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research article

Grace periods in comparative effectiveness studies of sustained treatments

Wanis, Kerollos Nashat
•
Sarvet, Aaron Leor  
•
Wen, Lan
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January 22, 2024
Journal Of The Royal Statistical Society Series A-Statistics In Society

Researchers are often interested in estimating the effect of sustained use of a treatment on a health outcome. However, adherence to strict treatment protocols can be challenging for individuals in practice and, when non-adherence is expected, estimates of the effect of sustained use may not be useful for decision making. As an alternative, more relaxed treatment protocols which allow for periods of time off treatment (i.e. grace periods) have been considered in pragmatic randomized trials and observational studies. In this article, we consider the interpretation, identification, and estimation of treatment strategies which include grace periods. We contrast natural grace period strategies which allow individuals the flexibility to take treatment as they would naturally do, with stochastic grace period strategies in which the investigator specifies the distribution of treatment utilization. We estimate the effect of initiation of a thiazide diuretic or an angiotensin-converting enzyme inhibitor in hypertensive individuals under various strategies which include grace periods.

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Type
research article
DOI
10.1093/jrsssa/qnae002
Web of Science ID

WOS:001149687400001

Author(s)
Wanis, Kerollos Nashat
Sarvet, Aaron Leor  
Wen, Lan
Block, Jason P.
Rifas-Shiman, Sheryl L.
Robins, James M.
Young, Jessica G.
Date Issued

2024-01-22

Publisher

Oxford Univ Press

Published in
Journal Of The Royal Statistical Society Series A-Statistics In Society
Subjects

Physical Sciences

•

Propensity Score

•

Adherence

•

Trial

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
BIOSTAT  
FunderGrant Number

National Institute of Diabetes and Digestive and Kidney Diseases | National Institutes of Health (NIH-NIDDK) grant

R01 DK 120598

Available on Infoscience
February 23, 2024
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/205376
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