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Propensity score and observational studies. Applications in surgical research

Abstract:

The ideal design to estimate the effects of interventions, is a randomized clinical trial (RCT), in which the random allocation (RA) to the intervention allows balancing the observed and unobserved characteristics of the subjects that make up the study groups. In situations where RA cannot be performed, there is an alternative to bias control, which is known as propensity score (PS). This tool is useful for estimating the effect of an intervention or exposure on an outcome in observational studies, especially when it is estimated that confounding and selection biases may exist due to an unintended intervention RA. Is an advanced matching technique for confounding variables such as age, sex, etc., which allows patients of similar age to be compared in the intervention and comparison groups. This can become more complex if it is decided to add many variables to the matching process (age, sex, ethnicity, educational level), since it will be difficult to find exact matches for the subjects under study. PS then solves this dimensionality problem by compressing the relevant factors into a single score, such that patients with similar PS are compared between the intervention and comparison groups. The aim of this manuscript was to generate a study document referring to some issues of the use of PS in surgical research.