TY - JOUR
T1 - Assessing the Most Vulnerable Subgroup to Type II Diabetes Associated with Statin Usage
T2 - Evidence from Electronic Health Record Data
AU - Guo, Xinzhou
AU - Wei, Waverly
AU - Liu, Molei
AU - Cai, Tianxi
AU - Wu, Chong
AU - Wang, Jingshen
N1 - Publisher Copyright:
© 2023 American Statistical Association.
PY - 2023
Y1 - 2023
N2 - There have been increased concerns that the use of statins, one of the most commonly prescribed drugs for treating coronary artery disease, is potentially associated with the increased risk of new-onset Type II diabetes (T2D). Nevertheless, to date, there is no robust evidence supporting as to whether and what kind of populations are indeed vulnerable for developing T2D after taking statins. In this case study, leveraging the biobank and electronic health record data in the Partner Health System, we introduce a new data analysis pipeline and a novel statistical methodology that address existing limitations by (i) designing a rigorous causal framework that systematically examines the causal effects of statin usage on T2D risk in observational data, (ii) uncovering which patient subgroup is most vulnerable for developing T2D after taking statins, and (iii) assessing the replicability and statistical significance of the most vulnerable subgroup via a bootstrap calibration procedure. Our proposed approach delivers asymptotically sharp confidence intervals and debiased estimate for the treatment effect of the most vulnerable subgroup in the presence of high-dimensional covariates. With our proposed approach, we find that females with high T2D genetic risk are at the highest risk of developing T2D due to statin usage. Supplementary materials for this article are available online.
AB - There have been increased concerns that the use of statins, one of the most commonly prescribed drugs for treating coronary artery disease, is potentially associated with the increased risk of new-onset Type II diabetes (T2D). Nevertheless, to date, there is no robust evidence supporting as to whether and what kind of populations are indeed vulnerable for developing T2D after taking statins. In this case study, leveraging the biobank and electronic health record data in the Partner Health System, we introduce a new data analysis pipeline and a novel statistical methodology that address existing limitations by (i) designing a rigorous causal framework that systematically examines the causal effects of statin usage on T2D risk in observational data, (ii) uncovering which patient subgroup is most vulnerable for developing T2D after taking statins, and (iii) assessing the replicability and statistical significance of the most vulnerable subgroup via a bootstrap calibration procedure. Our proposed approach delivers asymptotically sharp confidence intervals and debiased estimate for the treatment effect of the most vulnerable subgroup in the presence of high-dimensional covariates. With our proposed approach, we find that females with high T2D genetic risk are at the highest risk of developing T2D due to statin usage. Supplementary materials for this article are available online.
KW - Bootstrap
KW - Causal inference
KW - Debiased inference
KW - Precision medicine
UR - http://www.scopus.com/inward/record.url?scp=85146974362&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85146974362&partnerID=8YFLogxK
U2 - 10.1080/01621459.2022.2157727
DO - 10.1080/01621459.2022.2157727
M3 - Article
C2 - 38223220
AN - SCOPUS:85146974362
SN - 0162-1459
JO - Journal of the American Statistical Association
JF - Journal of the American Statistical Association
ER -