| Title: |
High-Throughput Computing to Automate Population-Based Studies to Detect the 30-Day Risk of Adverse Outcomes After New Outpatient Medication Use in Older Adults with Chronic Kidney Disease: A Clinical Research Protocol |
| Authors: |
Sheikh S. Abdullah, Neda Rostamzadeh, Flory T. Muanda, Eric McArthur, Matthew A. Weir, Jessica M. Sontrop, Richard B. Kim, Sedig Kamran, Amit X. Garg |
| Source: |
Canadian Journal of Kidney Health and Disease, Vol 11 (2024) |
| Publisher Information: |
SAGE Publishing, 2024. |
| Publication Year: |
2024 |
| Collection: |
LCC:Diseases of the genitourinary system. Urology |
| Subject Terms: |
Diseases of the genitourinary system. Urology, RC870-923 |
| More Details: |
Background: Safety issues are detected in about one third of prescription drugs in the years following regulatory agency approval. Older adults, especially those with chronic kidney disease, are at particular risk of adverse reactions to prescription drugs. This protocol describes a new approach that may identify credible drug-safety signals more efficiently using administrative health care data. Objective: To use high-throughput computing and automation to conduct 700+ drug-safety cohort studies in older adults in Ontario, Canada. Each study will compare 74 acute (30-day) outcomes in patients who start a new prescription drug (new users) to a group of nonusers with similar baseline health characteristics. Risks will be assessed within strata of baseline kidney function. Design and setting: The studies will be population-based, new-user cohort studies conducted using linked administrative health care databases in Ontario, Canada (January 1, 2008, to March 1, 2020). The source population for these studies will be residents of Ontario aged 66 years or older who filled at least one outpatient prescription through the Ontario Drug Benefit (ODB) program during the study period (all residents have universal health care, and those aged 65+ have universal prescription drug coverage through the ODB). Patients: We identified 3.2 million older adults in the source population during the study period and built 700+ initial medication cohorts, each containing mutually exclusive groups of new users and nonusers. Nonusers were randomly assigned cohort entry dates that followed the same distribution of prescription start dates as new users. Eligibility criteria included a baseline estimated glomerular filtration rate (eGFR) measurement within 12 months before the cohort entry date (median time was 71 days before cohort entry in the new user group), no prior receipt of maintenance dialysis or a kidney transplant, and no prior prescriptions for drugs in the same subclass as the study drug. New users and nonusers will be balanced on ~400 baseline health characteristics using inverse probability of treatment weighting on propensity scores within 3 strata of baseline eGFR: ≥60, 45 to |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2054-3581
20543581 |
| Relation: |
https://doaj.org/toc/2054-3581 |
| DOI: |
10.1177/20543581231221891 |
| Access URL: |
https://doaj.org/article/968e324d9f634da3ac9970efd1498e04 |
| Accession Number: |
edsdoj.968e324d9f634da3ac9970efd1498e04 |
| Database: |
Directory of Open Access Journals |
