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Distortions in Risk Assessment

Conference paper
Part of the Health Systems Research book series (HEALTH)

Abstract

Failure to adjust correctly for severity will invariably distort the assessment of risk in pharmacoepidemiologic studies. Drugs are not prescribed to patients at random. The decision to prescribe a given agent to a given patient is based on assessment of a complex of factors which the prescriber may not articulate. Drugs with certain real or perceived characteristics will be prescribed to patients with certain real or perceived characteristics. This process has been described by Urquhart as channelling. Patients who are perceived as sicker will be prescribed drugs perceived as stronger; patients with previous drug intolerance will be prescribed agents believed to be better tolerated. Moreover, the outcome of the patient’s illness is determined primarily by the underlying disease and only secondarily by treatment.

Keywords

Pharmacoepidemiologic Study Healthy Work Effect Poor Working Condition Respiratory Mortality Asthma Death 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

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    Crane J, Pearce NE, Flatt A et al. (1989) Prescribed fenoterol and death from asthma in New Zealand 1981–1983: case control study. Lancet I: 917–922Google Scholar
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    Pearce N, Grainger J, Atkinson M, Crane J, Burgess C et al. (1990) Case control study of prescribed fenoterol and death from asthma in New Zealand, 1977–1981. Thorax 15: 170–175CrossRefGoogle Scholar
  3. 3.
    Poole C, Lanes SF, Walker AM (1990) Fenoterol and fatal asthma. Lancet 335: 920PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • J. Haas

There are no affiliations available

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