title: Assessment of patient-specific surgery effect based on weighted estimation and propensity scoring in the re-analysis of the sciatica trial.
abstract: We consider a re-analysis of the wait-and-see (control) arm of a recent clinical trial on sciatica. While the original randomised trial was designed to evaluate the public policy effect of a conservative wait-and-see approach versus early surgery, we investigate the impact of surgery at the individual patient level in a re-analysis of the wait-and-see group data. Both marginal structural model re-weighted estimates as well as propensity score adjusted analyses are presented. Results indicate that patients with high propensity to receive surgery may have beneficial effects at 2 years from delayed disc surgery.
authors.affiliation: Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Bart J A
authors.initials: BJ
authors.lastname: Mertens
authors.affiliation: Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Wilco C H
authors.initials: WC
authors.lastname: Jacobs
authors.affiliation: Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Ronald
authors.initials: R
authors.lastname: Brand
authors.affiliation: Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands; Medisch Centrum Haaglanden, The Hague, The Netherlands.
authors.forename: Wilco C
authors.initials: WC
authors.lastname: Peul
mesh_terms: D000328:Adult; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D066230:Patient-Specific Modeling; D057216:Propensity Score; D012585:Sciatica / Q000175:diagnosis / Q000601:surgery*