Potential Bias in Testing for Hyperprolactinemia and Pituitary Tumors in Risperidone-Treated Patients
Author Information
Author(s): Gianfrancesco Frank D, Pandina Gahan, Mahmoud Ramy, Wu Jasmanda, Wang Ruey H
Primary Institution: HECON Associates Inc.
Hypothesis
Is there a bias in the testing for hyperprolactinemia and pituitary tumors among patients treated with risperidone compared to other antipsychotics?
Conclusion
Risperidone-treated patients are more likely to undergo prolactin assessment and MRI/CT scans, which may lead to a higher identification of pituitary tumors.
Supporting Evidence
- Risperidone treatment was associated with a 34% higher likelihood of prolactin testing.
- Patients treated with risperidone had a higher frequency of diagnosed pituitary tumors.
- Prolactin testing was about twice as common in risperidone-treated patients compared to those on other antipsychotics.
- Patients with hyperprolactinemia treated with risperidone were 65% more likely to undergo MRI/CT scans.
Takeaway
Patients taking risperidone get tested for hormone levels and brain scans more often, which might make it seem like they have more tumors than they actually do.
Methodology
The study analyzed claims data from patients treated with various antipsychotics to compare the likelihood of prolactin testing and MRI/CT scans.
Potential Biases
Potential biases include increased testing for prolactin and imaging in risperidone-treated patients, leading to more diagnoses of hyperprolactinemia and pituitary tumors.
Limitations
The study lacked detailed patient-level clinical information, including prolactin values.
Participant Demographics
The majority of patients had mental disorder diagnoses, with a significant portion covered by Medicaid.
Statistical Information
P-Value
0.007
Confidence Interval
1.09 to 1.66
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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