No clients have been involved in location the study query or the outcome steps, nor were they linked to creating strategies for style and design or implementation from the study.
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Our study experienced some limits. First of all, our study won't have captured all NSAID publicity, because Some drugs (eg, ibuprofen) are out there around the counter in the many four nations around the world. Consequently, people categorized as non-current consumers of NSAIDs in this study could possibly actually have been present users of in excess of the counter NSAIDs.
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Anonymised facts were being extracted regionally and processed with Jerboa application (formulated by Erasmus MC), furnishing particular person degree datasets in a common information structure.
Strengths of our study include things like the huge geographic distribution with the nurses plus the nesting in just a perfectly-defined cohort, which minimizes the probability of collection bias. Moreover, the specificity of our findings for the pregnancy time period locations important restrictions on achievable residual confounding. Precisely, any element that isn't differentially connected with PM in the course of pregnancy compared to before or immediately after pregnancy is incredibly not likely to confound our final results. So, for example, Even though inhabitants density, a option to consider folate dietary supplements during pregnancy, or a host of other possible confounders (Gray et al. 2013; Kalkbrenner et al. 2012) could possibly be linked to PM2.five publicity, they would be anticipated to get Similarly connected with PM2.five publicity just before or right after pregnancy as in the course of it.
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Relative hazard estimates for individual NSAIDs among sufferers with prior outpatient or secondary healthcare facility diagnoses of heart failure (which is, Those people by using a contraindication for NSAID use who also should be much more susceptible for acute scientific manifestations of heart failure) did not seem to vary considerably from Those people attained in the overall analysis. Taken collectively, these outcomes offer some defense to our results. Even so, we cannot exclude that residual variances in affected person's baseline traits could account for many of the observed variants in relative threat estimates associated with different specific NSAIDs.
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