Most causal inference methods consider counterfactual variables under interventions that set the treatment deterministically. With continuous or multi-valued treatments or exposures, such counterfactuals may be of little practical interest because no feasible intervention can be implemented that would bring them about. Furthermore, violations to the positivity assumption, necessary for identification, are exacerbated with continuous and multi-valued treatments and deterministic interventions. In this paper we propose longitudinal modified treatment policies (LMTPs) as a non-parametric alternative. LMTPs can be designed to guarantee positivity, and yield effects of immediate practical relevance with an interpretation that is familiar to regular users of linear regression adjustment. We study the identification of the LMTP parameter, study properties of the statistical estimand such as the efficient influence function, and propose four different estimators. Two of our estimators are efficient, and one is sequentially doubly robust in the sense that it is consistent if, for each time point, either an outcome regression or a treatment mechanism is consistently estimated. We perform a simulation study to illustrate the properties of the estimators, and present the results of our motivating study on hypoxemia and mortality in Intensive Care Unit (ICU) patients. Software implementing our methods is provided in the form of the open source \texttt{R} package \texttt{lmtp} freely available on GitHub (\url{https://github.com/nt-williams/lmtp}).
Many causal models of interest in epidemiology involve longitudinal exposures, confounders and mediators. However, repeated measurements are not always available or used in practice, leading analysts to overlook the time-varying nature of exposures and work under over-simplified causal models. Our objective is to assess whether - and how - causal effects identified under such misspecified causal models relates to true causal effects of interest. We derive sufficient conditions ensuring that the quantities estimated in practice under over-simplified causal models can be expressed as weighted av…
Analyses of biomedical studies often necessitate modeling longitudinal causal effects. The current focus on personalized medicine and effect heterogeneity makes this task even more challenging. Towards this end, structural nested mean models (SNMMs) are fundamental tools for studying heterogeneous treatment effects in longitudinal studies. However, when outcomes are binary, current methods for estimating multiplicative and additive SNMM parameters suffer from variation dependence between the causal parameters and the non-causal nuisance parameters. This leads to a series of difficulties in int…
In this paper we propose a new template for empirical studies intended to assess causal effects: the outcome-wide longitudinal design. The approach is an extension of what is often done to assess the causal effects of a treatment or exposure using confounding control, but now, over numerous outcomes. We discuss the temporal and confounding control principles for such outcome-wide studies, metrics to evaluate robustness or sensitivity to potential unmeasured confounding for each outcome, and approaches to handle multiple testing. We argue that the outcome-wide longitudinal design has numerous a…
Pollutant emissions from coal-burning power plants have been deemed to adversely impact ambient air quality and public health conditions. Despite the noticeable reduction in emissions and the improvement of air quality since the Clean Air Act (CAA) became the law, the public-health benefits from changes in emissions have not been widely evaluated yet. In terms of the chain of accountability (HEI Accountability Working Group, 2003), the link between pollutant emissions from the power plants (SO2) and public health conditions (respiratory diseases) accounting for changes in ambient air quality (…
In animal behavior studies, a common goal is to investigate the causal pathways between an exposure and outcome, and a mediator that lies in between. Causal mediation analysis provides a principled approach for such studies. Although many applications involve longitudinal data, the existing causal mediation models are not directly applicable to settings where the mediators are measured on irregular time grids. In this paper, we propose a causal mediation model that accommodates longitudinal mediators on arbitrary time grids and survival outcomes simultaneously. We take a functional data analys…
Dynamic prediction of causal effects under different treatment regimes conditional on an individual's characteristics and longitudinal history is an essential problem in precision medicine. This is challenging in practice because outcomes and treatment assignment mechanisms are unknown in observational studies, an individual's treatment efficacy is a counterfactual, and the existence of selection bias is often unavoidable. We propose a Bayesian framework for identifying subgroup counterfactual benefits of dynamic treatment regimes by adapting Bayesian g-computation algorithm (J. Robins, 1986; …
A Bayesian semi-parametric approach to causal mediation for longitudinal mediators and time-to-event outcomes with application to a cardiovascular disease cohort study
Longitudinal observational patient data can be used to investigate the causal effects of time-varying treatments on time-to-event outcomes. Several methods have been developed for controlling for the time-dependent confounding that typically occurs. The most commonly used is inverse probability weighted estimation of marginal structural models (MSM-IPTW). An alternative, the sequential trials approach, is increasingly popular, in particular in combination with the target trial emulation framework. This approach involves creating a sequence of `trials' from new time origins, restricting to indi…
The use of observational time series data to assess the impact of multi-time point interventions is becoming increasingly common as more health and activity data are collected and digitized via wearables, social media, and electronic health records. Such time series may involve hundreds or thousands of irregularly sampled observations. One common analysis approach is to simplify such time series by first discretizing them into sequences before applying a discrete-time estimation method that adjusts for time-dependent confounding. In certain settings, this discretization results in sequences wi…
University of Virginia（弗吉尼亚大学）；Global Infectious Disease Institute, University of Virginia（弗吉尼亚大学全球传染病研究所）
To mitigate the spread of COVID-19 pandemic, decision-makers and public authorities have announced various non-pharmaceutical policies. Analyzing the causal impact of these policies in reducing the spread of COVID-19 is important for future policy-making. The main challenge here is the existence of unobserved confounders (e.g., vigilance of residents). Besides, as the confounders may be time-varying during COVID-19 (e.g., vigilance of residents changes in the course of the pandemic), it is even more difficult to capture them. In this paper, we study the problem of assessing the causal effects …
Single-subject health data are becoming increasingly available thanks to advances in self-tracking technology (e.g., wearable devices, mobile apps, sensors, implants). Many users and health caregivers seek to use such observational time series data to recommend changing health practices in order to achieve desired health outcomes. However, there are few available causal inference approaches that are flexible enough to analyze such idiographic data. We develop a recently introduced causal-analysis framework based on n-of-1 randomized trials, and implement a flexible random-forests g-formula app…
Participant noncompliance, in which participants do not follow their assigned treatment protocol, often obscures the causal relationship between treatment and treatment effect in randomized trials. In the longitudinal setting, the G-computation algorithm can adjust for confounding to estimate causal effects. Typically, G-computation assumes that both 1) compliance is observed; and 2) the densities of the confounders can be correctly specified. We aim to develop a G-computation estimator in the setting where both assumptions are violated. For 1), in place of unobserved compliance, we substitute…
Most work in causal inference considers deterministic interventions that set each unit's treatment to some fixed value. However, under positivity violations these interventions can lead to non-identification, inefficiency, and effects with little practical relevance. Further, corresponding effects in longitudinal studies are highly sensitive to the curse of dimensionality, resulting in widespread use of unrealistic parametric models. We propose a novel solution to these problems: incremental interventions that shift propensity score values rather than set treatments to fixed values. Incrementa…
Causal effects may vary among individuals and can even be of opposite signs. When significant effect heterogeneity exists, the population average causal effect might be uninformative for an individual. Due to the fundamental problem of causality, individual causal effects (ICEs) cannot be retrieved from cross-sectional data. However, in crossover studies, it is accepted that ICEs can be estimated under the assumptions of no carryover effects and time invariance of potential outcomes. A generic potential-outcome formulation with appropriate statistical assumptions to identify ICEs is lacking fo…
Causal mediation analysis for zero-inflated longitudinal data in the presence of treatment non-compliance and multiple mediators
University of Chicago（芝加哥大学）；Smeal College of Business, The Pennsylvania State University（宾夕法尼亚州立大学斯米尔商学院）；University of Florida（佛罗里达大学）；University of Wisconsin–Madison（威斯康星大学麦迪逊分校）
A sensitivity analysis approach to principal stratification with a continuous longitudinal intermediate outcome: Applications to a cohort stepped wedge trial
University of Florida（佛罗里达大学）；Yale School of Public Health（耶鲁公共卫生学院）
A new class of Marginal Structural Models (MSMs), History-Restricted MSMs (HRMSMs), was recently introduced for longitudinal data for the purpose of defining causal parameters which may often be better suited for public health research or at least more practicable than MSMs \citejoffe,feldman. HRMSMs allow investigators to analyze the causal effect of a treatment on an outcome based on a fixed, shorter and user-specified history of exposure compared to MSMs. By default, the latter represent the treatment causal effect of interest based on a treatment history defined by the treatments assigned …
A standard assumption for causal inference about the joint effects of time-varying treatment is that one has measured sufficient covariates to ensure that within covariate strata, subjects are exchangeable across observed treatment values, also known as "sequential randomization assumption (SRA)". SRA is often criticized as it requires one to accurately measure all confounders. Realistically, measured covariates can rarely capture all confounders with certainty. Often covariate measurements are at best proxies of confounders, thus invalidating inferences under SRA. In this paper, we extend the…
Observational longitudinal data on treatments and covariates are increasingly used to investigate treatment effects, but are often subject to time-dependent confounding. Marginal structural models (MSMs), estimated using inverse probability of treatment weighting or the g-formula, are popular for handling this problem. With increasing development of advanced causal inference methods, it is important to be able to assess their performance in different scenarios to guide their application. Simulation studies are a key tool for this, but their use to evaluate causal inference methods has been lim…
Operationalizing Longitudinal Causal Discovery Under Real-World Workflow Constraints
Kyoto University Graduate School of Medicine（京都大学医学研究科）；SANKEN The University of Osaka（SANKEN 大阪大学）；Faculty of Data Science Shiga University（Shiga大学数据科学学部）；AIP RIKEN；Faculty of Medicine, University of Miyazaki（Miyazaki大学医学部）；Hiroshima University Graduate School of Biomedical and Health Sciences（广岛大学生物医学和健康科学研究生院）
Causal mediation analysis seeks to investigate how the treatment effect of an exposure on outcomes is mediated through intermediate variables. Although many applications involve longitudinal data, the existing methods are not directly applicable to settings where the mediator and outcome are measured on sparse and irregular time grids. We extend the existing causal mediation framework from a functional data analysis perspective, viewing the sparse and irregular longitudinal data as realizations of underlying smooth stochastic processes. We define causal estimands of direct and indirect effects…
Environmental Justice Implications of Power Plant Emissions Control Policies: Heterogeneous Causal Effect Estimation under Bipartite Network Interference
Correcting for confounding in longitudinal experiments: positioning non-linear mixed effects modeling as implementation of standardization using latent conditional exchangeability
