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arXiv 1111.1509stat.AP
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接受治疗时,主要因果效应估计的偏倚可能性取决于关键协变量

The potential for bias in principal causal effect estimation when treatment received depends on a key covariate

Corwin M. Zigler, Thomas R. Belin

摘要:

受潜在结局观点的启发,主要分层的想法因其在易受治疗后选择偏倚影响的环境中的相关性而得到广泛认可,例如随机临床试验,其中接受的治疗可能与分配的治疗不同。在这样的设置,我们解决微妙的因果关系的影响时,使用一个关键的协变量来预测成员在潜在的主要阶层的推断。我们发现,当接受的治疗可以不同于两个研究组中分配的治疗时,纳入分层预测协变量可以从具有不同协变量分布的两个治疗组中的观察结果中估计“符合者平均因果效应”(CACE)。采用贝叶斯的观点,并使用马尔可夫链蒙特卡罗计算,我们开发后验检查,其特征在于将预处理协变量的程度危及估计的CACE。我们应用该方法分析了一项临床试验,比较了两种治疗颌骨骨折的方法,其中研究方案允许外科医生根据他们的临床判断否决两种可能的随机治疗分配,并且数据包含一个关键协变量(损伤严重程度)预测接受的治疗。

英文摘要:

Motivated by a potential-outcomes perspective, the idea of principal stratification has been widely recognized for its relevance in settings susceptible to posttreatment selection bias such as randomized clinical trials where treatment received can differ from treatment assigned. In one such setting, we address subtleties involved in inference for causal effects when using a key covariate to predict membership in latent principal strata. We show that when treatment received can differ from treatment assigned in both study arms, incorporating a stratum-predictive covariate can make estimates of the "complier average causal effect" (CACE) derive from observations in the two treatment arms with different covariate distributions. Adopting a Bayesian perspective and using Markov chain Monte Carlo for computation, we develop posterior checks that characterize the extent to which incorporating the pretreatment covariate endangers estimation of the CACE. We apply the method to analyze a clinical trial comparing two treatments for jaw fractures in which the study protocol allowed surgeons to overrule both possible randomized treatment assignments based on their clinical judgment and the data contained a key covariate (injury severity) predictive of treatment received.

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