1. Indication bias - high LDL predicts less liver disease?
    George Henderson George Henderson New Zealand says:
    May 9, 2017 at 11:09 PM

    The authors do not appear to have controlled for indication bias.
    Indication bias occurs when the condition for which the patients were treated is related to the outcome of interest.
    Statins are normally prescribed on the basis of elevated (i.e. above a defined "target") LDL cholesterol counts, not cirrhosis per se.
    It is necessary to control for the LDL level at the time of prescribing statins to affirm that the benefits observed may be directly due to statins, because it is likely that this indication for prescribing statins predicts a significantly improved prognosis in liver disease even without the statin, one which may have been either abrogated by or enhanced by the statin. While we note that patients on statins prior to a diagnosis of cirrhosis were excluded from this study, the criteria for prescribing statins were not described; as many patients with cirrhosis were not prescribed statins, we cannot preclude the LDL cholesterol level being one of the criteria.

    See:
    pubpeer.com/.../B71A13C753A388308F480FCD864ED0

    Reply
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