Farmer, Yu-Tze Ng, Donald L. Harrison, Michael J. Miller |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Generalized linear model Prescription Drugs Prescription drug Adolescent Pharmaceutical Science Pharmacy Marginal model Generalized linear mixed model Gee Young Adult 03 medical and health sciences 0302 clinical medicine Statistics Econometrics Humans Medicine Longitudinal Studies 030212 general & internal medicine Segmented regression Medical prescription Estimation Epilepsy Medicaid business.industry Health Policy Mental Disorders Oklahoma Middle Aged Insurance Pharmaceutical Services United States Socioeconomic Factors Data Interpretation Statistical Linear Models Anticonvulsants Female business 030217 neurology & neurosurgery |
| Zdroj: | Research in Social and Administrative Pharmacy. 12:29-40 |
| ISSN: | 1551-7411 |
| Popis: | While the choice of analytical approach affects study results and their interpretation, there is no consensus to guide the choice of statistical approaches to evaluate public health policy change.This study compared and contrasted three statistical estimation procedures in the assessment of a U.S. Food and Drug Administration (FDA) suicidality warning, communicated in January 2008 and implemented in May 2009, on antiepileptic drug (AED) prescription claims.Longitudinal designs were utilized to evaluate Oklahoma (U.S. State) Medicaid claim data from January 2006 through December 2009. The study included 9289 continuously eligible individuals with prevalent diagnoses of epilepsy and/or psychiatric disorder. Segmented regression models using three estimation procedures [i.e., generalized linear models (GLM), generalized estimation equations (GEE), and generalized linear mixed models (GLMM)] were used to estimate trends of AED prescription claims across three time periods: before (January 2006-January 2008); during (February 2008-May 2009); and after (June 2009-December 2009) the FDA warning.All three statistical procedures estimated an increasing trend (P0.0001) in AED prescription claims before the FDA warning period. No procedures detected a significant change in trend during (GLM: -30.0%, 99% CI: -60.0% to 10.0%; GEE: -20.0%, 99% CI: -70.0% to 30.0%; GLMM: -23.5%, 99% CI: -58.8% to 1.2%) and after (GLM: 50.0%, 99% CI: -70.0% to 160.0%; GEE: 80.0%, 99% CI: -20.0% to 200.0%; GLMM: 47.1%, 99% CI: -41.2% to 135.3%) the FDA warning when compared to pre-warning period.Although the three procedures provided consistent inferences, the GEE and GLMM approaches accounted appropriately for correlation. Further, marginal models estimated using GEE produced more robust and valid population-level estimations. |
| Databáze: | OpenAIRE |
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