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Comment
. 2019 Jun;54(3):537-542.
doi: 10.1111/1475-6773.13129. Epub 2019 Mar 12.

Instrumental variables: The power of wishful thinking vs the confounded reality of comparative effectiveness research

Stephen B Soumerai  1 , Ross Koppel  2   3
Affiliations
Comment

Instrumental variables: The power of wishful thinking vs the confounded reality of comparative effectiveness research

Stephen B Soumerai et al. Health Serv Res. 2019 Jun.
No abstract available

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Figures

Figure 1
Figure 1
The arrows to IV‐Outcome confounders show that confounders, such as SES, poor health, and rural residence, may cause hospital mortality, possibly more than the hypothesized access to catheterization laboratories. [Arrows indicate associations]. The IV is biased if the IV Outcome Related Through Unadjusted 3rd Variable. Adapted from: Garabedian et al.3 Printed with permission from Annals of Internal Medicine
Figure 2
Figure 2
Several serious conditions of patients transported in advance life support vs basic life support ambulance Source: Prekker et al.27
See this image and copyright information in PMC

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References

    1. Keele L, Small D. Instrumental variables: don't throw the baby out with the bathwater. Health Serv Res. 2018. https://doi.org.10.1111/1475-6773.13130 - PMC - PubMed
    1. Soumerai SB, Koppel R. The reliability of instrumental variables in health care effectiveness research: less is more. Health Serv Res. 2017;52(1):9‐15. - PMC - PubMed
    1. Garabedian LF, Chu P, Toh S, Zaslavsky AM, Soumerai SB. Potential bias of instrumental variable analyses for observational comparative effectiveness research. Ann Intern Med. 2014;161(2):131. - PubMed
    1. Rassen JA, Brookhart MA, Glynn RJ, Mittleman MA, Schneeweiss S. Instrumental variables I: instrumental variables exploit natural variation in nonexperimental data to estimate causal relationships. J Clin Epidemiol. 2009;62(12):1226‐1232. - PMC - PubMed
    1. McClellan M, McNeil BJ, Newhouse JP. Does more intensive treatment of acute myocardial infarction in the elderly reduce mortality?: analysis using instrumental variables. JAMA. 1994;272(11):859‐866. - PubMed

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