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American Journal of Epidemiology Advance Access originally published online on June 4, 2009
American Journal of Epidemiology 2009 170(3):286-287; doi:10.1093/aje/kwp137
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American Journal of Epidemiology Published by the Johns Hopkins Bloomberg School of Public Health 2009.

Invited Commentary

Invited Commentary: Assessing Treatment Effects by Using Observational Analyses—Opportunities and Limitations

Philip S. Wang and Michael Schoenbaum

Correspondence to Dr. Philip S. Wang, National Institute of Mental Health, 6001 Executive Boulevard, Bethesda, MD 20892-9669 (e-mail: wangphi{at}mail.nih.gov).

Received for publication March 16, 2009. Accepted for publication April 9, 2009.

Making decisions about medical treatments based upon valid evidence is critical to improve health-care quality, outcomes, and value. Although such research commonly connotes the use of randomized controlled trials, experimental methods are not always feasible, and research using observational, quasi-experimental, and other nonexperimental methods may also be important. At the same time, nonexperimental methods are inherently susceptible to various types of bias and thus present special challenges in the search for valid and generalizable evidence. The study by Gardarsdottir et al. (Am J Epidemiol. 2009;170(3):280–285), on which this commentary is based, addresses a key potential source of bias—mismeasurement of patients’ duration of treatment—in previous research on pharmacotherapy for depression. However, the authors’ study is unlikely to address other potential sources of bias, which may make interpretation of their findings more difficult.

bias (epidemiology); depression; observation; research design; treatment outcome


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Related articles in Am. J. Epidemiol.:

Duration of Antidepressant Drug Treatment and Its Influence on Risk of Relapse/Recurrence: Immortal and Neglected Time Bias
Helga Gardarsdottir, Toine C. Egberts, Joost J. Stolker, and Eibert R. Heerdink
Am. J. Epidemiol. 2009 170: 280-285. [Abstract] [Full Text]  



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H. Gardarsdottir, T. C. Egberts, J. J. Stolker, and E. R. Heerdink
Gardarsdottir et al. Respond to "Assessing Treatment Effects With Observational Analyses"
Am. J. Epidemiol., August 1, 2009; 170(3): 288 - 288.
[Full Text] [PDF]


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