I use diagrams to illustrate the sources of potential selection bias in observational studies of comparative effectiveness.
I adapt these diagrams for three hypothetical scenarios that clarify the strengths and weaknesses of two prominent methods
used to account for potential selection bias: propensity scores and instrumental variables. After reviewing the fundamentals
of how to apply each method, including new developments that make implementation easier, I refer to some recent studies that
illustrate how choice of method can affect estimates. I conclude by emphasizing that many studies with apparently rich sources
of data are nevertheless unlikely to produce unbiased estimates and that conceptual modeling can help identify these problems
in advance.
Keywords Comparative effectiveness - Observational studies - Selection bias - Propensity scores - Instrumental variables