News from us in @jama.com π
News from us in @jama.com π
Fantastic work by @pmadleydowd.bsky.social ! If you're into multiple imputation - look this way
Have you ever tried to implement multiple imputation with several incomplete variables? How do you know whether MI will be valid for your data? We have just published an easy to use algorithm using modifications to DAGs (now they're colourful) to aid decision making with MI
doi.org/10.1093/aje/...
Cheers π
Going for top read 2025 too
#episky #ispe #pharmacoepi
I provided some comments on the #paracetamol and #autism debacle in Nature:
www.nature.com/articles/d41...
#episky #sibsky
@danielberglind.bsky.social @pmadleydowd.bsky.social and more @ki.se @au.dk
For those of you using sibling analysis, perhaps you'll find this useful π₯³: www.medrxiv.org/content/10.1...
Thank you, Magda! ππ This will enable even more synergies between us!
Thanks mate ! Would not have been possible without your help and support!
Fantastic news! This is entirely attributable to all my colleaguesβeveryone from mentors to studentsβwho have made this possibleππ
news.ki.se/safer-medica...
Hey hey hey. All for the CV mate
Loool! Perhaps they are relying on scholar rather than their own publisher link? π
Doing multiple imputation? Do your auxiliary variables also have missing?! Check out this brilliant paper by Paul et al.
#episky
as would larger cohorts with deep phenotyping, ideally including genetics; I am deeply concerned about genetic confounding, considering the known genetic overlap between both psychiatric and epileptic indications and neurodevelopmental outcomes!
And yes, I definitely agree that there is likely residual confounding despite controlling for observed indications and SES. Better data on siblings would be incredibly useful, ...
Yes, they were independent of the original safety signals. Lamotrigine has been estimated to not be associated with malformations or neurodevelopmental outcomes in a series of cohorts.
Itβs all quite challenging. However, we believe weβve identified some consistent signals for valproate (expected), topiramate (verification of prior findings), and carbamazepine (novel). Whether these hold up under further causal scrutiny remains to be seen...!
We tried to adjust for many of these imbalances (inc bipolar indication), but the coverage & quality of the registry data have limitations. This is partly why sibling comparisons are valuable, assuming indications remain somewhat stable across pregnancies (this may not hold for episodic conditions).
However, itβs not ideal. As you noted, lamotrigine is also used for bipolar (and on/off-label elsewhere). Also, individuals with more 'severe indications' (e.g., generalized epilepsies) are often treated with e.g. topiramate, introducing differential indication severity even within antiseizure meds.
Re Lamotrigine: It is first-line treatment for epilepsy and is generally considered the safest option during pregnancy (not linked to malformations). Using it as a reference, rather than βno use,β has clear advantages β and this approach has been used in the teratology literature.
Thanks for the interest, @sebatlab.bsky.social ! Agree that the sibling analysis shows (much) attenuation. However, weβre cautious about overinterpreting the statistical null given our limited power. Still, we believe this highlights the value of such analyses and the promise as samples grow larger.
Great end-of-year news (yes, I'm braggingβbut I can't hold back my excitement over this team effort): Our paper on acetaminophen safety was one of the most popular in *JAMA* this year! jamanetwork.com/journals/jam...
#EpiSky
New research out on antiseizure medications in pregnancy ππ
Nature Communications: nature.com/articles/s41...
Thread follows π§΅ π§΅:
Should probably tagg #EpiSky - god I've missed epitwitter
@pmadleydowd.bsky.social @draipsych.bsky.social @karolinskainst.bsky.social @aarhusuni.bsky.social @neilmdavies.bsky.social @danielberglind.bsky.social .. and many more... π₯³ @natureportfolio.bsky.social