Efficacy evaluation of hypertensive drugs based on targeted maximum likelihood estimation

PAN Feng-ming; ZHAO Hong-yu; WU Xin-ying; FENG Yi-ping; HOU Qing-zhen; WANG Shu-kang; JI Xiao-kang; ZHANG Zhen-tang; WANG Qing; XUE Fu-zhong

doi:10.16462/j.cnki.zhjbkz.2021.06.003

Volume 25 Issue 6

Jul. 2021

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Article Navigation > CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION > 2021 > 25(6): 632-636,643

PAN Feng-ming, ZHAO Hong-yu, WU Xin-ying, FENG Yi-ping, HOU Qing-zhen, WANG Shu-kang, JI Xiao-kang, ZHANG Zhen-tang, WANG Qing, XUE Fu-zhong. Efficacy evaluation of hypertensive drugs based on targeted maximum likelihood estimation[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2021, 25(6): 632-636,643. doi: 10.16462/j.cnki.zhjbkz.2021.06.003

Citation:

PAN Feng-ming, ZHAO Hong-yu, WU Xin-ying, FENG Yi-ping, HOU Qing-zhen, WANG Shu-kang, JI Xiao-kang, ZHANG Zhen-tang, WANG Qing, XUE Fu-zhong. Efficacy evaluation of hypertensive drugs based on targeted maximum likelihood estimation[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2021, 25(6): 632-636,643. doi: 10.16462/j.cnki.zhjbkz.2021.06.003

Citation:

PAN Feng-ming, ZHAO Hong-yu, WU Xin-ying, FENG Yi-ping, HOU Qing-zhen, WANG Shu-kang, JI Xiao-kang, ZHANG Zhen-tang, WANG Qing, XUE Fu-zhong. Efficacy evaluation of hypertensive drugs based on targeted maximum likelihood estimation[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2021, 25(6): 632-636,643. doi: 10.16462/j.cnki.zhjbkz.2021.06.003

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Efficacy evaluation of hypertensive drugs based on targeted maximum likelihood estimation

doi: 10.16462/j.cnki.zhjbkz.2021.06.003

1.
Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Health and Medical Research Institute of Shandong University, Jinan 250012, China
2.
Department of Health Management, Center for Disease Control and Prevention of Qingdao West Coast New Area, Qingdao 266400, China

Funds:

National Key Research and Development Program of China 2020YFC2003500

The National Natural Science Foundation of China 81773547

Natural Science Foundation of Shandong Province ZR2019ZD02

More Information

Corresponding author: WANG Qing, E-mail: wangqing1984@126.com; XUE Fu-zhong, E-mail: xuefzh@sdu.edu.cn
Received Date: 2021-04-19
Rev Recd Date: 2021-05-17
Publish Date: 2021-06-10

Abstract

Abstract

Objective To facilitate precision medicine design and hypertension disease control by the usage of big data, the targeted maximum likelihood estimation (TMLE) model was implemented to evaluate the average treatment effect and individualized treatment effect of captopril or nitrendipine on hypertension control based on the project named "Comprehensive Prevention and Control Project of Hypertension and Diabetes for All Populations" in Jiaonan, Shandong Province. Methods We first selected hypertension patients taking captopril or nitrendipine in the cohort as a starting point. The outcomes of these patients were defined as whether their blood pressure was controlled at the first follow-up. Age, gender, occupation, BMI, smoke, drink and exercise were then included as confounders. After that, we applied targeted maximum likelihood estimation inset with Super Learner combination prediction algorithm to fluctuate the initial estimate of the conditional expectation of the outcome. Based on the initial estimate, the optimization model was built until the best balance of deviation and variance was reached in the model. Finally, the average treatment effect and individualized treatment effect were calculated based on the model. Results In the selected 13 676 hypertensive patients, nitrendipine was better for blood pressure control than captopril (OR=1.24, 95% CI: 1.13-1.35, P=0.004). In terms of individual net effect, 98.65% of patients had better blood pressure control with nitrendipine. Conclusion TMLE can be used to analyze the average treatment effect and individualized treatment effect, which provides proof of concept for the causal inference in the real world study.
- Causal inference,
- Real world study,
- Super Learner,
- Targeted maximum likelihood estimation,
- Captopril,
- Nitrendipine

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References(14)

References

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