JoshuaJGagne3⃣The problem occurs only with truly persistent users -- i.e., those who will continue to be exposed until they die -- and not with long-term exposures as long as a steady-state of starting and stopping is reached. See box plot in 1⃣ for unbiased fixed 180-day exposure estimate.
JoshuaJGagne1⃣Bias is small but apparent when 10% of patients are persistent users (see figure: biased odds ratio = 1.11; true OR = 1.00). Bias is sizable (OR = 1.43) when 30% of patients are persistent users and it grows quickly from there. t.co/r0QXhXLvk0