Comparative effectiveness of colony-stimulating factors in febrile neutropenia prophylaxis: how results are affected by research design

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To examine the impact of research design on results in two published comparative effectiveness studies.


Guidelines for comparative effectiveness research have recommended incorporating disease process in study design. Based on the recommendations, we develop a checklist of considerations and apply the checklist in review of two published studies on comparative effectiveness of colony-stimulating factors. Both studies used similar administrative claims data, but different methods, which resulted in directionally different estimates.


Major design differences between the two studies include: whether the timing of intervention in disease process was identified and whether study cohort and outcome assessment period were defined based on this temporal relationship.


Disease process and timing of intervention should be incorporated into the design of comparative effectiveness studies.

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