Primary Submission Category: Applications in Health and Biology
Causal Impact of Visit Frequency and Type on Lung Function in Cystic Fibrosis Patients: A Target Trial Emulation Approach
Authors: Alexandra Hinton, Louisa Smith, Jonathan Zuckerman, Edmund Sears,
Presenting Author: Alexandra Hinton*
Background: The Cystic Fibrosis Foundation’s recommendation of at least four annual clinic visits is now two decades old. Since it was issued, life expectancy for pwCF has increased by 28 years as a result of treatment advances. The optimal frequency of clinic visits for CF patients needs reevaluation.
Methods: The study aims to estimate the causal effect of different clinic visit frequencies and types on lung function in stable adult CF patients. Using data from the Cystic Fibrosis Foundation Patient Registry (2022-2023: ~20,000 patients), the study will emulate randomization of patients to 12 treatment strategies, combining three care types (in-person, telehealth, hybrid) and four visit frequencies (quarterly, triennial, biannual, annual; subject to positivity constraints).
Planned Analysis: We will use doubly robust methods to estimate the effect of visit patterns on lung function. Sensitivity analyses will be conducted to address potential biases from missing data, missed visits, and unmeasured confounding.
Expected Results: This study will provide evidence on the causal impact of different clinic visit frequencies on lung function in stable adult CF patients. Results are pending and will be available for presentation at the conference.
Conclusions: Findings from this study may inform updates to clinical guidelines for CF care, potentially optimizing resource utilization while maintaining or improving patient outcomes.