How Much Did Biases in the Study of Chronic Obstructive Pulmonary Disease Medications and Mortality Affect the Outcome?
Authors: Takeharu Koga
Journal: Annals of Internal Medicine (2009)

Letters17 March 2009How Much Did Biases in the Study of Chronic Obstructive Pulmonary Disease Medications and Mortality Affect the Outcome?Takeharu Koga, MD, PhD, Tomoko Kamimura, MD, PhD, and Munetsugu Nishimura, MDTakeharu Koga, MD, PhDFrom Asakura Medical Association Hospital, Raiharu, Asakura 838-0069, Japan.Search for more papers by this author, Tomoko Kamimura, MD, PhDFrom Asakura Medical Association Hospital, Raiharu, Asakura 838-0069, Japan.Search for more papers by this author, and Munetsugu Nishimura, MDFrom Asakura Medical Association Hospital, Raiharu, Asakura 838-0069, Japan.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-6-200903170-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:It is interesting to note that patients with COPD in the study by Lee and colleagues (1) who received ICSs had reduced mortality compared with those who received other types of medication. However, before we discuss the direct association of the pharmacologic effect of ICS with the reduction in mortality, we must consider factors that were potentially confounding to the observation. In particular, potential bias in patients deserves attention, which the authors acknowledge. Although Lee and colleagues discuss bias in the severity of the disease and smoking status as potential confounders, potential bias in the sociodemographic distribution ...References1. Lee TA, Pickard AS, Au DH, Bartle B, Weiss KB. Risk for death associated with medications for recently diagnosed chronic obstructive pulmonary disease. Ann Intern Med. 2008;149:380-90. [PMID: 18794557] LinkGoogle Scholar2. Apter AJ, Boston RC, George M, Norfleet AL, Tenhave T, Coyne JC, et al. Modifiable barriers to adherence to inhaled steroids among adults with asthma: it's not just black and white. J Allergy Clin Immunol. 2003;111:1219-26. [PMID: 12789220] CrossrefMedlineGoogle Scholar3. Kozyrskyj AL, Mustard CA, Simons FE. Socioeconomic status, drug insurance benefits, and new prescriptions for inhaled corticosteroids in schoolchildren with asthma. Arch Pediatr Adolesc Med. 2001;155:1219-24. [PMID: 11695930] CrossrefMedlineGoogle Scholar4. Mackenbach JP, Bos V, Andersen O, Cardano M, Costa G, Harding S, et al. Widening socioeconomic inequalities in mortality in six Western European countries. Int J Epidemiol. 2003;32:830-7. [PMID: 14559760] CrossrefMedlineGoogle Scholar5. Kunst AE, Groenhof F, Mackenbach JP, Health EW. Occupational class and cause specific mortality in middle aged men in 11 European countries: comparison of population based studies. EU Working Group on Socioeconomic Inequalities in Health. BMJ. 1998;316:1636-42. [PMID: 9603745] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Takeharu Koga, MD, PhD; Tomoko Kamimura, MD, PhD; Munetsugu Nishimura, MDAffiliations: From Asakura Medical Association Hospital, Raiharu, Asakura 838-0069, Japan.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRisk for Death Associated with Medications for Recently Diagnosed Chronic Obstructive Pulmonary Disease Todd A. Lee , A. Simon Pickard , David H. Au , Brian Bartle , and Kevin B. Weiss How Much Did Biases in the Study of Chronic Obstructive Pulmonary Disease Medications and Mortality Affect the Outcome? Todd A. Lee , A. Simon Pickard , and David H. Au How Much Did Biases in the Study of Chronic Obstructive Pulmonary Disease Medications and Mortality Affect the Outcome? Samy Suissa and Pierre Ernst How Much Did Biases in the Study of Chronic Obstructive Pulmonary Disease Medications and Mortality Affect the Outcome? Nicholas J. Gross Metrics 17 March 2009Volume 150, Issue 6Page: 426KeywordsAsthmaCardiovascular diseasesChronic obstructive pulmonary diseaseConflicts of interestMortalitySocioeconomic statusTreatment guidelines ePublished: 17 March 2009 Issue Published: 17 March 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...