title: Variable selection on large case-crossover data: application to a registry-based study of prescription drugs and road traffic crashes.
abstract: OBJECTIVE
  In exploratory analyses of pharmacoepidemiological data from large populations with large number of exposures, both a conceptual and computational problem is how to screen hypotheses using probabilistic reasoning, selecting drug classes or individual drugs that most warrant further hypothesis testing.
  
  
  METHODS
  We report the use of a shrinkage technique, the Lasso, in the exploratory analysis of the data on prescription drugs and road traffic crashes, resulting from the case-crossover matched-pair interval approach described by Orriols and colleagues (PLoS Med 2010; 7:e1000366). To prevent false-positive results, we consider a bootstrap-enhanced version of the Lasso. To highlight the most stable results, we extensively examine sensitivity to the choice of referent window.
  
  
  RESULTS
  Antiepileptics, benzodiazepine hypnotics, anxiolytics, antidepressants, antithrombotic agents, mineral supplements, drugs used in diabetes, antiparkinsonian treatment, and several cardiovascular drugs showed suspected associations with road traffic accident involvement or accident responsibility.
  
  
  CONCLUSIONS
  These results, in relation to other findings in the literature, provide new insight and may generate new hypotheses on the association between prescription drugs use and impaired driving ability.
authors.affiliation: Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000, Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000, Bordeaux, France.
authors.forename: Marta
authors.initials: M
authors.lastname: Avalos
authors.forename: Ludivine
authors.initials: L
authors.lastname: Orriols
authors.forename: Hélène
authors.initials: H
authors.lastname: Pouyes
authors.forename: Yves
authors.initials: Y
authors.lastname: Grandvalet
authors.forename: Frantz
authors.initials: F
authors.lastname: Thiessard
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Lagarde
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D018592:Cross-Over Studies; D016208:Databases, Factual; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D017891:Pharmacoepidemiology / Q000379:methods*; D055553:Prescription Drugs / Q000008:administration & dosage / Q000009:adverse effects*; D012042:Registries; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D055553:Prescription Drugs
keywords: case-only design; injury; multiple exposures; paired data; pharmacoepidemiology; road safety