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There are other forms of bias in these datasets including channeling (e.g., the prescribing pattern depends on a patient characteristic (particularly diabetes or obesity) that is a PDAC risk factor), detection (e.g., overreporting due to additional testing to rule out a suspected adverse event (e.g., imaging triggered by pancreas enzyme elevations)), and Weber effect (initial increase in event reporting shortly after drug launch) 49

Sometimes, the most powerful tools are right in front of us, and conventional practice just hasnt caught up