Comparing Apples to Oranges

Q: What is the clinical evidence from this study?

Study design: Editorial. Intervention: Nitrous oxide.

Q: What does this research mean for the field?

Observational evidence associating nitrous oxide with reduced postoperative mortality conflicts with randomized trials largely due to substantial differences in surgical patient populations and unmeasured confounding that propensity score matching cannot resolve. Novelty: ClaimNovelty.CONTRADICTORY.

Thomas R. Vetter; Gerald McGwin

doi:10.1213/ane.0b013e31826e7632

April 20, 2013Anesthesia & Analgesia

Comparing Apples to Oranges

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PICO

E

Exposure / Comparator

Nitrous oxide

Limitations

Propensity scores cannot solve the problem of unmeasured confounders.
Propensity scores developed using administrative data do not necessarily balance patient characteristics contained in actual clinical data.
Comparing observational studies with randomized trials is confounded by vastly different study populations.
Observational nature of discussed study
Unmeasured confounders
Use of administrative data
Inclusion of outpatients truncating time-at-risk

Implication

Discordant results between observational studies and RCTs regarding nitrous oxide safety highlight the limitations of propensity scores in accounting for unmeasured confounders and differing baseline risks.

Discussion

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Cite This Study

Vetter et al. (2013) reported an editorial. Nitrous oxide was evaluated.

synapsesocial.com/papers/6aad11b5bdb1c3c786e04e4d https://doi.org/10.1213/ane.0b013e31826e7632

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Comparing Apples to Oranges

PICO

Limitations

Implication

Discussion

Cite This Study

Comparing Apples to Oranges

PICO

Limitations

Implication

Discussion

Cite This Study

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