Show simple item record

dc.contributor.authorVo, Tat-Thang
dc.contributor.authorRoy, Samrat
dc.contributor.authorYe, Ting
dc.contributor.authorErterfaie, Askhan
dc.contributor.authorNguyen, Thanh Phuong Pham
dc.contributor.authorFlory, James
dc.contributor.authorLeonard, Charles E.
dc.contributor.authorSmall, Dylan S.
dc.contributor.authorHennessy, Sean
dc.date.accessioned2025-05-22T03:39:45Z
dc.date.available2025-05-22T03:39:45Z
dc.date.issued2025-05-07
dc.identifier.issn1476-6256
dc.identifier.urihttp://hdl.handle.net/11718/27795
dc.descriptionThe cardiovascular risks of exogenous testosterone have been a subject of controversy. In this study, our objective was to examine the association between testosterone (versus glaucoma treatments as an active comparator, with no assumed effect) and the new onset of cardiovascular, cerebrovascular and thromboembolic adverse events, in a US commercial insurance database. Data was analyzed by three complementary designs: inverse propensity score weighting (IPSW), calendar time instrumental variable (IV) and instrumented difference-in-differences (iDiD). Results of these analyses suggest that there is no difference between testosterone and glaucoma treatments regarding the risk of the composite primary endpoint of acute myocardial infarction, ischemic stroke and sudden cardiac arrest / ventricular arrhythmia. In contrast, IPSW analysis identified a negative association between testosterone and the secondary endpoint of venous thromboembolism. However, this association was attenuated towards the null in the calendar time IV and iDiD analysis, which suggests that there might be unmeasured confounding in the IPSW analysis. Because there is no uniquely suitable method that offers a universally optimal solution for evaluating causal relationships between exposures and outcomes from observational data, using multiple state-of-the-art methods to answer the question of interest can help in assessing the robustness of findings to various forms of unmeasured confounding, thereby aiding in causal inference.en_US
dc.description.abstractThe cardiovascular risks of exogenous testosterone have been a subject of controversy. In this study, our objective was to examine the association between testosterone (versus glaucoma treatments as an active comparator, with no assumed effect) and the new onset of cardiovascular, cerebrovascular and thromboembolic adverse events, in a US commercial insurance database. Data was analyzed by three complementary designs: inverse propensity score weighting (IPSW), calendar time instrumental variable (IV) and instrumented difference-in-differences (iDiD). Results of these analyses suggest that there is no difference between testosterone and glaucoma treatments regarding the risk of the composite primary endpoint of acute myocardial infarction, ischemic stroke and sudden cardiac arrest / ventricular arrhythmia. In contrast, IPSW analysis identified a negative association between testosterone and the secondary endpoint of venous thromboembolism. However, this association was attenuated towards the null in the calendar time IV and iDiD analysis, which suggests that there might be unmeasured confounding in the IPSW analysis. Because there is no uniquely suitable method that offers a universally optimal solution for evaluating causal relationships between exposures and outcomes from observational data, using multiple state-of-the-art methods to answer the question of interest can help in assessing the robustness of findings to various forms of unmeasured confounding, thereby aiding in causal inference.en_US
dc.language.isoenen_US
dc.publisherOxford University Pressen_US
dc.relation.ispartofAmerican Journal of Epidemiologyen_US
dc.subjectTestosteroneen_US
dc.subjectCardiovascularen_US
dc.subjectCerebrovascularen_US
dc.subjectThromboembolicen_US
dc.subjectIPSWen_US
dc.subjectIVen_US
dc.subjectiDiDen_US
dc.titleEffect of exogenous testosterone on cardiovascular, cerebrovascular, and thromboembolic adverse events: results of three complementary research designsen_US
dc.typeArticleen_US
dc.identifier.doihttps://doi.org/10.1093/aje/kwaf098en_US


Files in this item

FilesSizeFormatView

There are no files associated with this item.

This item appears in the following Collection(s)

Show simple item record