Opioid Prescribing After Nonfatal Overdose and Association With Repeated Overdose
Authors: Charles T. Sullivan
Journal: Annals of Internal Medicine (2016)

Letters6 September 2016Opioid Prescribing After Nonfatal Overdose and Association With Repeated OverdoseCharles T. Sullivan, MSCharles T. Sullivan, MSFrom North Florida/South Georgia Veterans Health System, Gainesville, Florida.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L16-0169 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Larochelle and colleagues (1) used an extended Kaplan–Meier approach to evaluate the influence of time-varying dosage (by category) on the number of days until another overdose to establish cumulative incidence curves. This approach has been shown to be flawed (2). Kaplan–Meier estimates are suitable for time-invariant covariates only, unless strict criteria are met (conditions regarding state occupation). As noted previously, transition probabilities affect the hazards and are vital to this type of analysis (2).The Kaplan–Meier method that Larochelle and colleagues used in this article has been employed by many others (for example, Vigen and coworkers [3]). ...References1. Larochelle MR, Liebschutz JM, Zhang F, Ross-Degnan D, Wharam JF. Opioid prescribing after nonfatal overdose and association with repeated overdose: a cohort study. Ann Intern Med. 2016;164:1-9. [PMID: 26720742]. doi:10.7326/M15-0038 LinkGoogle Scholar2. Beyersmann J, Gerds T, Schumacher M. Comment on ‘Illustrating the Impact of a Time-Varying Covariate with an Extended Kaplan–Meier Estimator' [Letter]. Am Stat. 2006;60:295-6. Google Scholar3. Vigen R, O'Donnell CI, Barón AE, Grunwald GK, Maddox TM, Bradley SM, et al. Association of testosterone therapy with mortality, myocardial infarction, and stroke in men with low testosterone levels. JAMA. 2013;310:1829-36. [PMID: 24193080] doi:10.1001/jama.2013.280386 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From North Florida/South Georgia Veterans Health System, Gainesville, Florida.Disclaimer: The opinions and content are those of the author and do not represent the views of the U.S. Department of Veterans Affairs or the U.S. government.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L16-0169. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoOpioid Prescribing After Nonfatal Overdose and Association With Repeated Overdose Marc R. Larochelle , Jane M. Liebschutz , Fang Zhang , Dennis Ross-Degnan , and J. Frank Wharam Opioid Prescribing After Nonfatal Overdose and Association With Repeated Overdose Marc R. Larochelle , Jane M. Liebschutz , Fang Zhang , Dennis Ross-Degnan , and J. Frank Wharam Metrics 6 September 2016Volume 165, Issue 5Page: 376KeywordsConflicts of interestDisclosureHazard ratioOpioidsPsychiatry and mental healthSubstance abuse ePublished: 6 September 2016 Issue Published: 6 September 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...