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Abstract

Background: If participants recruited into randomized trials differ in terms of effect-modifiers when compared to some other population of interest, the average effect of treatment in the trial may not equal that in the other population. For example, the randomized trial TASTE recruited eligible patients with myocardial infarction in the SWEDEHEART registry and found no benefit of thrombus aspiration on 1-year mortality. However, individuals in the TASTE trial differed from other treatment eligible patients in the registry. Using the TASTE trial and SWEDEHEART registry data as an example, I will demonstrate the use of methods to estimate the effect of thrombus aspiration in the target population of treatment eligible individuals.

Methods: I will discuss the relevant target population for the taste trial and compare the use of two methods to transport the trial results to a target population: an outcome modelling method, and an inverse probability weighting based method. Both methods will be used to estimate the average treatment effect of the trial intervention in the target population. The relative strengths of each method will be discussed. Finally, I will discuss the implications of the results in the target population.

Discussion / Conclusion: Swedish register data uniquely allows identification of enrolled and non-enrolled populations eligible for the TASTE trial. Transporting the results from the trial to the entire eligible population will allow us to determine if the trial results were applicable to the target population

A part of the Tornblad/LUPOP seminar series on methodological issues in epidemiology and population research.