Instrumental variable analysis using multiple databases: An example of antidepressant use and risk of hip/femur fracture

Background: Instrumental variable (IV) analysis can reduce bias due to unmeasured confounding, yet it has not been widely used in pharmacoepidemiologic studies. Objectives: To assess the performance of several IVs across multiple databases in a study of antidepressant use and risk of hip/femur fracture (HF). Methods: Information on adult patients with at least one prescription of a selective serotonin reuptake inhibitor (SSRI) or tricyclic antidepressant (TCA) during 2001-2009 was extracted from three European databases: THIN (UK, n = 570139), BIFAP (Spain, n = 250865), and Mondriaan (Netherla... Mehr ...