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Nicole A. Silva, Belinda Shao, Michael J. Sylvester, Jean Anderson Eloy and Chirag D. Gandhi

these authors’ use of instrumental variable analysis adequately adjusts for the inherent selection bias that otherwise renders the 2 groups incomparable. 32 Our study avoids comparison across differential cohorts by comparing elderly patients to nonelderly patients within each intervention cohort, extracting valuable data on health care outcomes and hospital charges. Limitations of the Study As an NIS database analysis, this study has several important limitations. Coding inaccuracies are inevitable. The NIS does not include useful variables important to the natural