The years roll by.
You know what’s not often controlled well in large database studies? Time. It only takes common sense to see how, for example, breast-conserving surgery outcomes appear to be improving over time when really it’s largely due to concurrent improvements in individualized therapies. Here’s an interesting analysis that uses temporal trend tests (say that 3 times fast) to assess outcomes in a real world cohort following open versus laparoscopic colectomy for stage I-III colon cancer. Indeed, just as seen in randomized trials, outcomes after laparoscopic surgery are non-inferior to an open approach, even when adjusting for time period. | Hou, JAMA Netw Open 2022