When observational studies can give wrong answers: the potential of immortal time bias
Olaf M Dekkers, Rolf H. H. Groenwold
Abstract
Immortal time bias should always be considered in an observational study if exposure status is determined based on a measurement or event that occurs after baseline. This bias can lead to an overestimation of an effect, but also to an underestimation, which is explained. Several approaches are illustrated that can be used to avoid immortal time bias in the analysis phase of the study; a time-dependent analysis to avoid immortal time bias optimizes the use of available information.
Topics & Concepts
Observational studyPublication biasBaseline (sea)Event (particle physics)Internal medicineStatisticsMedicineMeta-analysisMathematicsPhysicsBiologyQuantum mechanicsFisheryAdvanced Causal Inference TechniquesStatistical Methods in Clinical TrialsStatistical Methods and Inference