Propensity Score Matching Approach Research Articles

Overcoming challenges in real‐world evidence generation: An example from an Adult Medical Care Coordination program

AbstractThe Adult Medical Care Coordination program (“the program”) was implemented at Mayo Clinic to promote patient self‐management and improve 30‐day unplanned readmission for patients with high risk for readmission after hospital discharge. This study aimed to evaluate the impact of the program compared to usual care using a pragmatic, stepped wedge cluster randomized trial (“stepped wedge trial”). However, several challenges arose including large differences between the study arms. Our goal is to describe the challenges and present lessons learned on how to overcome such challenges and generate evidence to support practice decisions. We describe the challenges encountered during the trial, the approach to addressing these challenges, and lessons learned for other learning health system researchers facing similar challenges. The trial experienced several challenges in implementation including several clinics dropping from the study and care disruptions due to COVID‐19. Additionally, there were large differences in the patient population between the program and usual care arms. For example, the mean age was 76.8 for the program and 68.1 for usual care. Due to these differences, we adapted the methods using the propensity score matching approach that is traditionally applied to observational designs and adjusted for differences in observable characteristics. When conducting pragmatic research, researchers will encounter factors beyond their control that may introduce bias. The lessons learned include the need to weigh the tradeoffs of pragmatic design elements and the potential value of adaptive designs for pragmatic trials. Applying these lessons would promote the successful generation of evidence that informs practice decisions.

Impact of neoadjuvant compared to adjuvant chemotherapy on prognosis in patients with hormone-receptor positive / HER2-negative breast cancer: A propensity score matching population-based study

BackgroundThe aim of this population-based cohort study was to investigate the impact of neoadjuvant chemotherapy (NACT) compared to adjuvant chemotherapy in prognosis among patients with HR+/HER2 negative breast cancer. MethodThis population-based study utilized data from the research database BCBaSe 3.0, based on the Swedish National Quality breast cancer register, including all patients with breast cancer diagnosis in Sweden between 2008 and 2019. Propensity score matching approach was applied. The outcomes of interest consisted of distant-disease free (DDFS), breast-cancer specific (BCSS), and overall survival (OS). ResultsIn total, 14 459 patients were included in the study cohort of whom 2086 received NACT. After 1:1 propensity score matching (PSM), 1539 patients in each study group were available for analyses. No statistically significant difference in survival outcomes were observed between patients treated with NACT compared to those treated with adjuvant chemotherapy (Hazard Ratio (HR) for DDFS: 1.20; 95 % CI: 0.80–1.79; HR for BCSS: 1.16; 95 % CI: 0.54–2.49; HR for OS: 1.14; 95 % CI: 0.64–2.05). ConclusionIn this population-based cohort study of patients with HR+/HER2-breast cancer, the use of NACT seems to be comparable to adjuvant chemotherapy in terms of prognosis, although non-inferiority cannot be proven by this study design. Until further evidence suggesting a survival benefit in favor of either treatment is available, NACT can be pursued when surgical-de-escalation is intended.

How Does Low-Carbon Financial Policy Affect Corporate Green Innovation?—Re-Examination of Institutional Characteristics, Influence Mechanisms, and Local Government Behavior

This paper employs a propensity score matching approach to construct a control group and estimate the impact of the CETS pilot policy, a low-carbon financial policy, on corporate green innovation and its impact mechanism in a difference-in-difference manner. The results show that the CETS pilot policy has a significantly positive effect on corporate green innovation. The higher the penalty degree and the carbon price, the more obvious the promotion of the green innovation of pilot enterprises. The mechanism test shows that the improvement of corporate green innovation is mainly due to the incentive effect rather than the anti-driving effect of the CETS pilot policy, that is, the policy promotes corporate green innovation by providing innovation resources and enhancing the willingness to innovate. Further analysis shows that only in regions where local governments have less competitive pressure can the CETS pilot policy effectively promote enterprise innovation resources and that a close and clean government–business relationship can help strengthen the promotion effect of the CETS pilot policy on the willingness of enterprises to innovate. Furthermore, this paper introduces its theoretical framework as a strategic tripod to explore the friction in the process of the CETS pilot policy affecting corporate green innovation from the perspective of the industry environment and corporate resources. This research shows that a lack of industry green technology and corporate human capital may hinder the positive impact of the CETS pilot policy on corporate green innovation. Finally, this study found that the CETS pilot policy has no significant impact on the quality of corporate green innovation, and the lack of industry green technology and corporate human capital may hinder the CETS pilot policy from improving the quality of corporate green innovation.

Touched by Quakes: Mortality Salience and Corporate Philanthropy

ABSTRACT This study examines how natural catastrophes affect corporate philanthropic activities in China. Firms located in areas experiencing severe seismic losses increase charitable donations. The effect is stronger when firms demonstrate stronger social responsibility, operate in higher-mortality regions, and are led by female or elder CEOs, supporting the mortality salience hypothesis. We address endogeneity issues with an instrumental variable and a propensity score matching approaches. Furthermore, firms with higher charitable donations experience a more positive stock market reaction around the 2008 Wenchuan Earthquake. Overall, our findings suggest that natural catastrophes amplify financial market participants’ mortality salience and affect their economic decisions.

Optimizing Autologous Stem Cell Transplantation in Multiple Myeloma: The Impact of Intensive Chemomobilization

Most transplant-eligible multiple myeloma (MM) patients undergo autologous peripheral blood stem cell collection (PBSC) using G-CSF with on-demand plerixafor (G±P). Chemomobilization (CM) can be used as a salvage regimen after G±P failure or for debulking residual tumor burden ahead of autologous peripheral blood stem cell transplantation (ASCT). Prior studies utilizing cyclophosphamide-based CM have not shown long-term benefit. At our center, intensive CM (ICM) using a PACE- or HyperCVAD-based regimen has been used to mitigate "excessive" residual disease based on plasma cell burden or MM-related biomarkers. Given the lack of efficacy of non-intensive CM, we sought to determine the impact of ICM on event-free survival (EFS), defined as death, progressive disease, or unplanned treatment escalation. We performed a retrospective study of newly diagnosed MM patients who collected autologous PBSCs with the intent to proceed immediately to ASCT at our center between 7/2020 and 2/2023. Patients were excluded if they underwent a tandem autologous or sequential autologous-allogeneic transplant, had primary plasma cell leukemia, received non-ICM treatment (i.e., cyclophosphamide and/or etoposide), or had previously failed G±P mobilization. To appropriately evaluate the impact of ICM among those who potentially could have received it, we utilized a propensity score matching (PSM) approach whereby ICM patients were compared to a cohort of non-CM patients matched on pre-ASCT factors most strongly associated with the receipt of ICM. Of 451 patients identified, 61 (13.5%) received ICM (PACE-based, n=45; hyper-CVAD-based, n=16). Post-ICM/pre-ASCT, 11 patients (18%) required admission for neutropenic fever and/or infection. Among 51 evaluable patients, the overall response rate was 31%; however, 46 of 55 evaluable patients (84%) saw a reduction in M-spike and/or involved FLCs. Among those evaluated with longitudinal peripheral blood flow cytometry (n=8), 5 patients (63%) cleared circulating blood PCs post-ICM. Compared to patients mobilized with non-CM, ICM patients collected a slightly greater median number of CD34+ cells (10.8 vs 10.2 × 10⁶/kg, p=.018). The median follow-up was 30.6 months post-ASCT. In a PSM multivariable analysis, ICM was associated with significantly improved EFS (HR 0.30, 95% CI 0.14 to 0.67, p=.003), but not improved OS (HR 0.38, 95% CI 0.10 to 1.44, p=.2). ICM was associated with longer post-ASCT inpatient duration (+4.1 days, 95% CI, 2.4 to 5.8, p<.001), more febrile days (+0.96 days, 95% CI 0.50 to 1.4, p<.001), impaired platelet engraftment (HR 0.23, 95% CI 0.06 to 0.87, p=.031), more bacteremia (OR 3.41, 95% CI 1.20 to 9.31, p=.018), and increased antibiotic usage (cefepime: +2.3 doses, 95% CI 0.39 to 4.1, p=.018; vancomycin: +1.0 doses, 95% CI 0.23 to 1.8, p=.012). ICM was independently associated with improved EFS in a matched analysis involving MM patients with excessive disease burden at pre-ASCT workup. This benefit came at the cost of longer inpatient duration, more febrile days, greater incidence of bacteremia, and increased antibiotic usage in the immediate post-ASCT setting. Our findings suggest that ICM could be considered for a subset of MM patients, but its use must be weighed carefully against additional toxicity.

To tell or not to tell? Examining voluntary disclosure of customers’ identities under capital market pressure

Using China’s short-sell reform as a quasi-natural experiment, we find that firms respond to short-sell pressure by reducing the disclosure of their customers’ identities after controlling for the influence of proprietary costs. The result remains robust after conducting a parallel trends test and a placebo test, and using a propensity score matching approach. Furthermore, non-disclosure becomes more prevalent among firms with highly perceived customer risks and significant discretionary revenues. These findings imply that negative information transmission between economically linked firms and potential agency issues inherent to supplier firms prompt them to withhold customer identity. Finally, a non-disclosing strategy benefits firms by lowering the probability of fraud detection and reducing operating uncertainty. We suggest regulators implement policies to incentivize firms to improve information transparency in the supply chain.

Impact of Korra tef adoption on farm household productivity and incomes in Central Ethiopia

Tef (Eragrostis tef) is a major staple and income sourcing crop in the horn of Africa; that has attracted tremendous investment particularly in research. It is expected that the improved seed varieties will contribute to raising farm productivity and consequently, farmers’ income. The objective of this study was to assess how the adoption of improved tef variety has influenced household productivity and incomes, with a focus on the Korra tef variety introduced by the Agricultural Growth Programme phase II, in Ethiopia. Cross-sectional data were collected from 479 randomly selected farm households, in two woredas in Central Ethiopia; one as an adopter and the other as a non-adopter. The Propensity Score Matching (PSM) approach was used to investigate the adoption of the Korra tef variety and its impacts on household production and income, over the yield obtained by the non-adopters. The PSM model’s robustness was tested using regression on variables and regression on propensity scores. The adoption of the Korra tef variety, according to the PSM approach, increased tef productivity by 598.78 kg (nearly 6 quintals) per hectare, over the yield obtained by the non-adopters. Additionally, switching to the Korra tef variety raised household income by US$ 806.73 per hectare. We conclude that the adoption of Korra tef variety increases the productivity and incomes of adopter farm households.

Prognosis of primary breast salivary gland-type carcinoma: a propensity score-matching analysis with invasive carcinoma of no special type based on the SEER database for years 2010-2020.

Primary breast salivary gland-type carcinoma has weak evidence to support its management due to its rare occurrence and limited data regarding its clinicopathological features and prognosis. Therefore, this study aimed to assess clinicopathological features and prognosis for this type of carcinoma diagnosed over the past decade and compared those to the common breast invasive carcinoma of no special type (NST). This study used the Surveillance, Epidemiology, and End Results (SEER) database to extract data regarding primary breast salivary gland-type carcinoma. Using a propensity score-matching approach, the prognosis was compared with invasive carcinoma, NST. This study included 488 cases of salivary gland-type carcinoma and 375,660 cases of invasive carcinoma, NST, giving an occurrence ratio of 1 to 770. Adenoid cystic carcinoma (81%) formed the majority of salivary gland-type carcinoma, followed by secretory carcinoma (13%). For salivary gland-type carcinoma, acinic cell carcinoma histological type, tumor grade 3, HER2-overexpressed status, and higher AJCC stage groups were significant worse prognostic factors for breast cancer-specific survival in univariate analyses (p < 0.05). Nonetheless, tumor grade 3 and higher AJCC stage groups remained as significant independent prognostic factors in multivariate analysis (p < 0.05). The apparent better breast cancer-specific survival of salivary gland-type carcinoma as compared to that of invasive carcinoma, NST, was diminished following adjustment for differences in baseline clinicopathological features and treatment-related variables. This study suggests that when managing primary breast salivary gland-type carcinoma, greater emphasis should be given to the tumor grade and AJCC stage group in addition to acinic cell carcinoma histological type and HER2 overexpression. Conventional prognostic factors are important as salivary gland-type carcinoma had similar prognosis as invasive carcinoma, NST, following adjustment for confounding variables.

Improving search efficiency in housing markets using online listings

AbstractThe use of online listing portals helps improve search efficiency in real estate markets. Unlike the traditional channel, buyers could search more properties and find ones with characteristics that were closer to their preferences via the online channel. Using the merged data sets containing online listings and transactions in the private residential property markets in Singapore, we found that real estate agents sell houses for an average premium of 4.21% using online listings relative to other agents using the traditional listing channel. The models use the propensity score matching approach to remove compositional differences in the samples and include property and spatial attributes in the controls, as well as the fixed effects on the agency, planning sector, and month‐year. Using only the matched online listing‐transaction samples, we found that exclusive listings, using more words and numeric in listing content, making listing descriptions easy to read, and selecting multiple listing portals are online listing strategies that enable real estate agents to sell houses faster and above the asking prices.

Mortality in a Nationwide Practice-Based Cohort Receiving Paclitaxel-Coated Devices for Lower Limb Peripheral Artery Disease

BackgroundAccording to a meta-analysis of randomized clinical trials, paclitaxel-coated devices (PCDs) for lower limb endovascular revascularization may be associated with increased risk of late mortality. ObjectivesThe purpose of this study was to determine whether PCDs are associated with all-cause mortality in a real-world setting. MethodsDETECT is a nationwide, exhaustive retrospective cohort study using medico-administrative data from the French National Healthcare System representing >99% of the population. The main selection criterion was the first procedure of interest: endovascular revascularization for lower limb peripheral artery disease involving ≥1 balloon and/or stent performed between October 1, 2011, and December 31, 2019. Patients with or without PCDs were compared for all-cause mortality until December 31, 2021. ResultsA total of 259,137 patients were analyzed, with 20,083 (7.7%) treated with ≥1 PCD. After a median follow-up of 4.1 years (Q1-Q3: 2.3-6.4 years), a total of 5,385 deaths/73,923 person-years (PY) (7.3/100 PY) and 109,844 deaths/1,060,513 PY (10.4/100 PY) were observed in the PCD and control groups, respectively. After adjustment for confounding factors, PCD treatment was associated with a lower risk of mortality in multivariable Cox analyses (HR: 0.86; 95% CI: 0.84-0.89; P < 0.001). Similar results were observed using propensity score matching approaches based on either nearest-neighbor or exact matching. ConclusionsIn a nationwide analysis based on large-scale real-world data, exposure to PCDs was not associated with a higher risk of mortality in patients undergoing endovascular revascularization for lower limb peripheral artery disease. (The DETECT Project; NCT05254106)

Does governmental venture capital (GVC) advance green innovation? Big data evidence from China

This paper examines the impact of governmental venture capital on green innovation utilizing a unique and comprehensive dataset in China between 2009 and 2018. Our results consistently reveal significant and positive effects of GVCs on green innovation, a result derived from the analysis of 317,870 firm-year observations conducted through a difference-in-differences and propensity score matching panel approach. Moreover, GVCs investments indicate a significant but smaller effect when they invest in start-ups. Following GVC investments, companies tend to attract additional private and other governmental financing. Interestingly, GVCs structured as limited partnerships appear to stimulate more green innovation compared to corporate-venture-structured GVCs.

Immediate application of frozen-thawed embryo transfer cycle in month following COVID-19 infection does not impair subsequent pregnancy outcomes.

To investigate whether immediate frozen embryo transfer (FET) in the next month following COVID-19 recovery affects the subsequent pregnancy outcomes. A retrospective cohort study was carried out at a university-affiliated reproductive medicine center. The study group (post-COVID-19 group) consisted of women who were afflicted with COVID-19 in December 2022 and immediately invested in FET in January 2023 after recovery, with embryos transferred and not exposed to the infection. The control group was composed of women treated during the pre-COVID-19 period (January 2019). Multivariable logistic regression analyses as well as a propensity score matching (PSM) approach were introduced to control for the potential confounders and selection bias. A total of 200 patients were included in the post-COVID-19 group while a total of 641 women were enrolled in the control group. The rate of ongoing pregnancy was comparable between the study cohorts in both the unadjusted and confounder-adjusted logistic regression models. The other reproductive outcomes, including the odds of the positive pregnancy test, implantation, clinical pregnancy, and early pregnancy loss were all similar between the comparison groups. Results from PSM models further confirmed the lack of significant differences in pregnancy outcomes between the post-COVID-19 group versus the control group. Our findings suggested that for patients who get infected with COVID-19, the immediate investment in a FET cycle in the next month after recovery did not seem to compromise the ongoing pregnancy outcomes in cases of transferred embryos resulting from the pre-infection stage. Thus, women who had frozen embryos from the pre-infection cycles should be counseled and encouraged to invest in IVF as soon as possible after recovering from COVID-19 infection. This article is protected by copyright. All rights reserved.

Association between short birth spacing and child malnutrition in Bangladesh: a propensity score matching approach

ObjectivesThis study aimed to explore the effects of short birth spacing (SBS), which is defined as a period of less than 33 months between two successive births, on multiple concurrent...

Impact of time from diagnosis to chemotherapy on prognosis in advanced pancreatic cancer.

Due to the aggressive nature and poor prognosis of advanced pancreatic cancer, prompt initiation of treatment is critical. We investigated the effect of the interval between cancer diagnosis and initiation of chemotherapy on survival in patients with advanced pancreatic cancer. In this retrospective, single-centre study, consecutive patients with advanced pancreatic cancer between April 2013 and March 2022 were analyzed. Data were extracted from the electronic medical records of patients who received chemotherapy for metastatic, locally advanced or resectable pancreatic cancer or who received chemotherapy due to either being intolerant of or declining surgery. We compared overall survival between two groups: the early waiting time group (waiting time≤30days from diagnosis to chemotherapy initiation) and the elective waiting time group (waiting time≥31days). Prognostic factors, including biliary drainage, were considered. The impact of waiting time on survival was assessed by univariate and multivariate analyses with Cox proportional hazard models. A 1:1 propensity score matching approach was used to balance bias, accounting for significant poor prognosis factors, age and sex. The study involved 137 patients. Overall survival exhibited no statistically significant difference between the early and elective waiting time groups (207 and 261days, P=0.2518). Univariate and multivariate analyses identified poor performance status and metastasis presence as predictors of worse prognosis. This finding persisted post propensity score matching (275 and 222days, P=0.8223). Our study revealed that initiating chemotherapy ˃30days later does not significantly affect treatment efficacy compared to within 30days of diagnosis.

Collaborative learning in the Vietnam Escuela Nueva Model and students’ learning behaviors: A mixed methods longitudinal study

We study how Vietnam’s Escuela Nueva, a pedagogical reform that promotes participatory and collaborative learning in primary schools, affects students’ learning behaviors in short and long run. Using a propensity score matching approach, we find that the model increases the likelihood of giving and receiving feedback from peers as well as asking questions in class. The peer-learning effects appear to persist in the long run as students enter lower secondary school. Qualitative interviews with lower secondary teachers and school principals also provide evidence of these long-term effects. However, teachers also highlighted important concerns of this model.

Empirical evidence for economic viability of direct seeded rice in peninsular India: An action-based research

PurposeThis study identified critical constraints in technology adoption for Direct Seeded Rice (DSR) compared with puddled transplanted rice (PTR) practices. We present the impact of DSR technology adoption on paddy yield, income generation, and cost incurred on various farm operations. Furthermore, the study investigates whether a dry DSR practice provides more economic and production benefits than a wet DSR. MethodologyWe used a multi-stage sampling (from state to district-to-village-to-farmers) and conducted a face-to-face questionnaire survey to collect primary farm-level data. We collected 669 farm and household-level data and analyzed the impact of DSR and dry DSR adoption over PTR and wet DSR, respectively. Initially, the study employed probit regression analysis to identify the DSR adoption determinants. Subsequently, using the Propensity Score Matching approach, the study measures the impact of DSR adoption over PTR in terms of yield, income, and cost management. Finally, using the PSM approach, the study estimated the impact of dry DSR adoption over wet DSR. FindingsProbit estimates suggest that variables like education, membership in farmers' organizations, farm experience, institutional credit, crop insurance, off-farm income, and smartphone and television ownership positively regulate DSR adoption. The impact assessment analysis reveals that the adoption of DSR over PTR results in marginal yield improvement. However, the cost of irrigation, land preparation, and fertilization is significantly lower in DSR, resulting in an additional income of ₹5192/acre for DSR adopters. Moreover, a comparative analysis between dry DSR and wet DSR indicates that farmers can achieve ₹2467/acre by adopting dry DSR. Practical implicationsOur research findings designate the necessity for implementing policies and strategies to promote the adoption of DSR among non-adopters. Besides economic benefits, adopting the DSR method can yield environmental benefits, improve soil health, mitigate soil erosion, and decrease water use.

Impact of Microdosing Practices on Technical Efficiency: An Analysis Accounting for Selection Bias Among Smallholder Maize Farmers in Burkina Faso

Smallholder maize farmers are currently confronted with the arduous challenge of managing limited financial resources while incessantly facing the issue of land degradation. To address this issue, an alternative solution has been implemented to optimize the use of chemical fertilizer by adopting microdosing. This innovative system not only helps them enhance their agricultural productivity but also allows them to protect the environment. However, it is unclear how microdosing adoption could increase the technical efficiency (TE) of maize production. Therefore, this research aims to assess how the adoption of microdosing affects the technical efficiency of maize production as well as identify the key factors that influence the technical efficiency of maize production in Burkina Faso. To achieve this goal, farm household survey data was conducted with 210 randomly selected farmers from the Plateau Central and northern regions of Burkina Faso. To account for potential selection biases that could result from both observable and unobservable factors, we used a sample selection stochastic production frontier model and a propensity score matching approach. A stochastic meta-frontier approach was applied to estimate TE differences and the technology gap between adopters and non-adopters. The findings showed that adopters of microdosing have an average efficiency of 68 percent, which is higher than the 53 percent estimated for non-adopters. Adopters of microdosing have been found to have high TE and better agricultural technology than non-adopters. The meta-frontier estimation revealed that the adoption of improved maize varieties would yield better returns. This study contributes significantly to the literature on how fertilizer microdosing affects maize productivity, as well as the policy implications of targeting and encouraging smallholder maize farmers in Burkina Faso to optimize the use of productive inputs and improve maize output by using microdosing.

Understanding the association between intimate partner violence and sexually transmitted infections among women in India: a propensity score matching approach

BackgroundIntimate partner violence (IPV) against women can significantly impact their overall health. While numerous studies in developing nations highlight the association between IPV and sexually transmitted infections (STIs), the evidence...

Low‐rise buildings in big cities: Theory and evidence from China

AbstractThis article explores the determinants of floor area ratio (FAR) limit, a major form of construction density regulation, in China. I develop a spatial equilibrium framework to study local governments’ optimal FAR design and investigate over 400,000 residential land transactions between 2007 and 2019 to perform the empirical analysis. Exploiting the exogenous variations generated by administrative adjustments and applying a propensity score matching approach, I find that a one standard deviation increase in local budgetary revenue decreases FAR limits by 0.29. Further counterfactual analysis suggests that the land finance model contributes to housing affordability issues and spatial inequality in China.

Consequences of caring for the physical health, mental health and subjective well-being of Chilean older adults

Using a propensity score matching approach, this study evaluates the effect of caring on the physical health, mental health and subjective well-being of Chilean older people. The average treatment effect was not significant in any of the outcomes to physical health. However, older carers – and those who care intensely – were more likely to have depressive and anxious symptomatology and lower life satisfaction than older non-carers. Interventions should consider strategies that favour mental health and avoid caregiver burden, considering the interaction between caring and the challenges of ageing. This could improve the quality of life of carers and those being cared for.