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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

These mechanisms involve key signaling pathways that determine not only cellular behavior but also the ability of the liver to rebuild

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