Assessing the bias due to non-coverage of residential movers in the German microcensus panel: an evaluation using data from the socio-economic panel

The German Microcensus (MC) is a large scale rotating panel survey over three years. The MC is attractive for longitudinal analysis over the entire participation duration because of the mandatory participation and the very high case numbers (about 200 thousand respondents). However, as a consequence of the area sampling that is used for the MC , residential mobility is not covered and consequently statistical information at the new residence is lacking in theMCsample. This raises the question whether longitudinal analyses, like transitions between labour market states, are biased and how different methods perform that promise to reduce such a bias. Based on data of the German Socio-Economic Panel (SOEP), which covers residential mobility, we analysed the effects of missing data of residential movers by the estimation of labour force flows. By comparing the results from the complete SOEP sample and the results from the SOEP, restricted to the non-movers, we concluded that the non-coverage of the residential movers can not be ignored in Rubins sense. With respect to correction methods we analysed weighting by inverse mobility scores and loglinear models for partially observed contingency tables. Our results indicate that weighting by inverse mobility scores reduces the bias to about 60 percent whereas the official longitudinal weights obtained by calibration result in a bias reduction of about 80 percent. The estimation of loglinear models for nonignorable nonresponse leads to very unstable results. --Panel survey,labour market analysis,residential mobility,non-coverage bias,log-linear modelling,inverse probability weighting

an evaluation using data from the socio-economic panel

The German Microcensus (MC) is a large scale rotating panel survey over three years. The MC is attractive for longitudinal analysis over the entire participation duration because of the mandatory participation and the very high case numbers (about 200 thousand respondents). However, as a consequence of the area sampling that is used for the MC , residential mobility is not covered and consequently statistical information at the new residence is lacking in theMCsample. This raises the question whether longitudinal analyses, like transitions between labour market states, are biased and how different methods perform that promise to reduce such a bias. Based on data of the German Socio-Economic Panel (SOEP), which covers residential mobility, we analysed the effects of missing data of residential movers by the estimation of labour force flows. By comparing the results from the complete SOEP sample and the results from the SOEP, restricted to the non-movers, we concluded that the non-coverage of the residential movers can not be ignored in Rubin’s sense. With respect to correction methods we analysed weighting by inverse mobility scores and loglinear models for partially observed contingency tables. Our results indicate that weighting by inverse mobility scores reduces the bias to about 60 percent whereas the official longitudinal weights obtained by calibration result in a bias reduction of about 80 percent. The estimation of loglinear models for nonignorable nonresponse leads to very unstable results

Assessing the bias due to non-coverage of residential movers in the German microcensus panel: an evaluation using data from the socio-economic panel

The German Microcensus (MC) is a large scale rotating panel survey over three years. The MC is attractive for longitudinal analysis over the entire participation duration because of the mandatory participation and the very high case numbers (about 200 thousand respondents). However, as a consequence of the area sampling that is used for the MC , residential mobility is not covered and consequently statistical information at the new residence is lacking in theMCsample. This raises the question whether longitudinal analyses, like transitions between labour market states, are biased and how different methods perform that promise to reduce such a bias. Based on data of the German Socio-Economic Panel (SOEP), which covers residential mobility, we analysed the effects of missing data of residential movers by the estimation of labour force flows. By comparing the results from the complete SOEP sample and the results from the SOEP, restricted to the non-movers, we concluded that the non-coverage of the residential movers can not be ignored in Rubin's sense. With respect to correction methods we analysed weighting by inverse mobility scores and loglinear models for partially observed contingency tables. Our results indicate that weighting by inverse mobility scores reduces the bias to about 60 percent whereas the official longitudinal weights obtained by calibration result in a bias reduction of about 80 percent. The estimation of loglinear models for nonignorable nonresponse leads to very unstable results

The German Microcensus as a Tool for Longitudinal Data Analysis: An Evaluation Using SOEP Data

The German Microcensus is a rotating panel, where the units stay in the survey for four observations. Because of the very large sample size and the mandatory participation it appears to be a valuable data base for short duration analysis. However, the German Microcensus (MC) uses area sampling where participants are not followed if they leave the area. Consequently there is no information on participants after they move. We investigate how the use of the German Socio-Economic Panel (SOEP) can help to measure the non-coverage bias of the MC. Our methodology is evaluated for labour force flows. The results indicate that the SOEP is a valuable instrument for assessing the non-coverage bias in the MC. For labour force flows the non-coverage bias of the MC appears to be only of moderate size

Changes in Oral Anticoagulation Therapy over One Year in 51,000 Atrial Fibrillation Patients at Risk for Stroke: A Practice-Derived Study

Background This study assessed changes in anticoagulation therapy over time in patients with atrial fibrillation (AF). Methods Analyses were performed on a claims-based dataset of 4 million health-insured individuals. The study population consisted of patients newly initiating a non-vitamin-K oral anticoagulants (NOACs) or vitamin K antagonist (VKA) for AF between 2013 and 2016. The study outcomes consisted of the proportion of patients who had (1) discontinued OAC treatment, (2) switched from VKA to NOAC, (3) switched from NOAC to VKA or (4) switched from one NOAC to another. Predictors of discontinuation or switching of OAC treatment were determined by Cox proportional hazards regression models with time-independent and time-dependent covariates. Results The study population comprised 51,606 AF patients initiating VKA (n = 21,468, 41.6%), apixaban (n = 8,832, 17.1%), dabigatran (n = 3,973, 7.7%) or rivaroxaban (n = 17,333, 33.6%). After 1 year, 29.9% of VKA and 29.5% of NOAC patients had discontinued OAC treatment without switching to another anticoagulant. A total of 10.7% of VKA patients switched to NOACs within 1 year, whereas 4.9% NOAC patients had switched to VKA. Of AF patients who were initiated on a NOAC, 5.2% switched to another NOAC. Treatment changes among NOAC starters were strongly associated with occurrence of stroke, myocardial infarction and gastrointestinal bleeding after treatment initiation. For VKA starters switching to a NOAC, stroke and bleeding events were associated with an increased likelihood of switching. Conclusion Overall discontinuation rates of VKA and NOACs are comparable over the first year of therapy, while switching from VKA to NOAC was more common than from NOAC to VKA. The majority of treatment changes were associated with clinical events.</jats:p

Effectiveness and Safety of Non-Vitamin K Oral Anticoagulants in Comparison to Phenprocoumon: Data from 61,000 Patients with Atrial Fibrillation

All pivotal trials have evaluated non-vitamin K oral antagonists (NOACs) against warfarin. However, in some regions of the world, phenprocoumon is the most widely used vitamin K antagonist (VKA). There is little evidence documenting effectiveness and safety of NOACs compared with phenprocoumon in atrial fibrillation (AF). Aretrospective cohort study using a German claims database was conducted to assess effectiveness (stroke, systemic embolism [SE]) and safety (bleeding leading to hospitalization) during therapy with NOACs and phenprocoumon in 61,205 AF patients. Hazard ratios (HRs) for effectiveness and safety outcomes were derived from Cox proportional hazard models, adjusting for baseline characteristics. Propensity score matching was performed as a sensitivity analysis. As a prespecified subgroup analysis, the effects of reduced NOAC dosing were compared with phenprocoumon. A total of 61,205 patients were identified in whom phenprocoumon (n = 23,823, 38.9%), apixaban (n = 10,117, 16.5%), dabigatran (n = 5,122, 8.4%), or rivaroxaban (n = 22,143, 36.2%) was initiated. After adjusting for baseline confounders, all three NOACs tested had significantly lower risks of stroke/SE compared with phenprocoumon (apixaban-HR: 0.77, 95% CI: 0.66-0.90; dabigatran-HR: 0.74, 95% CI: 0.60-0.91; rivaroxaban-HR: 0.86, 95% CI: 0.76-0.97). Apixaban (HR: 0.58, 95% CI: 0.49-0.69) and dabigatran (HR: 0.64, 95% CI: 0.50-0.80) were associated with lower bleeding risks than phenprocoumon, whereas the risk was similar for rivaroxaban and phenprocoumon. All threeNOACs showed reduced riskof intracranial bleeding compared with phenprocoumon. Reduced doses of NOACs were predominantly used in patients with advanced age and comorbidities with generally similar effectiveness and safety benefits compared with phenprocumon as standard-dose NOACs

Budget impact analysis of the use of oral and intravenous therapy regimens for the treatment of relapsed or refractory multiple myeloma in Germany

Abstract Background In Germany, several triplet therapies for treating relapsed or refractory multiple myeloma (rrMM) patients have recently been approved. While most of them are administered intravenously, ixazomib-based combination is the only orally bioavailable regimen. Objective To conduct a 1-year and 3-year budget impact analysis (BIA) of different novel triplets to treat patients with rrMM in second or subsequent therapy lines accounting for costs covered by German statutory health insurance (SHI). Methods A 3-state partitioned survival model (PSM) was developed to evaluate the budget impact of the following regimens: carfilzomib plus lenalidomide plus dexamethasone (KRd), elotuzumab plus lenalidomide plus dexamethasone (ERd), daratumumab plus lenalidomide plus dexamethasone (DRd), and ixazomib plus lenalidomide plus dexamethasone (IRd). The analysis included direct medical costs such as drug acquisition, comedication and preparation for parenteral solutions, drug administration and other 1-time costs, adverse event management costs and direct non-medical costs, such as transportation costs. Results Based on current drug market shares in German healthcare market, the estimated costs after 1 year of treatment was €551 million (KRd), €163 million (ERd), €584 million (DRd), and €95 million (IRd). The total budget impact of €1393 million is mainly driven by drug acquisition and subsequent therapy costs. Conclusion Among the regimens of interest, the oral-based therapy regimens offered cost advantages over intravenous-based therapy regimens. The higher overall costs of intravenous therapy regimens were attributed primarily to higher drug acquisition costs. </jats:sec