Supplementary Online Content Welk B, McArthur E, Ordon M, Anderson KK, Hayward J, et al. Association of suicidality and depression with 5α-reductase inhibitors [published online March 20, 2017]. JAMA Intern Med. doi:10.1001/jamainternmed.2017.0089 eTable 1. STROBE/RECORD checklist eTable 2a. Administrative data definitions used to define medical comorbidities eTable 2b. Specific drugs included within each medication class eTable 2c. Administrative data definitions used to define medical investigations and procedures eTable 4. Coding definition for primary and secondary outcomes eTable 5. Complete baselines for unmatched and matched cohorts eTable 6. 5ARI medication utilisation details among the exposed cohort. eTable 7. Significance of the potential effect modifiers of prior depression, and recent use of antidepressants on suicide between our matched cohorts of 5ARI users and non-users eTable 8. Risk of suicide, self-harm and depression among men exposed to 5ARI medications compared to matched unexposed men after excluding matched pairs with evidence of prostate cancer eTable 9. Risk of suicide, self-harm and depression among men exposed to 5ARI medications compared to matched unexposed men, with adjustment for the competing risk of non-suicide mortality eResults. Example of SAS code used for primary analysis, and resulting raw output from SAS model eFigure 2. Graph of Schoenfeld residuals for suicide, self-harm, and depression. eFigure 3. Kaplan meier graphs of self-harm and depression. This supplementary material has been provided by the authors to give readers additional information about their work. © 2017 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/26/2021 Supplemental Material eTable 1. STROBE/RECORD checklist ........................................................................................................ 2 eTable 2a. Administrative data definitions used to define medical comorbidities .................................. 6 eTable 2b. Specific drugs included within each medication class .......................................................... 10 eTable 2c. Administrative data definitions used to define medical investigations and procedures ...... 14 eTable 4. Coding definition for primary and secondary outcomes ........................................................ 17 eTable 5. Complete baselines for unmatched and matched cohorts ..................................................... 19 eTable 6. 5ARI medication utilisation details among the exposed cohort. ............................................ 24 eTable 7. Significance of the potential effect modifiers of prior depression, and recent use of antidepressants on suicide between our matched cohorts of 5ARI users and non-users. .................... 25 eTable 8. Risk of suicide, self-harm and depression among men exposed to 5ARI medications compared to matched unexposed men after excluding matched pairs with evidence of prostate cancer .................................................................................................................................................................. 26 eTable 9. Risk of suicide, self-harm and depression among men exposed to 5ARI medications compared to matched unexposed men, with adjustment for the competing risk of non-suicide mortality .................................................................................................................................................. 27 eResults. Example of SAS code used for primary analysis, and resulting raw output from SAS model. 28 eFigure 2. Graph of Schoenfeld residuals for suicide, self-harm, and depression ................................. 31 eFigure 3. Kaplan meier graphs of self-harm and depression ................................................................ 33 © 2017 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/26/2021 eTable 1. STROBE/RECORD checklist. Item STROBE items Location in RECORD items Location in No. manuscript manuscript where where items items are reported are reported Title and abstract 1 (a) Indicate the study’s Title, Abstract RECORD 1.1: The type of data Abstract (Design, design with a commonly (Design) used should be specified in the Setting). Note: due used term in the title or the title or abstract. When to numerous data abstract possible, the name of the sources they are databases used should be only fully listed in (b) Provide in the abstract an Abstract included. Methods (Data informative and balanced Sources) summary of what was done and what was found RECORD 1.2: If applicable, the Abstract (Setting) geographic region and timeframe within which the study took place should be reported in the title or abstract. RECORD 1.3: If linkage between Abstract (Design) databases was conducted for the study, this should be clearly stated in the title or abstract. Introduction Background rationale 2 Explain the scientific Introduction background and rationale for the investigation being reported Objectives 3 State specific objectives, Objective: including any prespecified Introduction hypotheses (last paragraph), Hypothesis: Methods (study outcomes) Methods Study Design 4 Present key elements of study Methods design early in the paper (design and setting) Setting 5 Describe the setting, Methods locations, and relevant dates, (design and including periods of setting, data recruitment, exposure, sources, patient follow-up, and data collection population) Participants 6 (a) Cohort study - Give the Methods RECORD 6.1: The methods of Methods (patient eligibility criteria, and the (patient study population selection population) sources and methods of population) (such as codes or algorithms selection of participants. used to identify subjects) Describe methods of follow- should be listed in detail. If up this is not possible, an explanation should be (b) Cohort study - For Methods provided. matched studies, give (patient matching criteria and number population), RECORD 6.2: Any validation Reference: Levy AR, of exposed and unexposed eFigure 1 studies of the codes or O'Brien BJ, Sellors C, algorithms used to select the et al. Coding population should be accuracy of referenced. If validation was administrative drug © 2017 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/26/2021 conducted for this study and claims in the Ontario not published elsewhere, Drug Benefit detailed methods and results database. Can J Clin should be provided. Pharmacol 2003;10:67–71. RECORD 6.3: If the study Methods (design and involved linkage of databases, setting). All consider use of a flow individuals were diagram or other graphical successfully linked in display to demonstrate the this study. data linkage process, including the number of individuals with linked data at each stage. Variables 7 Clearly define all outcomes, Methods RECORD 7.1: A complete list Covariates/ exposures, predictors, (patient of codes and algorithms used confounders: eTable potential confounders, and population, to classify exposures, 2 effect modifiers. Give study outcomes) outcomes, confounders, and diagnostic criteria, if effect modifiers should be Outcomes/effect applicable. provided. If these cannot be modifiers: eTable 4 reported, an explanation should be provided. Data sources/ 8 For each variable of interest, Covariates/ measurement give sources of data and confounders: details of methods of eTable 2, assessment (measurement). Describe comparability of Outcomes/ assessment methods if there effect modifiers: is more than one group eTable 4 Bias 9 Describe any efforts to Methods address potential sources of (patient bias population) Study size 10 Explain how the study size NA was arrived at Quantitative variables 11 Explain how quantitative Methods variables were handled in the (patient analyses. If applicable, population) describe which groupings were chosen, and why Statistical methods 12 (a) Describe all statistical Methods methods, including those (statistical used to control for analysis) confounding (b) Describe any methods Methods used to examine subgroups (statistical and interactions analysis) (c) Explain how missing data Methods (data were addressed sources) (d) Cohort study - If Methods applicable, explain how loss (statistical to follow-up was addressed analysis) (e) Describe any sensitivity Methods analyses (statistical analysis) Data access and RECORD 12.1: Authors should Acknowledgements: cleaning methods describe the extent to which Contributors © 2017 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/26/2021 the investigators had access to the database population used to create the study population. RECORD 12.2: Authors should eFigure 1 provide information on the data cleaning methods used in the study. Linkage RECORD 12.3: State whether Methods (design and the study included person- setting) level, institutional-level, or other data linkage across two or more databases. The methods of linkage and methods of linkage quality evaluation should be provided. Results Participants 13 (a) Report the numbers of eFigure 1 RECORD 13.1: Describe in eFigure 1 individuals at each stage of detail the selection of the the study (e.g., numbers persons included in the study potentially eligible, examined (i.e., study population for eligibility, confirmed selection) including filtering eligible, included in the study, based on data quality, data completing follow-up, and availability